Grade 4 cartilage injury options at 46y
Posted: Mon Apr 14, 2025 8:48 pm
I’m 5 months out from a significant knee injury and looking for input from anyone who’s had the same injury. For context, I (was) a flight nurse and injured my right knee while climbing out of the helicopter last May. I was found to have sustained an MPFL tear which caused a patella dislocation, and grade 4 cartilage tears to the patella cartilage as well as the medial femoral condyle. This being workers comp, I jumped through their hoops and did PT and an injection, followed by a scope at the end of july. The scope showed how severe the cartilage injuries actually are. There is a traumatic tear and 1cm of exposed bone at both injury sites. He also said there is grade 2-3 damage surrounding both areas, making me not a candidate for a MACI procedure. He said my only option is a total knee replacement. I have been in increasing pain since the scope and cannot walk more than 10 yards without significant pain. I have swelling daily. I’m currently awaiting workers comp to approve a referral to another orthopedic surgeon, one who specializes in knee replacements. I live in a very rural area and thus, my question is this: has anyone else had this injury and had any other treatment that worked? Or has anyone my age or younger had the replacement? The surgeon who did the scope made it sound like getting a total knee replacement at my age was a bad idea due to the likelihood of needing multiple revisions. I’m a healthy weight and was pretty active prior to my injury. I am certainly feeling a whole gamut of emotions from the constant pain and not working, nor being able to be the active mom I was before I got hurt. Is it worth driving a couple hours to a larger hospital for a second opinion? Or is the total knee my best option?