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Dr Brims
Dr Brims, U.S. Licensed Physician
Category: Medical
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Experience:  MD
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How do you best treat a small subchondral fracture involving

Resolved Question:

How do you best treat a small subchondral fracture involving the medial rim of the medial femoral condyle with extensive associated marrow edema. How long should this take to heal. When it is healed may I return to full activiity?
Submitted: 4 years ago.
Category: Medical
Expert:  Dr Brims replied 4 years ago.
Hello,
How large is this fracture?
Customer: replied 4 years ago.
Based on an MRI at the Mass Geberal Hospital it is a small subchondral fracture involving the medial rim of the medial femoral condyle with extensive associated marrow edema. There is attenuatioon of the adjacent medial patellar retinaculum with possible perforation and surroundingg soft tissue edema
Expert:  Dr Brims replied 4 years ago.
Was it detected on an xray?
Customer: replied 4 years ago.
no
Expert:  Dr Brims replied 4 years ago.
I see, based on what you nhave told me it is a very small fracture.This means that you may return to full activity immediately without restrictions,because the fracture is not in the weight bearing portion of the bone.It will likley take about 8 weeks to heal, but this should not affect you activity

Let me know if you have more questions or concerns
Customer: replied 4 years ago.

The injury occurred 9 weekd ago while on a stationary weight machine doing leg curls to build hamstring strength at a machine and weight I had been using for 5 months. There is still some pain on weight bearing and Dr. Bert Zarins at MGH(who examined me twice and read the x-rays and MRI) said to avoid any activity which causes pain. He recommmeded biking and swimming if they do not cause pain and thought I could do Physical Therapy to build strength in muscles above knee as long as that did not cause pain.

 

Would this information modify your answer.

Expert:  Dr Brims replied 4 years ago.
No , what the doctor has recommended is weight bearing as tolerated, which is precisely what I have recommended.If something is causing pain, you may desist from doing it, but it will not affect your bone healing as well as the fracture, because the fracture is not in a weight bearing portion of your bone, so there is little you can do to stop it from healing.So, I would not modify my answer.The MRI also suggests you may have some patellar tendonitis,which may also cause pain.That is also why he told you to avoid painful activities, but it has little to do wthe fracture based on the facts you given me

Let me know if you have more questions or concerns
Customer: replied 4 years ago.

How soon after pain stops may I start playing golf? Unless you think I may play with the pain.

 

 

I am afraid the the twisting of my knee to swing the club might may the fracture worse or the pain worse.

 

Thanks-

Expert:  Dr Brims replied 4 years ago.
Hello,
You may start playing golf as soon a the pain stops, and if you experience pain, wait about a week and try again.You can"t do very much to make the fracture worse.Most of the pain will likely come from your patella tendon.So if you experience pain,stop and wait about a week before you try again, to give the inflammation a chance to go down

Let me know if you have more questions or concerns
Dr Brims, U.S. Licensed Physician
Category: Medical
Satisfied Customers: 9206
Experience: MD
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