Knee: marginal osteophytes and joint space narrowing
 

I'm 57. In 2003, I had arthroscopic surgery on my left knee which revealed that a quarter-size piece of articular cartilage had come off of my femur near the medial side. They cleaned out the loose bits and scraped the bone to induce a scar cartilage. That seems to work very well with my only occasional symptoms being some discomfort in that part of the knee if I did too much incline.

In April of this year, I did a strenuous hike in the Shenandoah National Park which made my knee very angry. I had a lot of discomfort when sitting, driving, and sleeping. I kept wishing the pain to go away. It did not affect my biking so I've continued to rack up a lot of miles. I hiked over Memorial Day weekend and just took it easy and that didn't make things worse (yay!). By June I was feeling better but still having issues especially when trying to sleep of getting my knee in just the right position so it didn't hurt.

I finally saw my doctor yesterday and she ordered an x-ray. Report was "Left medial compartment and patella compartment moderate arthropathy with marginal osteophytes and joint space narrowing". Translation - there is arthritis present. She has ordered 8 sessions of PT which will start at the end of this month.

Obviously I'm going to keep up my cycling as well as my hiking. I haven't run since this problem started and I'm figuring my running days are over as I don't want to make things worse.

Any thoughts on how to stop the progression of the joint space narrowing? Obviously I will be asking the PT but thought I'd see what all of you had to say. I've been strength training regularly for the past 2 years.

ETA: I was morbidly obese for many years of my adult life. I finally got back to a normal weight in 2002 then regained about 40 pounds during my graduate coursework and my father's long illness and death. I got back to a normal weight in 2012 and have stayed stable ever since. But surely the years of carrying an extra 130 pounds put a lot of stress on my joints. I was the fat kid back when kids were of normal weight.

The only stuff I know about this is from riding with people with arthritic knees. They don't run anymore or hike. They ride at high cadence only, climbing at ~90, over 100 on the flat. Yes, they're mostly slower doing that, but they can still ride. I'm talking about people still riding in their 60's, mostly broken runners, and they are thin, BMI's down in the low 20's if not the upper teens. I just did a 115 mile climbing ride with a woman in her mid-60s. She just got back from a bike tour in France, climbing 79,000' in 15 days riding. She's about 5'5", weighs maybe 115. Her knees are fine, but she also climbs at high cadence. Gotta reduce the strain on the knees. That means light weight and for most, big cassettes.

I can't comment on the diagnosis or treatment options, but given your history I'd stop running immediately and limit hiking to whatever you can do without any knee discomfort at all. Many (perhaps most) of us, including myself, simply do not have the knees to continue high-knee-impact sports later in our lives. If you continue on ignoring the warning signs, you're probably looking at early-on knee replacement surgery just to be able to climb stairs without pain.

In general, cycling is great for knees. If your problem is just with the cartilage cushion, then I wouldn't worry that much about cadence, provided you're not experiencing pain.

- Mark

I did switch out my rear cassette this past spring to give me more lower gear-inch options (went from 12-25 to 11-34, have triple on front 30-39-53). I'm very glad that I spent that money.

As for body weight, I'm 168, 5' 11". Not sure I can lose much more without triggering food obsession. Lowest I've ever seen as an adult was 159, but it was hard to sustain. I don't have the bone structure of some willowy females thanks to my Polish/German heritage. It is what it is.

ETA: I haven't run since this all started and have no desire to return to running. I do have a desire to finish segment hiking the Ice Age Trail before I turn 65. I did one of the hardest sections, Devil's Lake, back in June and my knee did not complain. I have given up walking on the treadmill, too, as that seemed to trigger a lot of discomfort.

68 years of bowed legs plus arthritis = right knee bone on bone medial condyle on tibia plateau with left knee not far behind. Earlier this year my Orthopedic Surgeon mentioned to resolve issue would require high tibial osteotomy with total knee replacement

....... 5' 8.5" at 140/145 pounds being close to ideal of 136 pounds for IRONMAN triathlons, my third planned for November 2019
SW FL location = 100+ mile rides 2 to 3 times/week, going for another 150+ miler this Saturday, comfortable cadence is 80/90 but 53/12 or 50/11 low cadence occasionally used at easy effort is relaxing
....... minimize meat, dairy, SUGAR in diet
copious amounts of SPICES, whole fruits, vegetables, fish, whole grains, nuts, seeds, legumes, homemade marinara sauce, fresh garlic and onions every day = ANTI-INFLAMMATORY DIET that is required to reduce pain/discomfort associated with arthritis. NO drugs or injections that doctors have suggested if I wanted quick but not long term relief
........ just registered for Disney World's Marathon in early January with Celebration half marathon 3 weeks later completing both WALKING not being able to run or jog

@OldTryGuy - which spices do you prefer? I've been taking tumeric and I use fresh ground pepper in my morning omelete that is packed with peppers, onions, spinach, and fresh pico de gallo salsa. I've recently upped my daily intake of nuts and reduced my sugar intake and it seems like things are better but not sure if it is just coincidence.

I have friends who have been quick to go for the injections but I'm not convinced about the long term effects of some of them. Cortisone can actually cause further deterioration of cartilage if used too often.

All your level of activity is very inspiring!

First told arthritis in early 80's, hand issues from bicycle wrenching, wheel building and truing, tubes/tires etc. then knees. Prescribed pills, tried a couple, BAD reactions, stopped so took OTC stuff. New PCP and friend said STOP PILLS AND ADD SPICES and anti-inflam foods.


Turmeric/curcumin, cumin, ginger, Allspice, cinnamon, cayenne pepper, basil, oregano, paprika, fresh ground black pepper see the lists online for more. I chop onion/garlic add to EVO heat up, then in go muscles or sardines or salmon then spice mix heat up then chopped veggie mix and my easy made Marinara sauce, heat up and lay on over 8" whole wheat tortillas as a pizza. Drink 6oz/8oz of combo - low sodium V8 with ground pepper, cayeene pepper, Tabasco, curcumin-cumin-ginger, toothpick dipped in Dave's Insanity Sauce, Brag Apple Cider Vinegar, pickle juice. Cruciferous veggies with spicy brown mustard, sweet potato with lots of cinnamon. So much good anti-inflam spices/foods that don't need pain killers. When going out for 100+ milers I sometimes pop one acetaminophen and stay away from ibuprofen.

Thanks for this very useful information! I'm already pondering the tweaks that I can make to my diet.