33-year-old male status post right knee arthroscopy, chondroplasty of a patellar chondral lesion, as well as a DeNovo NT procedure in the right knee trochlea. Now presenting with persistent knee pain. MENISCI: There is mild intrasubstance degeneration of the menisci, but no discrete tears are identified.ARTICULAR CARTILAGE AND BONE: There is full thickness degeneration and marked fraying of the articular cartilage of the medial facet of the patella, which appears progressed from the prior study. There is a full-thickness cleft within the articular cartilage just lateral to the median eminence of the patella with additional fraying of the articular cartilage of the patella centrally.Full-thickness central trochlear defects seen on the prior study have been replaced with heterogeneous signal intensity, presumably the site of prior microfracture, likely reflecting new cartilage formation, which is either immature or degenerated, based on the signal characteristics. There is a near full-thickness cleft within the articular cartilage along the inferior margin of this heterogeneous signal, best seen on the sagittal images. There is a near full-thickness cleft traversing the articular cartilage of the lateral trochlear facet with what appears to be delamination of the articular cartilage from the underlying bone. There is mild increased signal within the underlying bone consistent with edema, which is likely degenerative in etiology.There is a new near full-thickness to full-thickness defect of the articular cartilage of the medial femoral condyle, measuring just under one cm in AP dimension, just above the posterior horn of medial meniscus with heterogeneous signal of the adjacent articular cartilage posteriorly, suggesting degeneration. There is also what appears to be thinning of the articular cartilage of the lateral femoral condyle above the anterior horn of the lateral meniscus, but this may be artifactual.LIGAMENTS: The anterior cruciate and posterior cruciate ligaments are intact, as are the medial collateral and lateral collateral ligament complexes.EXTENSOR MECHANISM: The extensor mechanism is intact.ADDITIONAL
Findings of trochlear microfracture, but with overall progression of cartilage degeneration in the patellofemoral and medial tibiofemoral compartments as described above.