early onset Patellar cartilage breakdown - experiences?

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 GraMc 14 Feb 2022

After increasing knee pain going up hills i went for an MRI. 

Results are back and along with other bits of wear and tear (thining of medial compartment, and surface fissures of lateral)  I have focal full thickness cartilage  fissuring in the mid third of my knee cap (which is what is giving me pain). Probably brought on by a misdiagnosed  childhood patellar sleeve avulsion (of which the MRI has evidence of) and then lots of wear and tear over the subsequent 20 years.

I have an appointment (privately) with a recommended knee surgeon in early march and unfortunately its written off my Scottish winter season until then (at least). Until I have an opinion from them I am sort of in the dark about how severe this is - and unsure whether i need to come to terms with having a f*cked knee / not going into the mountains much again / very young knee replacement at somepoint in the future or whether this kind of cartilage damage can be trimmed out and further damage minimised until later in life while still alpine and winter climbing (I suspect as its wear and tear rather than acute the answer may be less positive). Although I'll obviously be cutting out any form of running (which i think has been the primary driver) 

From reading various journal articles it looks like repairs to Patellar cartilage aren't as successful as elsewhere in the knee due to the forces involved. 

I appreciate it is highly highly subjective and will vary wildly between people and injuries - but would be interested to hear peoples experiences (both good and bad) of Patellar cartilage breakdown at a young age (30 feels very young for this). Physio who referred me didn't really want to comment on it, but im considering finding one who might. keen to get as many opinions as I can. 

thanks for any replies in advance (i'm not so good at replying individually)

 Myr 15 Feb 2022
In reply to GraMc:

Bumping this thread as I had basically same results from MRI last week. 15mm long damage to cartilage in centre of kneecap. It has started to affect the bone underneath now. Probably from ski accident 9 years ago.

I'm already quite restricted in what I can do with my knee. I don't know whether I'm more able now than I would be after surgery/replacement. Therefore I'm torn between trying to delay the remaining deterioration as long as possible, or trying to hasten the deterioration so I get to the post-surgery state sooner...

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