Hello Dr. XXXXXXX Tayal, This Is A Follow-up To Our

Posted on Fri, 15 Nov 2019

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 15 Nov 2019 Answered on

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Question : Hello Dr. XXXXXXX Tayal,

This is a follow-up to our previous communications which have now been closed before I was able to respond to your detailed answer. Please refer to my file regarding my left knee issues.

I have some questions I would like your medical opinion on to help me decide on what actions I should take going forward.

My feet have always been the strongest part of my body and I have relied on their health and strength for my current retirement job as a custodian at a college.

Based on my MRI is there a possibility that my injury could be a pathologic fracture caused by disease such as cancer?

I have a tendency to push my body to the maximum. I have been a high performance athlete in my younger days and still am in whatever I do.

Is the subchondral fracture a slow healing process?
Is immobilization the recommended treatment along with physiotherapy?
What approximate time frame could I possibly be looking at for recovery?

I would appreciate your help while I am dealing with these concerns.

Thank you.
Regards, XXXXXXX Fodchuk

Answered by Dr. Dr. Praveen Tayal (5 hours later)

Brief Answer:
Rest and physiotherapy will help in healing.

Detailed Answer:
Hello,
Thanks for posting your query.
The small subchondral fracture that you have is more related to degenerative changes in the knee joint - age related. This is not related to cancer in any way. Since the bones become weak, the healing is slow. Taking a multimineral supplement will also help. Immobilization with a proper knee support along with physiotherapy will help in proper healing. It usually takes 4-6 weeks for healing.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Praveen Tayal (3 days later)

Hello,

Doctor I am following up with another email shortly. I wanted to send this before automatic closure to your last answer to my query.
Regards, XXXXXXX Fodchuk

Answered by Dr. Dr. Praveen Tayal (4 minutes later)

Brief Answer:
Will wait for the next mail.

Detailed Answer:
Hello.
Do write about any more clarifications that you want.
Best regards.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Dr. Praveen Tayal (1 hour later)

Hello Dr XXXXXXX Tayal,

I am curious to know if the subchondral insufficiency fracture of the left knee medial tibial plateau could be related to my job environment at the college which I have worked at for the past seven years.

Effective Sept.3,2019 I have been responsible for cleaning three buildings on the campus: recreation center, theater, student dorm.

Daily walking distance to get to my buildings plus cleaning them is: 7.5 km approx.

Number of stairway steps to vacuum and wet mop: 153 steps

Weight of vacuum cleaner: 15kg with dust bag empty.

Cleaning:
Daily cleaning stairway steps..... 300 steps av. total up and down walking.
When weather conditions are bad.... 400 steps or more total up and down walking.

The pain on the medial left knee started on Sept. 12,2019 after I had done 240 steps total up and down at the dorm and had mopped and was finishing machine scrubbing the gym floor. Within four hours the pain became progressively worse.

For the past two months I have been self treating the knee at home before and after work with light exercises and application of an aloe vera heat lotion.
I have a high tolerance for pain and I don't want to take any medication.

My physiotherapy Functional Abilities Assessment is on Dec.5,2019.

Am I wise to carry on with my job or am I risking more major damage to my left knee and other joints and muscles that are compensating for the weakness and pain on the left knee?

My BMI is in the normal range and I live a clean lifestyle.

On Dec.3,2019 I will be 75 years old; being the oldest employee at this two campus college. I am a high performance, achiever and responsible person who is results oriented. Plus I have enjoyed what I have been doing. This is what is making it difficult for me in making decisions going forward.

Please inform me on the possible high risks of continuing my daily cleaning procedures as described in my current responsibilities.

I trust and thank you for your help.

Regards, XXXXXXX Fodchuk

Answered by Dr. Dr. Praveen Tayal (22 hours later)

Brief Answer:
Continuing the job can cause further deterioration.

Detailed Answer:
Hello.
Thanks for writing again.
I have read all the details provided. I am amazed at the amount of work you do daily at this age. Since you have been doing this work for last 7 years and your body is used to it, this is not likely to directly cause the fracture unless there is an accident. But at your age due to the degenerative changes in bones and cartilages, such a fracture can happen. Continuing with such a job can cause further deterioration of the problem as proper rest is needed for it to heal.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar