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Limited Range Of Motion, Chronic Pain, Burning In Knee. MRI Done, Shows Loss Of Articular Cartilage, Small Joint Effusion. Treatment?

I am a 56 year old male........still very active in sports. A recent MRI I had showed the following : 1. considerable loss of articular cartilage of medial femoral condyle and to lesser extend medial tibial plateau 2. small joint effusion 3. focal area of moderate loss of articular cartilage of median ridge of patella 4. myxoid generation of the anterior cruciate ligament . I had a partial medial minescectomy in September of last year. Physical symptoms include limited range of motion, chronic pain and burning in different parts of the knee. What are my treatment options? Thanks,
posted on Fri, 15 Jun 2012
Twitter Fri, 15 Jun 2012 Answered on
Twitter Fri, 6 Jul 2012 Last reviewed on
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Orthopaedic Surgeon,  's  Response
Dear mstrode,
Thank you for logging onto the Healthcare Magic forum.
Your letter is especially clear & succinct.
Judging by your description along with MRI report, I would say that your knee has become quite arthritic.
The increased damage on the medial half of your joint is contributed mostly by the partial medial menisectomy last year. Normally the brunt of the bodyweight is more concentrated medially than lateral part of the knee.
There is no doubt that there is wear & tear in all parts of the knee.
One can buy time by injection of artificial lubricant into knee joint. Its a process called vissco-supplementation and involves a yearly or biannual injection of synthetic hyaluronic acid ( by your doctor) into the knee. It helps cut down the pain and makes movement smoother.
The next more invasive alternative is a Partial ( Unicondylar)knee replacement.
The only factors against it are the fact that you have a limited range of motion & that your ACL is already degenerating. Your pain will be relieved but the movement may not improve drastically.
Finally , and the more predictable & better alternative is a Total knee replacement.
Your pain will be gone, along with good recovery of motion in your knee. The only downside is that the modern knee prosthesis may last a maximum of 20 years ; after which you will need a revision total knee replacement.
Also, it'll mean your sporting days may be over. Swimming, cycling and golf may be permissable but certainly no more running & contact sport.
I hope that i have answered your questions.
Best of luck!
Regards,
Dr. Mohan Thadi
MBBS, MS, DNB, FRCS
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Limited Range Of Motion, Chronic Pain, Burning In Knee. MRI Done, Shows Loss Of Articular Cartilage, Small Joint Effusion. Treatment?

Dear mstrode, Thank you for logging onto the Healthcare Magic forum. Your letter is especially clear & succinct. Judging by your description along with MRI report, I would say that your knee has become quite arthritic. The increased damage on the medial half of your joint is contributed mostly by the partial medial menisectomy last year. Normally the brunt of the bodyweight is more concentrated medially than lateral part of the knee. There is no doubt that there is wear & tear in all parts of the knee. One can buy time by injection of artificial lubricant into knee joint. Its a process called vissco-supplementation and involves a yearly or biannual injection of synthetic hyaluronic acid ( by your doctor) into the knee. It helps cut down the pain and makes movement smoother. The next more invasive alternative is a Partial ( Unicondylar)knee replacement. The only factors against it are the fact that you have a limited range of motion & that your ACL is already degenerating. Your pain will be relieved but the movement may not improve drastically. Finally , and the more predictable & better alternative is a Total knee replacement. Your pain will be gone, along with good recovery of motion in your knee. The only downside is that the modern knee prosthesis may last a maximum of 20 years ; after which you will need a revision total knee replacement. Also, it ll mean your sporting days may be over. Swimming, cycling and golf may be permissable but certainly no more running & contact sport. I hope that i have answered your questions. Best of luck! Regards, Dr. Mohan Thadi MBBS, MS, DNB, FRCS