Simple English What Do Exams, Xrays and MRI Mean

Age 61,chronic R knee injury. Constant pain. Using cane and medial unloader brace. Pos.Lachman’s, degen. MMT and LMT. Chronic ACL tear. Antalgic gait. Grade I Anterior Drawer Test. Pos.Pivot Shift.4 injections,2 yrs. 1&2 were Corticosteroid; 3&4 SynvisONE. X-RAY REPORTS: Degen. changes knee joint, unfused Apophysis of Tibial Tuberosity. Bone on Bone Medial Joint Space w/marked arthrosis. Moderate degen.changes to Articular Surface Sclerosis and Osteophytosis. Mild degen. changes in Patellofemoral Joint Compartment.MRI : BONES/JOINTS – Tricompartment degen. Osteophytosis. Medial Tibial Plateau  minimal subchondral cystic changes. Small joint effusion. Diffused full-thickness cartilage loss along Medial Femorotibial Compartment. Grade II/III Chondromalacia affecting lateral femorotibial and Patellofemoral Compartments. Focal Grade IV Chrondromalacia of Medial Femorotibial Compartment along Trochlea with subchondral cystic change. LIGAMENTS/TENDONS – Inferior Patellar Tendon thickened w/intermediate T2 weighted signal consistant with degeneration. Posterior Cruciate Ligament is thickened w/intermediate T2 weighted signal consistent with remote tear. Anterior Cruciate Ligament not visualized compatible with remote full-thickness rupture. MEDIAL MENISCUS – Meniscus body and Posterior Horn appear diminutive and macerated consistent with complex tear,extends into the Posterior Root Insertion. LATERAL MENISCUS – Complex tear of the Lateral Meniscus body. SOFT TISSUES – subcentimeter Baker’s Cyst noted.

Total knee replacement mentioned but considered major surgery, Should continue with SynvisONE  injections Could you tell me in simple english how unstable is my knee and how  the arthritis is going to continue affecting my mobility. Need to make an informed decision to either continue injections, have total knee replacement or get a second opinion. Thank You in advance...

[Michael L Gross, MD]

Quite honestly, it sounds as if your knee is fairly degenerative. If the synvisc gives you relief, great.  If not, it sounds as if total knee replacement is your best alternative.