Bursitis and adolescent anterior knee pain

[Monkeymorgan]

I'm 16 and for 3 years now I have had knee problems. I have had x-rays, 2 MRI's and 2 sets of blood tests. I have seen my doctor, 2 orthopedic specialists, and a rheumatologist. I went to physical therapy for a few months 2 years ago. They said I had flat feet and gave me orthotics. The second orthopedic specialist said I had adolescent anterior knee pain and there was nothing he could do for me. A few weeks ago I went to the rheumatologist and he diagnosed me with bursitis. He started me on some anti-inflamitories but I am still having lots of swelling and tons of pain. Next time I go in he wants to drain my knees and inject some cortisone. Is the swelling likely to come back and will the pain come back? How should I treat these problems on my own? I have iced lots of times and have never gotten any results. I am in karate and pretty active all the time. I power through the pain while I'm doing an activity but later I end up in tears on the floor. What should I be doing to help get back to normal?

[Monkeymorgan]

I have done PT, bracing and taken so many NSAIDs that they no longer work. Meloxicam didn't even make a difference. Mom doesn't want me to have surgery. Is there anything else I can do?

[Michael L Gross, MD]

From what you've described, I agree with the probable diagnosis of anterior knee pain syndrome, or patella femoral syndrome. This is commmon in active adolescant females, and usually responds to non-surgical management, with physical therapy, bracing or taping, and NSAIDs.
For the few patients that do not respond to conservative treatment, surgery can be an option. Surgical procedures range from arthroscopic procedures, to large open procedures.