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Avatar universal

knee trauma and lingering problems

    I had arthroscopic surgery 6 months ago. For as the doctor described in his surgical notes. A very significant chondral defect on my medial femoral condyle. I had a 2nd doctor`s opinion and followup MRI 4 months later. Which says I have the following problems. Chondromalacia of the patellofemoral compartment without evidence of a full thickness articular cartilage defect.  A small Baker`s cyst, with small joint effusion. And there is mucoid degeneration within the posterior horn of the medial meniscus, without evidence of a discrete tear.  And post traumatic arthritis.
     I was an active,and a fit 48 year old male before all this happened! I fell hard on a concrete floor at work twice. Tackling inmates fighting with staff members. In the institution I work at. Now its the constant nagging pain, and stiffness that bother me. Especially when kneeling,squatting, and going up and down inclines and declines. I used to jog regularly. Now its just walking on a treadmill.  
     Am I destined to remain this way until the day comes that my knee needs to be replaced? I`ve had cortisone shots with little relief. And I take glucosomine pills now too. Is there anything else surgically or otherwise that might help? I plan on asking about synvisc injections when I see my doctor soon. But I`ve heard that results are only fair at best.  I plan on returning to work soon. But by walking on surfaces and stairs that are concrete and steel. My knee won`t appreciate that! Any advice is appreciated!
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700223 tn?1318165694
MEDICAL PROFESSIONAL
Alot of the answers require a few more questions.  What were your symptoms before surgery?  Was the original injury the result of trauma or gradual wear and tear?  What was done at surgery? How do your symptoms now compare to those before surgery?

Assuming that things went well at surgery and the lesion on your MFC was successfully treated, usually with shaving chondroplasty, microfracture revascularization, or osteochondral implants; and your MRI does seem to indicate that the surgery was successful, then your recovery can be prolonged. This is not a simple partial menisectomy in a 25 year old.  It sounds now that many of your symptoms are from the patella-femoral joint.  The findings on the MRIalong with incomplete rehab post-operatively could easily be the root of the problem.  My experience has been that the rehab process in patients over 40 can take over 6 months until the patient has complete relief.

I also have had gtremendous success using Synvisc for patients in their 40's with post traumatic arthrits.  Be aware however, that Synvisc takes up to 3 months to have its full effect.  Be patient.
Helpful - 1
Avatar universal
No symptons before the injury.  It was caused by trauma to the knee. from the above described incidents, at the state prison where I work. As a sergeant in our mental health units. The arthroscopic surgery supposedly cleaned up the  chondral fracture on my medial femoral condyle.  But my problems remain. With constant nagging pain and swelling. And problems kneeling,squatting,bending, and just going up and down stairs. I saw another orthopedic doctor today. He suggests microfracture surgery on my knee. But that entails 6 weeks on crutches, and 3-6 months of PT afterwards. I need to think about that!
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