MCL Injury

[erijon]

I posted a couple of weeks ago about a recent MCL injury. I got my MRI results back and it does show a grade II MCL injury without a complete tear. However, it also showed "significant early tricompartmenal degenerative changes, greatest in the patellofemerol compartment as well as areas of significant chondral thinning and irregularity". I knew I had this going on in the other knee and we always suspected it in this one, I guess we just confirmed OA is getting worse.

Orthopedic is starting me on therapy first, then Sinvic treatments and we'll go from there. Any suggestions?

Thanks in advance,

Jon

[DJA5955]

I had My First Synvisc Shot Last Week On Wed My Keen Still Has Pain & Still Is Swollen I Have Not Been Able To Stand To Long ,Or Walk To Much ,And Haven't Been Able To Return to work Because Of Pain, It Is Now Going Down My leg A Little , Not Sure If It Will Take Longer To Heel Because I'm A Diabetice . I Fell At Work Last Year And Hurt My Right Keen And Right Elbow It Fell On Black Top ,And Hit A Piece Of Cut Rusty Medal Were There Was An Old Fence , Please Help Me Will This Ever Get Better .

[JainMD]

Hi,
You should ask for the line of management and type of intervention at each interval.
How is the doctor going to monitor your progress?
Is there any investigation like complete blood count or ESR which needs to be done?
Did you ask about Glucosamine and Chondroitin sulfate injection?
Keep me posted if you have any queries.
Bye.

[erijon]

I see the Orthopedic Therapist on Monday for a consult and outline the type of therapy and number of sessions. Any suggestions what I should ask for?

Jon

[JainMD]

Hi,
Synvisc should work as it will help in joint lubrication. I am not sure about wedge procedure as of now for your ailment.
I am sure the doctor has told you about the pros and cons of Synvisc injection.
Apart from the Synvisc you should be started on a program to preserve muscle strength and ROM and to avoid contractures.
Is there any physical therapy advised for you?
If so, what is it?
Osteoarthritis progressively worsens with time. No cure exists. Modern methods of joint replacement provide excellent function and pain relief.
Keep me posted if you have any queries.
Bye.

[erijon]

The doctor is planning on going to the Synvisc as we have already been the steroids route over the past two years and the results are not as strong as the OA progresses. If Synvisc fails then we are discussing a wedge procedure, hopefully it won't get that far.

For the MCL, it's therapy for now and a brace. There is not a complete rupture so there is nothing to fix surgically.

Thanks,

Jon

[JainMD]

Hi Jon,
A MCL injury is a sprain of the MCL, which is the primary restraint to valgus stress on the knee.
Initially, a patient with a MCL injury is treated with ice, elevation; analgesics, a hinged knee brace, and protected weight-bearing as tolerated.
The patient should be referred to physical therapy. Intra-articular injection of corticosteroids, and hyaluronic acid, may have a small effect on knee pain.
I think Synvisc treatments are fine.
You need to monitor your improvement on Synvisc treatment. If you do not have any response then what is the second line of treatment.
What is the line of management the doctor has planned?
Keep me posted if you have any queries.
Bye.