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Greetings Shane Sims.Your MRI has three main findings;1) Grade III chondromalacia patella2) premature osteoarthritis; it is secondary to above and in your case would be considered as an overuse complication which occurs in athletes.3) joint effusion; it is inflammatory fluid collection sequelae to both of the above conditions.The medical imaging findings need to be corroborated with the medical history (working in army can predispose to it as prolonged standing, walking and overwork is expected), symptoms, signs and physical examination. This will need an extensive rehabilitation program. A specialist in physical medicine and rehabilitation, apart from orthopedics is the best to handle it. Following is the mainstay of the management;
1) Knee care in the activities of daily living. Few simple self-care measures can be remarkably effective in ending pain cycle.
a) Avoid prolonged standing or walking or sitting with joint in a single position.
b) Whenever you sit, keep the knee stretched and fold them intermittently.
c) Squatting, sitting cross legged should not be done.
d) Avoid climbing stairs for about 3 weeks.
e) Avoid sitting legs unsupported or hanging.
f) Reduce weight if over weight/obese.
2) Rest: Taking a break from your normal activities reduces repetitive strain on your knee, gives the time to heal and helps prevent further damage.
3) Anti-inflammatory medications
4) Physical therapy; the goal of physical therapy is to strengthen the muscles around your knee and help you regain knee stability. Ideal is supervised physical therapy. Stretching exercises are also part of the physical therapy regime.Exercises in a pool (hydrotherapy) is most important component in your case.
5) Orthotics and bracing.
6) Glucosamine and chondroitin orally for about 1-2 years and a trial of diacerin for three months.
7) Hyaluronic acid injections in knee / steroid shot in knee.
8) Local analgesic sprays and ointments to your skin may help relieve the symptoms of osteoarthritis.
9) Deep Electrotherapy by physical therapist.
These are the exercise resources for the knee. You can pick the exercises which suits you;
An arthroscopic surgery (minor procedure done by minimal access surgery or key hole surgery) can also help.
Please feel free for your follow up questions.
I would be happy to assist you further, if you need any more information.
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