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Hello Sharon , My name isXXXXX and I will be helping you today.Both of your MRI findings; partial thickness articular fissure in the medial femoral condyle and focal partial thickness cartilage loss are wear and tear arthritis which was increased because of the injury. In your age group following surgical procedures may be considered;1) arthroscopic (key hole camera surgery) joint toileting. This removes debris from the joint and symptoms may be better. Though physical therapy may be still be needed.2) partial or total joint replacement; if the symptoms are severe, you have night pain or pain in rest and there is no over weight issue; this can be chosen. In your age group ideally this would be postponed for about 5-10 years, though can be done if nothing is helping you.You should consult an orthopedic surgeon. Consulting an MD in physical medicine and rehabilitation specialist would also help, who can chalk out a customized physical therapy and deep electrotherapy plan for you. This is the conservative treatment;
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.
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.Pool exercises too can help.
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.
8) Local analgesic sprays and ointments to your skin may help relieve the pain and stiffness of osteoarthritis (wear and tear / degenerative arthritis).
9) Deep Electrotherapy by physical therapist.
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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