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Dr.tiwari
Dr.tiwari, Doctor
Category: Medical
Satisfied Customers: 5256
Experience:  M.D.
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My MRI shows a fissure in my patella. I remember hitting my

Resolved Question:

My MRI shows a fissure in my patella. I remember hitting my knee about 2 months ago. Currently, my knee swells up half of the time. When will the knee heal? What should I do to prevent swelling? Should I take ibeuprofen to deal with the swelling? If so, is there any problem with taking in on an ongoing basis? What activities should I avoid, and how long?
Submitted: 4 years ago.
Category: Medical
Expert:  Dr .Saha replied 4 years ago.
Hello,

What type of doctor did you see?

Did you consult an orthopedic doctor?

Can you raise your leg straight in the air after lying flat in the bed?

Customer: replied 4 years ago.
I am not sure if I am waiting for the doctor to respond, or if the doctor is waiting for me to respond.
Expert:  Dr .Saha replied 4 years ago.
I am waiting for your response to the above questions.

Customer: replied 4 years ago.

I saw an internist only.

When my knee is not swollen, I can put my leg in the air, no problem.

Expert:  Dr .Saha replied 4 years ago.

Thank you for the information,

The fissure can be due to a crack from trauma.

When you can raise your leg , then the muscle power is good.

It may need conservative treatment only.

Some immobilisation with brace , analgesics will be helpful.

Analgesics need to be used only when needed.

Physical therapy can also be useful here.

However you can take an opinion of an orthopedic specialist .

I hope this information will be helpful.

Please ask if you need any clarification.

Best wishes.
Customer: replied 4 years ago.
Hello Dr. . Is it just a matter of waiting for the knee to heal? The swelling gets in the way of walking, etc. I visited the physical therapist, and since I am already strong (according to his evaluation), there isn't much he can do (other than recommend glute exercises). Do I just avoid going up any type of elevation? If I go up a hill (or maybe it is down a hill that agravates it), I have swelling the next day. The swelling is so bad that it affects my gait. What to do? I
Customer: replied 4 years ago.
Also, doctor, what do you mean by a brace? Since both knees seem to have the same problem (interchangeably), should I brace them? Should I brace them only when they become swollen? I purchased something from the drugstore, but I don't think you are referring to that.
Thank you.
Expert:  Dr .Saha replied 4 years ago.
I had a misunderstanding that the swelling is affecting one joint which was affected by trauma.

Did you got hit in both the knees?

Customer: replied 4 years ago.
I only had an MRI in one leg, but I believe both patellas are cracked. It was very hard to just get an MRI for one leg. The main problem is that I don't know how long it will take to heal, what I should avoid. I just would like some reassurance that this will one day heal, and that my knees won't always swell after I walk uphill.
Expert:  Dr .Saha replied 4 years ago.
Hello again,

I am opting out of your question.

Another expert will take over it.

Customer: replied 4 years ago.
Thank you for your help anyway.
Expert:  Dr.tiwari replied 4 years ago.
Hello,
As Dr. Saha has opted out i am here to help you.
The fissure in patella is not a major fracture but it s a minor .It is generally treated by putting the limb in XXXXX XXXXX compression bandage or with cyllindrical slab or cast .It generally heals within 6-8 weeks.
As you have passed about 2 months then most probably the lesion could have been healed up.
The swelling you are facing at present may be a part of the healing process in which there is secretion of excess amount of the synovial fluid in the joint due to increased circulation as well to provide the intrarticular structures with good amount of the nutrition & to fight from the pathology.

Generally this swelling goes away with development of strength in the quadriceps muscles ,I want to add here that if your muscles are not developed to the previous stage at present then in contrast your knee may look swollen.So the first step here is to develop your quadriceps muscle .You may have anti inflammatory analgesic like advil to get relief if it is excessively there.

Even after all this if this swelling continue to be ther then you should think of presence of post traumatic osteoarthritic changes which may be there in your age.It will be better to use glucosamine ,MSM, S-ADENOSYL METHIONINE which are chondroprotective agents & are helpful in early stages.
At this stage i will advice you not to wear the brace after the 2 months but to keep the knee in mobility if fissure has healed instead you may wear knee cap & protected activities.

Hope this will be helpful.

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Dr.tiwari, Doctor
Category: Medical
Satisfied Customers: 5256
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Dr.tiwari and 4 other Medical Specialists are ready to help you
Customer: replied 4 years ago.
Dr. Tiwari,
Would you mind clarifying: should I avoid going up hills as that seems to trigger the swelling? Should I just spend a lot more time in the pool in the event that the healing isn't complete?
Thanks,
Mary Anne
Customer: replied 4 years ago.
Also, Dr. Tiwari, the MRI was done recently (3 weeks ago). It shows a fissure. Therefore, it appears it hasn't healed. Does that change anything you have said earlier?
Expert:  Dr.tiwari replied 4 years ago.
Yes ,You should avoid going to the hill as well as frequent stairing up & down as these are the positions which does put maximum stress on the patellofemoral articulation.

Doing pool exercises are good for you.But remember excess should always be avoided.

MRI REPORT of 3 weeks back does not change the matter as this is the time post injury that is 4-8 weeks when tissues are healing .The important time is first 3 weeks after injury.

I think you should have a follow up MRI after next 1 month which if show you recovery then nothing has to be done but if there is still fissuring with pain at the patella then you may need some drilling procedure by arthroscopic method to help with healing.

Hope this will be helpful.

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