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I had knee surgery a couple years ago for a small, indistinct

 

Customer Question

Additional info: Male; age 55; no problems with joints prior to meniscus tear, jog/ran three times a week; and even the knee with the tear was feeling close to 100% prior to surgery, but I was told that the tear was in an area that would not heal, and if I did a full crunch I could feel some pain.

 

I had knee surgery a couple years ago for a small, indistinct complex tear of the medial meniscus; however, the surgeon also did a chondroplasty (was not discussed before surgery) although the MRI just said Chondromalacia I/II. However, in the hospital report the surgeon noted Chondromalacia II.

 

As a result I had a lengthy recovery (despite starting physical therapy one week after surgery; I had a very difficult time straitening my leg for weeks, but was told that was normal, but I was expecting to be near 100% after a couple months), and my knee still hurts after a couple years. My left knee is fine.

 

I can give you the results of the MRI's and X-Rays for your opinion on the necessity of the chondroplasty and prognosis in "new" questions if you desire and believe you can given an opinion of the surgery and prognosis.

 

I have an appointment with the surgeon in late June and plan on asking him for Platelet-Rich Plasma Therapy to promote healing. I know he does this in his practice. Your view on this treatment?

 

What concerns me now is that in just the the last couple weeks not only is my knee a bit sorer (some time periods are better than others), but my right foot and lower ankle is also quite sore. It may be due to a new shoe I was wearing for a time that was loose on my foot. But I am also noticing soreness in the middle joint of my left hand. Reason to be concerned? Steps I should take?

 

I stopped drinking milk two months ago after a prostate cancer scare (risen PSA but biopsy was negative), and wonder if there could be a correlation. I know milk can be protective of Osteoporosis and also colon cancer (both colon cancer and prostate cancer in my family). Comments on milk consumption?

Submitted: 341 days and 8 hours ago.
Category: Orthopedics
Value: $31
Status: CLOSED
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Expert:  Danielle-Mod replied 340 days and 6 hours ago.

Hi, I’m a moderator for this topic and I wonder whether you’re still waiting for an answer. If you are, please let me know and I will do my best to find a Professional to assist you right away. If not, feel free to let me know and I will cancel this question for you. Thank you!

Accepted Answer

Expert:  orthosportsdoc replied 337 days and 9 hours ago.

Hi there. I'm sorry you are still having a problem with your knee. I am an Orthopedic Surgeon and would like to help answer your questions. Please understand that the information that I provide is for educational and informational purposes and is not treatment or meant to substitute for being treated by a live physician. I get online once a day and therefore please bear with me if you post and I haven't responded yet. I will in do time. Please do not accept until you have had your question answered in a satisfactory fashion. Did the surgeon indicate where in the knee the chondroplasty was done? Patella, trochlea, medial or lateral femoral condyle or tibial plateau? In layman's terms grade 2 cartilage damage is some focal areas where there is fraying and some fissures but that do not go down to bone. Grade 1 and 2 is not bad. Grade 3 and 4 involves deep lesions down to bone which would be more concerning. For someone aged 55, grade 1 and 2 is to be expected, particularly in someone who is active. In general there is no good solution for cartilage damage particularly in someone over the age of 35 or 40. If you want you can post the actual MRI images but I'm pretty sure that the pain you are feeling is from worsening of the cartilage injury. Essentially you are early stage osteoarthritis which is the natural breakdown of cartilage from aging, activity, and genes. I do not recommend surgery for people with osteoarthritis unless they have a mechanical problem from a meniscus tear or if there is loose body or something in the knee. For someone with cartilage wear of grade 2, I do not recommend surgery as you will feel better for a transient period and the pain will come back.

PRP is a new treatment but there is not data to show that it helps in osteoarthritis or focal small cartilage defects. My view along with the American Academy of Orthopedic Surgeons is that there is no convincing evidence that it helps. Regarding the soreness of your ankle and foot, it may be related to the knee pain and your body accommodating to the pain of walking but adjusting. I cannot explain the soreness of your finger at the same time. There is a condition called inflammatory arthritis such as rheumatoid arthritis but it does not present in this fashion. It might be beneficial to get xrays of those joints to see if you have arthritis there as well but my suspicion is that the ankle and foot pain will resolve when the knee pain resolves. Regarding milk consumption, it can help in osteoporosis but probably the best thing would be to take a vitamin D and/or calcium pill. The amount of milk you would have to consume to have a lasting metabolic effect on bone density would probably be too much. Regarding the knee, I think you should get a recent set of Xrays to see if the arthritis has worsened. I hope I have answered your questions. Feel free to follow up. Thanks.
orthosportsdoc41063.9806373495

Expert TypeBoard Certified Physician
Category: Orthopedics
Pos. Feedback: 100.0 %
Accepts: 116
Answered: 6/3/2012

Experience: Orthopedic Surgeon

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