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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 35717
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I am experiencing severe knee pain, MRI state near-complete

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I am experiencing severe knee pain, MRI state near-complete to complete focal cartilage loss involving the pateilar apex with mild subchondral cystic formation

Hello Debbi,
I am Dr. Arun and will be helping you today.

What are the treatment measures you have tried?

Customer: replied 4 years ago.

I have used ice, elevated the knee, but the pain is severe. I would like the MRI results explained to me, which is the information that i entered. Do you have that info?

Customer: replied 4 years ago.

MRI states near-complete to complete focal cartilage loss involving the pateilar apex with mild subchondral cystic formation. There is a tiny medial based popliteal cyst.

Could you please explain the above and what the next steps might be, what do you suggest to do to relieve the pain

Hello Debbi,

The MRI changes denote osteoarthritis, which is age related changes in the joint (also termed degenerative arthritis). Following are the meaning;

near-complete to complete focal cartilage loss involving the patellar apex
=there is loss of cartilage which is tissue which helps in the smooth movement of the joint. Cartilage acts as a cushion and shock absorber and this has been lost specifically between the joint formed between patella (knee cap) and thigh bone.

with mild subchondral cystic formation
=there is a small fluid collection (cyst formation) below the cartilage surface of knee cap.

Following measures would be helpful in the knee osteoarthritis;

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.

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.

9) Deep Electrotherapy by physical therapist.

These are the exercise resources for the knee. You can pick the exercises which suits you;

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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Customer: replied 4 years ago.

Is surgery required to repair this, how to replace the cartilage

Customer: replied 4 years ago.

How is this fixed? Surgery? How is cartliage replaced

Hi Debbi,

Surgery would be required;

1) If the above measures are unable to relieve the pain.
2) Pain is excruciating and round the clock.
3) There is severe pain even during sitting or lying down.

A partial or total knee replacement surgery would be recommended than.

The Chondroitin and Glucosamine supplements may help to replace the cartilage.

It is privilege assisting you.