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Had ACL reconstruction. MRI showed distal femur and proximal tibia with Baker's cyst. Suggestion?

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Orthopaedic Surgeon
Practicing since : 1994
Answered : 10347 Questions
I had a MRI completed because I have had constant pain in my knee for the past 6 months, walking or sitting. II can't see the Dr. for 2 weeks for the follow up to this MRI. Can you help explain what I am looking at for repair to my knee... I do not understand the portion stating hardware has been removed since last MRI. I have not had any surgeries since the initial. I would appreciate any feed possible.
EXAM: Magnetic resonance imaging right knee without contrast      
INDICATION: Pain. ACL reconstruction 7 years ago.      
COMPARISON: MRI from 1/30/2007.      
TECHNIQUE: Routine sequences were performed through the knee without      
intravenous contrast.      
FINDINGS: The patient is status post ACL repair. The graft appears intact. The      
hardware in the distal femur and proximal tibia appears to have been removed      
since the prior study. Small cysts are seen in the bone tracts, more prominent      
in the tibia than femur. Signal from the bone marrow is otherwise within normal      
limits. Mild chondromalacia in the medial joint compartment has progressed when      
compared with the previous study. Moderate chondromalacia in the patellofemoral      
joint has progressed when compared with the prior study. Tricompartmental      
osteoarthritis has progressed. A loculated Baker's cyst is present measuring 2.4      
cm in transverse dimension, 2.3 cm in AP dimension, and 7.1 cm in craniocaudal      
dimension. This has mildly increased in size since the prior study. The medial      
meniscus has a stable, mild degeneration of the posterior horn without evidence      
for tear. The anterior horn is unremarkable. The lateral meniscus has mild,      
stable degeneration the posterior horn. The anterior horn is unremarkable. The      
posterior cruciate ligament, extensor mechanism, medial collateral ligament,      
iliotibial band, fibular collateral ligament, and biceps femoris tendon appear      
1. ACL graft remains intact. The hardware appears to been removed.      
2. Progression of moderate chondromalacia in the patellofemoral joint, mild      
chondromalacia in the medial joint compartment, and tricompartmental      
3. Baker's cyst, mildly increased in size.
Posted Tue, 25 Jun 2013 in Back Pain
Answered by Dr. Praveen Tayal 3 hours later
Thanks for posting your query.
The findings of MRI scan are suggestive of degenerative changes in the knee joint which are mainly age related changes. This is causing the knee pain that you are having. The mild increase in the size of Baker's cyst is not worrisome.
The ACL graft is intact. The hardware is the material with which graft is fixed with the bones- it can be screws, buttons, pins, or similar devices. Some of those devices are made out of materials that reabsorb or dissolve with time and are replaced with bone by the body. This is why it has been mentioned that the hardware appears to be removed.
Stretching and strengthening the quadriceps and hamstring muscle groups is critical for proper treatment of chondromalacia patellae. Quad sets are done by contraction the thigh muscles while the legs are straight and holding the contraction for a count of 10. Sets of 10 contractions are done between 15-20 times per day.You can do the required exercises under the care of an expert physiotherapist.
Heat application and use of knee brace is advised for proper knee support at the time of exercise.
Avoid such activities as squatting, kneeling, heavy lifting, climbing, etc.
Adding glucosamine sulfate as supplement after consulting your orthopedician may help in relieving your symptoms.

I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Dr. Praveen Tayal.

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