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MRI showing synovial effusion in knee joint. No improvement with physical therapy. Is it necessary to go for surgery?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
I have an Mri that says the following: synovial effusion in the knee joint Lateral patellar tilt and lateral patellar subluxation with patellofemoral chondromalacia And posterior patella and anterolateral femoral subcortical bruising with narrowing of the lateral patellofemoral joint compartment Had multiple traumas to the knee,,,,,working in the NYC Dept. of Corrections.....inmate altercations.. I am a 47 yr old male....6'0" 205 pounds.....very good condition for my age.....working out over 30 years My left knee grinds,,,catches,,,and has the feeling of giving way,,when weight is place on it the wrong way,,,especially when going up and down stairs I have tried physical therapy,,,and it has not provided any relief,,,,is surgery a good option for me The P.T. Says my knee is slowly grinding away
Posted Sat, 23 Nov 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 3 hours later
Brief Answer: Surgery is the last option for your condition. Detailed Answer: Hi, thanks for writing to XXXXXXX All the MRI findings as well as your symptoms suggests WEAR & TEAR in your knee joint, typically affecting the Patello-femoral compartment (the joint surface between the knee cap bone & the lower portion of the thigh bone). Conservative management (non surgical management) is always the primary choice of treatment for your condition. Treatment of this condition often begins with simple measures as mentioned below - -Rest your knee as much as possible. Avoid any activities that increase the pain such as climbing stairs and deep knee bending movements. - If needed, take over-the-counter pain relievers such as acetaminophen, ibuprofen or naproxen. - Weight loss alone will often fix the problem if you are substantially overweight. - Specific exercises can strengthen the muscles that support your knees and control limb alignment, such as your quadriceps, hamstrings and the muscles around your hips (especially the hip abductors). They are done individually on a daily basis for at least three months. - Knee braces or arch supports may help protect your joint and improve the alignment of your kneecap. Bracing involves control of the tracking position of the patella and restriction of full knee flexion. - Icing your knee after exercise may be especially helpful. - Bracing or taping the patella can help you do exercises and activities with less pain. The idea is that by bracing or taping the knee, the patella stays in better alignment within the femoral groove. This in turn is thought to improve the pull of the quadriceps muscle so that the patella stays lined up in the groove. Patients report less pain and improved function with these forms of treatment. - Corticosteroid injections in to the knee joint will be helpful for a severe flare-up pain If everything else fails in providing you symptom relief and if your condition is worsening despite the treatment, then surgical management may be an option. Hope I have addressed your query. Happy to help further Regards
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Follow-up: MRI showing synovial effusion in knee joint. No improvement with physical therapy. Is it necessary to go for surgery? 4 hours later
My condition has persisted for years,,,,,has only deteriorated,,,,and after many attempts at conservative treatment has simply not gotten any better.......ive been told my surgery because of the nature of injury,,,,involving the patellar,,,would require a lengthy recovery
Answered by Dr. K. Naga Ravi Prasad 11 hours later
Brief Answer: Try Intraarticular injections. Detailed Answer: Hi, Nice to hear from you. If you are really vexed up with your pain in the knee and the conservative management is not offering you any improvement, then there is no rationale in continuing the medical treatment. Before you resort to surgical management, you can try INTRA ARTICULAR SYNVISC INJECTIONS and see whether it is going to benefit you or not. Approach your treating doctor and discuss about Synvisc injections. Even if this procedure also fails to provide you pain relief, then appropriate surgical management is needed depending upon the pattern and severity of cartilage loss in the patello-femoral compartment. Hope I have justified your query. Good day
Above answer was peer-reviewed by
Follow-up: MRI showing synovial effusion in knee joint. No improvement with physical therapy. Is it necessary to go for surgery? 3 hours later
My doctor has already suggested surgery.....the only 2 diagnostics he has done are xrays and of course the MRI....can the MRI show the severity and pattern of cartilage loss....or does another test have to be performed to diagnose
Answered by Dr. K. Naga Ravi Prasad 36 minutes later
Brief Answer: Arthroscopy is better than MRI scan. Detailed Answer: Hi, this is just to let you know that ARTHROSCOPY of the knee provides better inform than MRI scan in estimating the severity and cartilage loss over the articular surfaces of the knee joint. This is because of the fact that arthroscopy allows for direct visualisation of the inside of the joint through arthroscope. So, I personally feel that arthroscopy is a better tool than MRI in your case. Have a great day.
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