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Suggest treatment for pain in knee after fall

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Answered by

Orthopaedic Surgeon
Practicing since : 2003
Answered : 1041 Questions
Question
Hi Doc,

I had a MRI scan of my left knee because I fell on my kneecap and it still hurts more than a month later. I also have a history since childhood of this same kneecap dislocating several times. I'm scheduled to have surgery on the 5th of August for a patella realignment. I do not understand the MRI report however and I was wondering if you could help me with that.

I'm not able to copy and paste the report--so Im going to you the link where the report is located and give the log in and password for the report.

https://www.frcforpatients.com/patientservices/main.htm
Username: XXXx
Password: XXXX2

Thanks,

XXXXXXX XXXX
Posted Tue, 19 Aug 2014 in Bones, Muscles and Joints
 
 
Answered by Dr. Chander Mohan Singh 5 hours later
Brief Answer:
Chondromalacia patella I have explained for you.

Detailed Answer:
Hi,

I have read your query.

There are many causes of chondromalacia, but in your case it seems to be congenital or trauma during childhood.

That is why you have dislocations in childhood.

MRI report always use technical language, so let me simplify it.

The cartilage under your kneecap is a natural shock absorber. Overuse, injury or other factors may lead to a condition known as chondromalacia patella.

Chondro means cartilage and malacia means softening. In this condition the cartilage under the knee fissures and basically breaks down. It leads to a grinding sensation and pain in your knee.


It causes anterior knee pain.

Abnormal "tracking" allows the kneecap (patella) to grate over the lower end of the thighbone (femur), causing chronic inflammation and pain.

You have trochlear dysplasia means that your femur trochlea loses its normal concave anatomy to become flat and sometimes convex with highly asymmetrical facets.

Chondromalacia patella has also been called patellofemoral syndrome.

Your MRI report show that you have abnormal patellar "tracking" toward the lateral (outer) side of the femur. This slightly off-kilter pathway allows the undersurface of the patella to grate along the femur, causing chronic inflammation and pain.

This all leads to tendinitis and bursitis in joint.

Treatment of chondromalacia patella involves improving the alignment of the patella during contraction of the thigh muscle.

I hope you have got your answer.

Thanks.

Dr.Singh.
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