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What Causes Painless Spasms Behind The Knee?

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Posted on Wed, 19 Oct 2016
Question: Dear Dr. Tayal,
You may recall that three weeks ago exactly we discussed my behind-the-knee painless spasm. Fortunately it has improved but I am concerned that it has taken 3 weeks. I am still afraid to walk at a normal pace because I can still get a clicking and slight spasm that makes me feel like I could fall. Also, if I sit too long with my knee bent I have the clicking when I get up to start walking. I did an MRI last week. I am attaching the report of that MRI as well as the report from exactly 2 years ago, I notice there are differences between them, regarding the meniscal root and the chondromalacia. Could you review them and give me your comparative analysis? The physiatrist recommends Supartz injections that I received 2 years ago, plus a knee band and therapy to strengthen my muscles. My main concern is this clicking and spasm. Please see attached, and thank you.
doctor
Answered by Dr. Praveen Tayal (21 minutes later)
Brief Answer:
Surgical repair will help.

Detailed Answer:
Hello,
Thanks for posting your query.
I have seen the attached reports. The MRI scan in 2014 shows lesser degenerative changes. The recent MRI scan suggests more inflammation, osteoarthritis and tear of posterior meniscus. IT can be related to stress or a direct injury and is responsible for the instability of the joint.
The knee injections and physiotherapy can reduce inflammation and strengthen muscles but will not cause healing of the tear. Do consult an orthopedician and see if arthroscopic repair is possible. The clicking and spasm wil reduce after a surgical repair.
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.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Tayal (14 minutes later)
Thanks again. I don't know what could have caused the tear, but in any event it does not even give me pain. All I experience is the clicking/spasm even though it is much reduced now after 3 weeks. Would I consider repair even if I have no pain? Is it possible that arthroscopic repair is not able to be done on the posterior tear? Is it an unusual case? And what about the matter of the chondromalacia mentioned in 2014 that is not mentioned in 2016? Thanks.
doctor
Answered by Dr. Praveen Tayal (6 minutes later)
Brief Answer:
Surgery will help in better recovery.

Detailed Answer:
Hello.
Thanks for writing again.
A complete tear cannot heal with rest or physical therapy and sooner or later it will add to the complications and instability.
Even if it is painless, getting it repaired will make the physiotherapy and muscle strengthening even easier.
Arthroscopic repair can be done but sometimes an old tear due to wear and tear is difficult to repair due to a fragile tissue. It is not unusual or a difficult case but getting 100% results is doubtful and depends on expertise of the surgeon.
Chondromalacia can decrease with time and osteoarthritic and other inflammatory changes are more prominent now.
Hope my answer is helpful.
Do accept my answer in case there are no further queries.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Praveen Tayal (19 minutes later)
Thank you. Do you mean that my case as seen in the reports is such that arthroscopic repair into that difficult area of the meniscus may do very little good? And does the fact of a root tear mean that the meniscal root itself is detached from the bone which cannot be repaired easily in my case?

Also, in terms of exercising the knee area, does the information limit what kind of exercise I could do, including a stationary bicycle? And given my gait problems because of the surgery for the monoplasia 50 years ago, am I headed for a full knee replacement in 5 or 10 years?!
doctor
Answered by Dr. Praveen Tayal (8 hours later)
Brief Answer:
Knee replacement may be needed after few years.

Detailed Answer:
The arthroscopic repair is difficult but will provide stability to the knee. You will be able to do the daily activities better.
The exercise depends on the amount of stress your knee can bear without getting injured. This can be assessed by a physiotherapist. He can guide you regarding the exercises and range of movement.
A full knee replacement may be needed after 5-10 years if the degenerative changes progressed like this.
Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Praveen Tayal

Orthopaedic Surgeon

Practicing since :1994

Answered : 12314 Questions

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What Causes Painless Spasms Behind The Knee?

Brief Answer: Surgical repair will help. Detailed Answer: Hello, Thanks for posting your query. I have seen the attached reports. The MRI scan in 2014 shows lesser degenerative changes. The recent MRI scan suggests more inflammation, osteoarthritis and tear of posterior meniscus. IT can be related to stress or a direct injury and is responsible for the instability of the joint. The knee injections and physiotherapy can reduce inflammation and strengthen muscles but will not cause healing of the tear. Do consult an orthopedician and see if arthroscopic repair is possible. The clicking and spasm wil reduce after a surgical repair. 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. Wishing you good health. Regards. Dr. Praveen Tayal. For future query, you can directly approach me through my profile URL http://bit.ly/Dr-Praveen-Tayal