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Sports Medicine

Knee Pain

05/17/2010

Question:

I have had 6 knee surgeries since 1990. ACL reconstruction and lateral release included. Others have been to clean the knee up and the last was 7 years ago to re-tighten the ACL. I have just had another MRI done and it showed a meniscus tear, severe grade 4 chronomalacia and other things I am not sure of. I do have an appt. to see an orthopedic but need to know what my concerns would be this time.

Answer:

You will most likely want to ask if you can avoid undergoing a 7th knee surgery, and find out if there are any non-surgical treatment options which may help or which haven't yet been tried. A torn meniscus does not necessarily have to be operated on, since it may not be the cause of your knee symptoms.

 

Grade 4 chondromalacia - a term which means "cartilage softening", and which refers to degenerative changes in the cartilage surface on the end(s) of the bone(s) - may account for some or even the majority of your knee symptoms, in which case trimming the torn portion of your meniscus may not significantly improve your pain. Alternatively or in addition, the "other things" you noted which were mentioned in your knee MRI report may be contributing to your knee symptoms, as well.

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Response by:

Brian L Bowyer, MD Brian L Bowyer, MD
Clinical Associate Professor
Physical Medicine & Rehabilitation
College of Medicine
The Ohio State University