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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Knee Arthroscopy Found Grade IV Wear And Tear Of Patella, Lateral Meniscus Tear. Still Painful, Draining Fluid. Long-term Prognosis?

I recently had a left knee arthroscopy . Finding Grade 4 wear and tear of the patella and also lateral tear in meniscus which was not repaired or removed. Still having pain 3 months post op despite numerous physio and acupuncture sessions. Also had fluid drained off knee last week and cortisone injection. What do you think my long term prognosis will be
Tue, 22 Jul 2014
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Orthopaedic Surgeon 's  Response

Hello,

I have studied your case.

According to your symptoms and findings there is osteoarthritis of your knee.
You can start cartilage protecting medication like chondritin sulphate, that you need to take for couple of months.

Physiotherapy like ultrasound and tens will help, along with knee exercises

Life style changes will help in reducing pain which include,
LOAD REDUCTION : Protecting the joint from excessive load may slow down the rate of cartilage loss. It is also effective in relieving pain. The heavier you are, the more stress you put on your joints.
ACTIVITY MODIFICATION -It is important to maintain as much activity and joint motion as possible, but impact activities will aggravate arthritis. Running and jumping will often accelerate cartilage loss from the joint. The key is to focus on low impact activities, such as swimming or cycling.

ANALGESIC MEDICATION : Simple over the counter medications like acetaminophen is sufficient in most cases.
VISCOSUPPLEMENTATION: Hyaluronic acid injections given into the joint (especially large joints like knee joint) in prescribed dosages will give good short term pain relief in arthritic joints ranging from 1-2 years.

Prognosis is not good in your case.
If there is no relief with all these procedures then the last option remains of total knee joint replacement.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.
If you are satisfied with answer do not forget to give rating to this answer.

Wishing you good health.

Take care
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Knee Arthroscopy Found Grade IV Wear And Tear Of Patella, Lateral Meniscus Tear. Still Painful, Draining Fluid. Long-term Prognosis?

Hello, I have studied your case. According to your symptoms and findings there is osteoarthritis of your knee. You can start cartilage protecting medication like chondritin sulphate, that you need to take for couple of months. Physiotherapy like ultrasound and tens will help, along with knee exercises Life style changes will help in reducing pain which include, LOAD REDUCTION : Protecting the joint from excessive load may slow down the rate of cartilage loss. It is also effective in relieving pain. The heavier you are, the more stress you put on your joints. ACTIVITY MODIFICATION -It is important to maintain as much activity and joint motion as possible, but impact activities will aggravate arthritis. Running and jumping will often accelerate cartilage loss from the joint. The key is to focus on low impact activities, such as swimming or cycling. ANALGESIC MEDICATION : Simple over the counter medications like acetaminophen is sufficient in most cases. VISCOSUPPLEMENTATION: Hyaluronic acid injections given into the joint (especially large joints like knee joint) in prescribed dosages will give good short term pain relief in arthritic joints ranging from 1-2 years. Prognosis is not good in your case. If there is no relief with all these procedures then the last option remains of total knee joint replacement. Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries. If you are satisfied with answer do not forget to give rating to this answer. Wishing you good health. Take care