What is the exact problem with my right knee?

Question

Hi doctor,

One year back, I had problems in my right knee like loose feeling, instability, slight pain, etc. When I consulted a doctor, he suggested Cartigen-Duo, Miol-OD, and Acepark gel. In the X-ray, he found that the pain was due to cartilage damage in the knee. I continued the full course of medicine and after that, there was no problem in my knee. I have attached that x-ray report and doctor's prescription here for your reference. If I walk a long distance then the problem starts again and it gets cured as soon as I apply that gel. However, last week again the problem started. This time I am using a kneecap for support while walking. What is the exact problem with my right knee? Should I start Cartigen-Duo and Miol-OD again? Please suggest any alternative gel as the earlier one is not available. What should be done for a permanent cure of this knee problem? Can I walk a long distance? What precautions should be taken for knee pain? I am looking forward to your positive reply. Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through your history as well as the images attached (attachment removed to protect patient identity) with it. The history points towards a diagnosis of internal derangement of knee, which means injury to the soft tissues in and around the knee providing stability to it. Injury to these can cause instability of the knee and such injurie require MRI evaluations rather than a plain X-ray film. There is some change in the upper part of tibia and its articular surface, but it is not clear from the X-ray. There are no clinical notes regarding knee examination findings which are of utmost important now. My recommendation is to get clinically examined and if possible provide clinical notes. Also get a new x-ray to know the current change as the attached one is old. Lastly, I would like to know the history of injury to the knee joint either it happened while playing or any twist at the knee. Is there any feeling of giving way of the knee while walking? Kindly provide answers to these questions for better evaluation of your condition. After learning details I will answer your question with detail to your satisfaction.

Thank you.

Answer 2

Hi,

Welcome back to icliniq.com.

As I suggested there is a ligament injury and the old injury is also seen on x-ray. You had ACL injury (anterior cruciate ligament) during your childhood along with the fracture of tibial spine. There is some component of cartilaginous changes occurring due to instability. We need to see the fresh MRI and clinical examination notes. Then, I can comment on the need for surgery.

Thank you.