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Knee Cartiledge and Petelar Alignment

Getnbiggger

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So my right knee has been getting swollen lately. Went to the orthopedist and he drained over 100 cc and gave me a cortisone shot. The swelling went down but about 4 weeks later its back on and off. I had an MRI and the ortho said my cartiledge under right side of patella is gone to the point of bone on bone, showing bone bruising. He also said my knee cap was not aligned properly. Dr. advised having at least petella realignment surgery and also cartridge replacement at the same time. He indicated that the realignment was at minimum necessary but could not say if that alone would be enough to take the stress off of the area where there was no cartiledge so that I could avoid cartiledge replacement and or a knee replacement down the road. He seemed to indicate it could help eliminate or avoid knee replacement but would give no guarantees. He did indicate that if I had the cartiledge replacement as well I could avoid knee replacement since my knee was otherwise in good shape. The recovery from realligment surgery is supposed to be relatively short and easy while recovery from cartiledge replacement could take a year before I'm back to full speed. Anyone have either or both of these surgeries? Are there alternatives which will allow me to eliminate the need for a knee replacement. If I do go with surgery should I go with just the reallignment or do both at the same time. As always, advise is greatly appreciated, thanks

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Last edited:
So my right knee has been getting swollen lately. Went to the orthopedist and he drained over 100 cc and gave me a cortisone shot. The swelling went down but about 4 weeks later its back on and off. I had an MRI and the ortho said my cartiledge under right side of patella is gone to the point of bone on bone, showing bone bruising. He also said my knee cap was not aligned properly. Dr. advised having at least petella realignment surgery and also cartridge replacement at the same time. He indicated that the realignment was at minimum necessary but could not say if that alone would be enough to take the stress off of the area where there was no cartiledge so that I could avoid cartiledge replacement and or a knee replacement down the road. He seemed to indicate it could help eliminate or avoid knee replacement but would give no guarantees. He did indicate that if I had the cartiledge replacement as well I could avoid knee replacement since my knee was otherwise in good shape. The recovery from realligment surgery is supposed to be relatively short and easy while recovery from cartiledge replacement could take a year before I'm back to full speed. Anyone have either or both of these surgeries? Are there alternatives which will allow me to eliminate the need for a knee replacement. If I do go with surgery should I go with just the reallignment or do both at the same time. As always, advise is greatly appreciated, thanks

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Sounds like a very bad recommendation. Please post up your MRI results so i may give you an informed opinion
 
Sounds like a very bad recommendation. Please post up your MRI results so i may give you an informed opinion
Not sure how I would post results as they are on CD ?

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Not sure how I would post results as they are on CD ?

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I meant the written report but sure ideally if you uploaded the files and shared them I could look at them and give an unbiased opinion. But if that is not possible you can post the written report ( not just the impression) and I can tell you how to manage based on that and after some more info.
 
I meant the written report but sure ideally if you uploaded the files and shared them I could look at them and give an unbiased opinion. But if that is not possible you can post the written report ( not just the impression) and I can tell you how to manage based on that and after some more info.
Will do, thanks

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Try a chiropractor first AND prolotherapy in your city before any surgery my friend.

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Try a chiropractor first AND prolotherapy in your city before any surgery my friend.

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I've never in my hours and hours and hours of being worked on by a chiropractor ever gotten anything out of it. Just my experience. Physical therapy fixed all of my issues. I struggle with knee and hip issues.
 
Try a chiropractor first AND prolotherapy in your city before any surgery my friend.

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I appreciate the input but chiropractic ain't gonna regrow cartiledge. Prolotherapy on the other hand may. I'm looking in to it... Thanks

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A mis alignment of you hip/knee can be the reason why you have no cartilage left. Ice, collagen, curcumin, and flossing should help.
 
The question of the day is: will petallar realignment alone without cartiledge transplant allow me to eliminate the need for knee replacement in the future by taking stress off of area where cartiledge no longer exists?

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if you want collagen type II message me, ill give you a special pm bro price
 
The question of the day is: will petallar realignment alone without cartiledge transplant allow me to eliminate the need for knee replacement in the future by taking stress off of area where cartiledge no longer exists?

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Impossible to answer without knowing what patellar alignment issues you have. Flattened patella median ridge? hypoplastic facet? what does your trochlea look like? How is your MPFL an LPFL look? Where is the patella defect? What is the size? Is the fragment gone or just unstable?

Getnbigger: I literally do this for a living. This is the type of decisions i make on a daily basis. If you would like a real answer I will need more info.
 
Impossible to answer without knowing what patellar alignment issues you have. Flattened patella median ridge? hypoplastic facet? what does your trochlea look like? How is your MPFL an LPFL look? Where is the patella defect? What is the size? Is the fragment gone or just unstable?

Getnbigger: I literally do this for a living. This is the type of decisions i make on a daily basis. If you would like a real answer I will need more info.
Thanks for. I'm in process of getting my records which I will post once received. I really appreciate your assistance on this as surgery is obviously not my preferred option but will go that route if absolutely necessary to avoid knee replacement. I'm not feeling any pain at this point, just intermittent swelling so i'd like to explore all options while I have this window of opportunity. Once again, I very much appreciate your input! Thanks

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Are you genetically predisposed to arthritis? Hope they did labs to check for markers like HLA-B27, Sero, etc.
 
Impossible to answer without knowing what patellar alignment issues you have. Flattened patella median ridge? hypoplastic facet? what does your trochlea look like? How is your MPFL an LPFL look? Where is the patella defect? What is the size? Is the fragment gone or just unstable?

Getnbigger: I literally do this for a living. This is the type of decisions i make on a daily basis. If you would like a real answer I will need more info.

Hey Gotgame-
Attached are the MRI results . I hope this is what you need. Ill PM them to you as well. thanks for your help and any direction you can give.
 

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Hey Gotgame-
Attached are the MRI results . I hope this is what you need. Ill PM them to you as well. thanks for your help and any direction you can give.

No..realignment surgery is NOT indicated bro. That would be complete bullshit. You dont have an underlying "alignment" issue you have a degenerative issue which is then resulting in the alignment issue. its like saying oohhh my car is tilting to the right it has an alignment issue i could correct the frame.. NO you have two flat tires so its tilting that way.

You already have subjacent reactive marrow edema on both sides of the PF joint you cant just go in there and do a microfracture procedure and hope to heal it..It does not work like that.

The good news is that you weight bearing tib fem joint is ok and your menisci are even in decent shape.

At you age and those findings already progressed there is not much you are gonna do. My suggestion is Depo Medrol shot do drop down the synovitis. Lay off the leg extensions its making things worse upon extension. For your given knee findings you are gonna be doing any more real damage to be honest just grinding down some more PF joint cartilage which is considered to be acceptable as any time of surgery would make things worse and your weightbearing is not effected.

You can wear a brace and tape lateral to medial to help give it some stability and slow down the process as you are laterally subluxed.

I repeat...realignment surgery is NOT going to help you. Not with those findings. No surgeon i have ever met would go on with those findings because its just going to make things worse without actually taking the graft because of the issues.

In summary.. no realignment or cartilage surgery, dont worry you cant do too much more damage, steroid shots, no supplement is gonna help, bracing and taping.

However...if you really really want something more done and this is greatly affecting your quality of life then just have a petalla resurfacing done and that will help. None of this alignment BS.
 
Thanks so much for the great info. Couple of questions:
1. Is knee replacement a foregone. necessity down the road? If so, can it be avoided?
2. Why is injectable prednisone advised vs oral ?
3. Do you prefer I get Synvis as 1 shot or 3?
4. Can you recommend a brace that you feel works best?
5. Can I continue to squat, and lunge?

Thanks!!!!


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No..realignment surgery is NOT indicated bro. That would be complete bullshit. You dont have an underlying "alignment" issue you have a degenerative issue which is then resulting in the alignment issue. its like saying oohhh my car is tilting to the right it has an alignment issue i could correct the frame.. NO you have two flat tires so its tilting that way.

You already have subjacent reactive marrow edema on both sides of the PF joint you cant just go in there and do a microfracture procedure and hope to heal it..It does not work like that.

The good news is that you weight bearing tib fem joint is ok and your menisci are even in decent shape.

At you age and those findings already progressed there is not much you are gonna do. My suggestion is Depo Medrol shot do drop down the synovitis. Lay off the leg extensions its making things worse upon extension. For your given knee findings you are gonna be doing any more real damage to be honest just grinding down some more PF joint cartilage which is considered to be acceptable as any time of surgery would make things worse and your weightbearing is not effected.

You can wear a brace and tape lateral to medial to help give it some stability and slow down the process as you are laterally subluxed.

I repeat...realignment surgery is NOT going to help you. Not with those findings. No surgeon i have ever met would go on with those findings because its just going to make things worse without actually taking the graft because of the issues.

In summary.. no realignment or cartilage surgery, dont worry you cant do too much more damage, steroid shots, no supplement is gonna help, bracing and taping.

However...if you really really want something more done and this is greatly affecting your quality of life then just have a petalla resurfacing done and that will help. None of this alignment BS.
Also do you have any opinion regarding prolotherapy and PRP? Thanks

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Also do you have any opinion regarding prolotherapy and PRP? Thanks

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responded to the other questions via PM.

As for this...bro your cartilage is gone.. nothing you do is gonna change that. Prolo and PRP has its uses for very specific tendon and muscular injuries. I perform both under ultrasound but those WILL NOT help you in any way and may cause more damage then if you didnt.
 
Gotgame to the rescue. Pretty awesome of you GG.

Hope you have a good 4th.
 

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