I have knee stiffness and cracking sound in the knees with walking difficulty. Do I need surgery?

Question

Hello doctor,

I am a 30-year-old. I have pain, stiffness, and cracking or creaking sounds in both the knees and joints. Pain is persisting for 24 hours and there is difficulty in walking. There are some other symptoms apart from pain which I have listed below: Locking of joints and stiffness if I sit in a specific posture for long. Weakness in joints all the time in standing and walking positions. I cannot sit down in a squat position due to enormous pain and even if I do I would not be able to stand without any support. Not able to climb up and down the stairs properly. I can only able to bend the right leg knee on the stairs. No history of any injury, but I have bow legs. During a consultation for the same issue, one of the doctors did say that my axis is a little twisted and advised me to wear a correcting innersole in my shoes, which unfortunately I was not able to wear as no shoe was fitting me after inserting those soles. My height is 5 feet 11 inches and my weight is 80 kg so I am a little overweight but not much. I am not a fitness freak, in fact, I do not do much exercise and the majority of my time goes sitting in front of my computer owing to my IT profession.

Chronology of events:

The pain started in my right knee ten months back. The pain was not much at the start and only happened when I used to stand for long. Consulted a couple of doctors who gave me certain medicines like Novovartalon and Celebrex capsules. The medicines did not help and the situation only deteriorated further. Approximately two months back I played football for a little while and the pain started to occur in the left knee as well after which I again went for a diagnosis. This time it was told to me that I have damaged the meniscus and cartilage in both my knees and thus surgery will be required. I went to another doctor who tried exercise and the medicine Celebrex for three weeks which ended last week without any significant improvement. I am currently living abroad due to my professional assignment. Language is one of the biggest barriers here, therefore I wanted to be sure that is this the only safe and best option before proceeding with any of the surgical solutions.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your reports. (attachment removed to protect patient identity). The main findings of the reports are as follows: Left knee rupture of anterior horn of medial meniscus and posterior horn of lateral meniscus. Right knee has a rupture of posterior horn of medial and lateral meniscus. X-ray of both knees suggest chondromalacia (softening of cartilage) in both knees. To summarize you have meniscal injury in both knees. They are unlikely to develop without prior trauma. And as such, based on the MRI (magnetic resonance imaging) reports both your knees require arthroscopic (key hole surgery) repair of the torn menisci. Non-operative treatment is likely to cause continuous pain on the long-run. Arthroscopic surgery has been associated with good results. However, I would advise you to consult a well trained and experienced knee arthroscopic surgeon for your condition. It is a good sign that the rest of your cartilage are relatively normal in MRI, though the exact picture is likely to be confirmed only during arthroscopy. Unfortunately the images in your file did not open up. Kindly send in JPEG format if possible. At present, I would advise you pain killers, relative rest, brace in both knees to prevent further injury to your menisci and cartilage before you plan for surgery.

I have knee stiffness and cracking sound in the knees with walking difficulty. Do I need surgery?

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