Dr. Renjit George Marcus
Orthopedician and Traumatology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have attached a report of a male adolescent. Every day, he would jog 6 to 8 kilometers. Two months ago, he started experiencing moderate pain in his right knee. He had stopped running for a week, but the pain continued. Also, the discomfort and swelling in his right knee persisted. Walking became difficult for him, and the swelling and pain surrounding his right knee worsened. He has intermittent mild pain in his left knee and has been unable to attend school for the past 15 days. What should he do, considering his local doctor does not have many treatment options based on his MRI results?
Hello,
Welcome back to icliniq.com.
I understand your concern.
I reviewed the reports (attachment removed to protect the patient's identity). This is a common occurrence of patellar instability. As patella is slipping to one side while bending and exerting himself, causing discomfort. It is due to his patella being higher than usual and more lateral than previously. Prolonged running or another trauma has weakened the ligament on one side, worsening the condition, and resulting in the current impairment. Surgery is required to rebuild and strengthen the medial patellofemoral ligament along with medialisation and lowering of the patella. A course of physiotherapy with thigh muscle strengthening can be done, although it is unlikely to resolve the condition. I would recommend surgery. Until then, use a knee brace with an open patella. Avoid intensive exercise until surgery. After surgery, he will need to take rest for three weeks.
The Probable causes
Investigations to be done
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Orthopedician and Traumatology
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