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  • Q&A with Australian Health Practitioners

    How can I stop grade 4 chondromalacia pain in my right knee?

    Related Topics
    Osteoarthritis Rheumatology Sports Injuries & Prevention
    I am 52 and suffer bad knee pain. Pain is there nearly all day everyday. I am using a walking stick to help me walk. Going up and down stairs is excruciatingly painful as is sitting for too long. I have been told I need arthroscopic surgery and lateral release surgery on my right knee. Now my left knee is also painful. Will this surgery help ease my pain and will I need knee reconstruction surgery at a later date. Please help.
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  • Errol Lim

    Physiotherapist

    Errol is the managing director of BJC Health, an arthritis centre located in three suburbs across Sydney. BJC Health's group of doctors and health practitioners … View Profile

    From the history you have presented, it sounds like you mean chondromalacia in your knee cap joint (patella). It is difficult to comment on whether you require surgery or not as multiple factors will need to be assessed such as whether you have trialled conservative care (exercise rehab, medications), what sort of biomechanics you present with and other pathology in your knee apart from the kneecap joint.
    If I can assume that your general biomechanics are not so bad and that you do present with osteoarthritis in your knee, then all the research points to losing weight if you are overweight to lessen the load on the knee. If you are not overweight, then an intense rehabilitation program is needed specific to your knee/leg focused at regaining the correct muscle activation patterns to help keep your knee cap stable and tracking the right way. Other considerations with your rehab program should involve looking at your hip, pelvis, lower leg, feet and surrounding muscles at these regions to make sure they are all working in alignment and turning on at the right time respectively. Only then will the load in the knee be dispersed lessening the pain in the region. Be prepared for weeks to months of exercise rehabilitation.

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  • Ingrid Pitt

    HealthShare Member

    Thankyou for your response to my question. I have trialled 6 months of exercise rehabilitation, medication and steroid injection all to no relief. I am overweight and have lost 4kgs so far. I have grade 4 chondromalacia and severe OA of patello femoral joint. Really hard to get any great pain relief. I have knee swelling and shooting pain into my shin now. Is the surgery suggested the best for me. I need relief from this constant pain.

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    Thanks

    Errol Lim

    Physiotherapist

    Errol is the managing director of BJC Health, an arthritis centre located in three suburbs across Sydney. BJC Health's group of doctors and health practitioners … View Profile

    Again, it is hard to comment whether the lateral release is the treatment of choice. It will really be up to your surgeon dependent on what sort of knee alignment and biomechanics you present with. Other options (and I am not a surgeon) would be to change the alignment of the patella with other surgical techniques. If you are unsure, you should get a second surgical opinion.
    Well done with trying so hard with the rehab program thus far. It does really need to be specific for you. I hope you keep at it. As for weight loss, the best way to do this is to see a dietitian. Studies have shown they get the best results and all the research shows that not having the excess weight is the best thing for an osteoarthritic knee

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