Dear Ask The Doctor: Hi, I was injured back in Sept 09 and surgury was preformed to remove a horizontal cleavage tear to the posterior horn of the medial meniscus. Since that time I have had constant burning pain in my knee. I had another MRI performed 2 weeks ago and they found there is a focal osteochondal lesion within the posteromedial quadrant of the medial femoral condyle chaacterized by focal fissuring of hyaline cartlage with associated mild to moderate bone marrow edema. The lesion measures approx 9mm in diameter. The is another horizontal cleavage tear in the posterior horn and body of the medial meniscus and a subacute grade 2 tear of the MCL. I am being told that there is nothing that can be done and will have to deal with the pain and go to a pain clinic. I feel that there is something wrong, any ideas?
Dear Patient: According to the description that you made of your burning knee pain and how it developed, there is a high probability that we are in presence of a Neuritis, which produces a pain occurring from a peripheral nerve inflammation probably resulting from the surgery, in which the sensitive nerve that supplies sensation to that part of the knee was involuntarily touched. The recovery of the inflammation or lesion of the peripheral nerves takes time.The suggested strategy would be: conservative therapy, such as physical therapy, moist heat application, analgesics, anti-inflammatory drugs as Ibuprofen (“Motrin”, “Aleve”) and avoid wearing constrictive garments close to the affected knee, also you can try capsaicin cream locally. If does not get better with these measures it is strongly recommend to be evaluated by a orthopedic surgeon and maybe consider the local corticosteroid injection which might provide more chronic relief of symptoms.