Grade one intra meniscus SI changes seen in posterior horn of medial meniscus

Patient

Q: Hello Doctor
I am a 27 year old male. About 1.5 years ago i experienced this knee problem for the first time. I am not a sportsperson. I had this habit of folding my left leg for all the time while working(even while sleeping).One day when i unfolded i felt some sort of numbness for the first time. Since then i used to experience that dull pain whenever i bend the knee.It was just some dull pain. I could walk, climb stairs and it was very normal.But if i bend my leg for 10 min i fell that dull pain and the discomfort.After more than a year of suffering i tried to consult a physiotherapist. He initially diagnosed it as chondromalacia and kept giving physiotherapy for sometime. The therapy included some electric simulation(not sure about the name), thermal heat and occasionally ultrasound and gave the treatment for about a month (with some gap of 10 days break due to my personal commitments)When i complained it is only getting worsened he said it was grade 3 chondromalacia and increased the intensity of the electric simulation. After that my situation got worse. I could not even stand for more than 10 min.This time i consulted ortho and described everything and got the MRI scan. The doctor said the physio can't do much harm. He said there is a minor medial meniscus tear and i do not need surgery. He suggested some quadriceps strengthening exercises and asked me to consult after 6 months.

My question is

1) Can physio therapy go wrong? He gave the treatment assuming it was chondromalacia when it is actually grade1 meniscus tear.
2)Can this condition (Grade 1 intra meniscus SI changes seen in posterior horn of medial meniscus)be cured with out surgery? I just read some where that these exercise will only minimize the pressure on the meniscus. So is it left split or will it automatically merge the split part. Here are my details of MRI scan
Technique: Multiplanar, Multisequence imaging
Findings:
Retropatellar bursa (knee joint space): Appears normal.
ACL:Appears intact
PCL: intact
MCL: intact
lateral collateral ligament complex: intact
Medial Meniscus:Grade 1 intra meniscus SI changes seen in posterior horn of medial meniscus.Possible degeneration
Lateral Meniscu: intact
Bones in view: Bo bone marrow edema is seen.


Awaiting your reply

Thanks
Srikanth

Doctor

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