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Sports Medicine/knee pain treatment options


I recently injured my knee thanks to my 100 lb dog. I just got my mri results and I'm trying to figure out if surgery is in my future. If so what will the extent of the surgery be. I've had 3 surgeries in the past but this is the most extensive mri result ive ever received. I'm just wondering what the mostly likely treatment plan that would be recommended.
There is an ovoid, complex, lobulated parameniscal cyst (10 x20 mm) arising along hoffa's fat pad at the anterior intercondylar notch adjacent to the lateral meniscus ventral root ligament which represents a tear.
the medial meniscus is normal and morphology and signal intensity.
the anterior cruciate ligament demonstrates thinckening with intasubstance signal abnormality representing a partial thickness and  imtasubstance tear.  Of note, the parameniscal cyst extends into the reason of the tibial attachment of the anterior cruciate ligament.
the posterior cruciate ligament is normal and morphology and signal intensity. the medial collateral ligament, lateral collateral ligament complex and patellar tendon are normal and morphology and signal intensity. A punctate enthesophyte arising along the quadriceps tendon attachment to the patella.
there is a physiologic amount of fluid in the joint space. trace semi membraneous bursal fluid is identified.
the marrow signal demonstrates no infiltrative process. A subchondrial cyst is identified within the midline tibial plateau.
there is a slight patellar tilt. the tibial tubercle to trochlear groove distance is 8 mm. there is a pateller articular cartilage signal cartilage signal heterogeneity. No osteochondral defect, fracture or significant cartilage loss is identified.
1. large, avoid parameniscal cyst adjacemt to a torn lateral meniscus dorsal root ligament.
2. Partial thickness intrasubstance anterior cruciate ligament tear.Of note, the parameniscal cyst extends along the anterior cruciate ligament attached to the tibia.
3 slight lateral patellar.

Hi Leslie- I recc that you get orthopaedist opinions re surgical options including whether non surgical options would be possible like physical therapy. Your age & history, (3surguries) are factors.  Also your activity level. Another question is what "new damage" was done with latest injury. Consulting with your previous surgeon makes sense since they would know what was done previously & what has changed. Often in women, foot mechanics play a roll so make sure orthotics are included in your future.
Sounds like surgical problem, but make sure you get few orthopaedic opinions & explore conservative options. Good luck,.. Dr. Bob Weil

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Dr. Bob Weil


Diagnosis & treatment & PREVENTION of foot & foot related lower extremity sports related problems. Indications & uses of prescription in shoe orthotics. Foot, ankle functional exercises for injury prevention & enhanced performance. Specific specialty in orthotic use in figure skating & hockey. Access to all topics re sports medicine at radio shows & articles re "the physical & mental challenges of the high performance youth athlete.


Podiatry Management Magazine, 9/10/10, "Hitting the Airwaves- this podiatrist uses his own radio show to promote Podiatry Podiatry Management Mag-6/-7/2010, "Figure Skating, Olympic Gold, & Podiatry Lower Extremity Review,7/2012, Pediatric Obesity weighs on Bones & Joints Numerous articles,"the sports doctor"- listed news articles 3 years of weekly radio shows, "the sports doctor", listed shows

BA degree science Univ. Louisville, Doctor Podiatric Medicine, Scholls College Podiatric Medicine, Chicago, Ill.

Past/Present Clients
Treated many athletes in all sports, tennis- John McEnroe, Tracy Austin, numerous members of 85 Super Bowl Bears Evan Lysacek, 2010 men's Olympic Gold Medal figure skating champion.

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