The OSTEOARTHRITIS DEPARTMENT => KNEE ARTHRITIS - Injections into the joint => Topic started by: Kefu on November 20, 2013, 09:42:20 PM

Title: Chondromalacia patella and Tight IT band for over 6 years. HELP me!
Post by: Kefu on November 20, 2013, 09:42:20 PM
Chronic anterior knee pain // chondromalacia patella // patella femoral pain

History: Let me begin with some backround. I am 23 years old male currently living in Canada.  I have had anterior knee pain in my right knee for over 6 years. It started when I played soccer, and it just got worse. My IT bands, quads, and hip flexors are really tight. Nothing seems to really loosen them. I have tried physiotherapy from multiple physiotherapists, ART, trigger point dry needling, acupuncture, massage therapy, foam rolling (lacross ball, PVC pipe, rumble roller), suction cupping, strengthing glute medius and maximus, VMO strengthening, orthotics, prolozone, joint supplements, heel wedge for leg length discrepency (my right leg is 1 cm shorter). I dont do any physical activity besides physiotherapy. My pain is at a constant 5/10, sometimes its lower, but sometimes like in rainy days or cold days its even higher. Basically all the physiotherapists are perplexed at my issue and they say that I should not be feeling so much pain. They think my overall mobility and flexibility isn't that bad. But when they massage they notice that my soft tissue is really tight with lots of "junk", adhesive knots, and scar tissue.

Joint supplements:
1) NEM - natural egg shell membrane (500mg)
2) pycnogenol (100mg)
3) fish oil (2000mg)
4) krill oil (500mg)
5) curcumin (500mg)
Note: They dont seem to have helped much. I am thinking of replacing my curcumin with Thorne Meriva (a high potency curcumin, with 20x more absorption) based on all the good reviews. Someone even said its worked better than cortisone shots. I have also tried MSM, glucosomine, and chondroitin, and type 2 collagen from fortigel.

Other supplements for general healthy
1) Magnesium
2) Vitamin D

Diagnostic imaging done:
1) X-ray - showed nothing abnormal besides patella tilt
2) ultrasound - showed mild inflammation in my right knee, nothing serious
3) MRI - getting it done in January

Previous treatments:
1) Physiotherapists - looked at mobility, muscular imbalances, glute medius, glute maxmus, VMO strengthening, stretching, self myofascial release, foam rolling, suction cupping, ART, massage therapy, orthotics, gait analyses, heel wedge for leg length discrepency, trigger point dry needling, acupuncture, postural work, went to Fowler and Kennedy sports medicine clinic in London Ontario, and many other places

2) Dr Robert Banner (London ON) - 6 treatments of Prolozone injections, once every month so far. Only noticed temporary relief of pain, maybe for 2 weeks after each injection. He has recommended EMF (electromagnetic field) protective devices such as diodes. He says it may help since my symptoms are worse on rainy days
Prolozone solution includes: ozone, dextrose, vit b12, lidocaine

Possible Future treatments:
1) Botox (Dr. Gordon Ko in Markham) - into the vastus lateralis (any maybe hip flexor). This has shown to be effective in some recent studies for patients with refractory anterior knee pain. The idea is you shut down the vastus lateralis for 3 months, and you continue to do physiotherapy, this gives you a window of time for selectively strengthening and isolating the VMO. This will help with tracking and tilt issues, and can give symptomatic relief of muscle tightness during the 3 months. Its good for addressing muscular balance issues. Dr. Gordon Ko also does PRP, prolotherapy, hyaluronic acid, and botox into the joint.

2) HGH or testosterone or IGF-1(self injection) - have read this has helped some people on this forum. Particularly Irentat. I am looking into injecting into my own knee to save thousands of dollars. This can help regenerate possible cartilage damage I might have.

3) Dr. Anthony Galea (Etobicoke/Toronto) - he is a prominent sports medicine physician infamous for treating athletes and giving them HGH. Don't know what kind of treatment he would give me. I know he does PRP, but I dont know if he can give HGH anymore since its illegal here in Canada and hes gotten in trouble for that.

If anyone can provide any help on what I can do to help my case, It would be greatly appreciated. I feel like I almost tried everything, and I have gotten almost no relief in knee pain. The only thing that has improved is my muscle tightness, and IT band tightness, but even this might be temporary, as I work my IT bands and muscles every day, and see someone every week for them to be massaged or released.
Title: Re: Chondromalacia patella for over 6 years. HELP ME. Might inject IGF-1 into knee
Post by: JamesDean on November 30, 2013, 08:55:07 PM
Hey Kefu,

Any updates? What did you end up doing? I've gotten HGH injection for my one knee by Dunn and had good results but it is costly, so I was looking into test suspension as it is a lot cheaper.

Hope all is well! Here's to hoping we can cure these knees.
Title: Re: Chondromalacia patella and Tight IT band for over 6 years. HELP me!
Post by: Kefu on January 07, 2014, 08:13:11 PM
Title: Re: Chondromalacia patella and Tight IT band for over 6 years. HELP me!
Post by: Kefu on February 16, 2014, 11:51:42 PM
Had a visit today to an experienced osteopath. She recommends a heel wedge for my leg length discrepancy (right leg is shorter by 1.1 cm, which is the side of my knee pain). I had an argument with her that heel wedges are advised for greater than 2cm discrepancy. She said she did her thesis on leg length discrepancy, and says the osteopathic manipulations wont be of much help if I dont address the leg length discrepancy with a heel wedge. She said the body is out of alignment due to the leg length discrepency and this is causing the right pelvis to shift/rotate anteriorly. She said if I dont use the heel wedge and she does the manipulations the body will just get out of alignment again.

I am confused on what to do. I was wearing the heel wedge for 1-2 months from oct-nov and it didnt help. In fact my knee pain was slightly increasing during this time (dont know if its due to the heel wedge or some other reason such as colder weather). She thinks it didnt help b/c I did not get osteopathic manipulations done during the same time. Their is a lot of conflicting info:

People who told me not to wear a heel wedge: family physician, clinical biomechanical expert who does research at my university and is focused on gait analysis, and foot mechnaics, soc-doc (a highly regarded chiropractor on the internet who specializes in this area), a massage therapist, and other internet sources.

People who told me to wear a heel wedge: initially the PM&R physician (physiatrist) with a chiropractor who work together, and now the osteopath I have seen today.
Title: Re: Chondromalacia patella and Tight IT band for over 6 years. HELP me!
Post by: Clarkey on February 20, 2014, 06:16:31 PM
Hi Kefu,

I have posted on your other post in the general section just click on the link below.

[email protected]
Title: Re: Chondromalacia patella and Tight IT band for over 6 years. HELP me!
Post by: Kefu on April 05, 2014, 05:51:54 AM
Thanks, I replied to your post