First of all is Anterior knee pain a symptom and not a disease. Somehow it is similar with Trochlear Dysplasia, which means a shallow or flat groove for the kneecap. You might have an MRI that says trochlear dysplasia, but it is likely you have no symptoms from this. Nevertheless are a few patients troubled by severe chronic anterior kneepain based upon trochlear dysplasia. Some of these patient might be helped very well by a trochleoplasty surgery. Read more on the page for anterior knee pain, the page for trochleoplasty and the page for trochlear dysplasia
Eventually get a second opinion from another patellofemoral surgeon - not just a standard orthopaedic surgeon. You are also welcome to book at Skype or Whatsapp consultation with me for 150 euro prepaid. I need to see you MRI before the meeting. (contact me on [email protected]). Another solution is to accept the pain and reduce your level of activity to a lower level. The knee surgeon, Scott Dye, has for years spoken for the 'functional envelope'. This could be a solution for you. Eventually you can do some reading in the following special issue incl a paper from my hand.
Left you see a axial view of a 36 year old women. She had severe anterior knee pain for 20 years. During her patellofemoral arthroplasty surgery there were no cartilage left in the patellofemoral joint. If she just have had a trochleoplasty when she was younger, this may have given her 20 years without pain and likely this soulc also have prevented the development of osteoarthritis
Chronic anterior knee pain
Back in 1998 we did a follow-up on patients having anterior knee pain.We found, that about half of the patients continue to have light to moderate pain for years. About one out of 10 continues to have severe chronic pain. You can download a PDF copy here. Later have these findings been confirmed by several others. For a group of patients having severe chronic pain, a number of anatomical factors can cause the patella to maltrack or cause the pressure in the patellofemoral joint to increase. These issues can stress the cartilage (chondromalacia patellae) and this can cause inflammation or increased pressure that eventually leads to pain.
In case you would like a second opinion regarding your MRI or just your general knee situation, I do Skype consultations. The cost is 150 euro - email [email protected]