Knee Pain: Potential Causes and Treatment Options - Orthopedics

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Knee pain can be a complex issue, often stemming from various underlying causes. In your case, the symptoms you've described, particularly the pain during activities such as climbing stairs, suggest a potential issue with the knee joint, possibly related to patellar cartilage softening, commonly known as patellofemoral pain syndrome or chondromalacia patellae. This condition occurs when the cartilage on the underside of the kneecap (patella) becomes softened or damaged, leading to pain, especially during activities that put stress on the knee.

The X-ray findings you mentioned, where one side of the joint space appears narrower than the other, could indicate early signs of osteoarthritis or other degenerative changes in the knee joint. This asymmetry might contribute to the uneven distribution of forces across the joint, exacerbating your pain during movement.

Regarding the treatment options, your physician's recommendation to perform exercises while seated with your legs elevated is a common conservative approach aimed at strengthening the muscles around the knee, particularly the quadriceps. Strong quadriceps can help stabilize the knee joint and reduce the load on the patella, potentially alleviating pain.
If conservative measures do not yield improvement, surgical options may be considered. The "small surgery" your doctor mentioned could involve procedures such as lateral release, which aims to relieve pressure on the patella by cutting the tight lateral retinaculum (the tissue on the outer side of the knee). This procedure can help realign the patella and improve tracking, thereby reducing pain. However, as with any surgical intervention, there are potential risks and side effects.
One concern with lateral release is that it may lead to weakness in the quadriceps muscle, particularly if the muscle is not adequately rehabilitated post-surgery. This weakness can sometimes result in instability or a feeling of giving way in the knee. Additionally, there is a possibility of over-releasing the lateral structures, which could lead to patellar instability or dislocation. Therefore, it is crucial to follow a structured rehabilitation program after surgery to strengthen the knee and restore function.

As for your question about growth, at 20 years old, you are likely nearing the end of your growth period. Most individuals experience their final growth spurts in their late teens to early twenties, with growth plates closing around this age. However, some individuals may experience slight increases in height into their early twenties, but significant growth is unlikely.

In summary, your knee pain could be related to patellar cartilage softening, and while conservative treatments are a good first step, surgical options like lateral release may be considered if symptoms persist. It's essential to discuss all potential risks and benefits with your physician to make an informed decision about your treatment plan. Additionally, focusing on strengthening exercises and proper rehabilitation will be critical for your recovery and long-term knee health.