Osteochondromas: Should You Consider Surgery for Knee Pain?

Q: Osteochondromas: Should You Consider Surgery for Knee Pain?

Hello： <br>1. <br>Based on your description, it does seem to be an osteochondroma, but there are several classifications of osteochondromas, and the management approaches can vary. <br>I personally think you should seek a second opinion. <br>For example, in Taipei, you can consul

Osteochondroma

Hello, Doctor.
Several years ago, I discovered a hard lump on the inner side of my knee, so I went to the hospital for an examination.
The doctor said it was a hereditary osteochondroma and that I needed surgery, but he also mentioned that it could grow back after the surgery.
Therefore, I did not undergo the surgical treatment.
Later, I went to another hospital for a check-up, and the doctor said that as long as it did not affect my daily life, surgery was not necessary.
However, in recent years, I have noticed that if I engage in sports or perform activities that put more strain on my knees, or if I press on the bony protrusions on the inner side of my knees, I experience pain quite easily.
Sometimes, when I squat down, I cannot stand up directly and need to bend my legs first and then slowly straighten them; otherwise, it feels like something is getting caught (but I do not experience pain while walking normally).
So, I went to the hospital for another examination.
This time, the doctor said I have bilateral tibial osteochondromas (X-rays show pointed bone growths on the inner side of both knees).
It is unusual for both sides to have growths.
He recommended surgical removal.
I would like to ask the doctor: Does this count as multiple osteochondromas? Should I undergo surgery? Will it stop growing after the surgery? If I have the surgery, will there be any complications with my knee? How long is the recovery period? Thank you, doctor, for your assistance in answering these questions.

Xiao Pei, 20~29 year old female. Ask Date: 2008/03/15

Dr. Li Wenlin reply Orthopedics

Hello:
1.
Based on your description, it does seem to be an osteochondroma, but there are several classifications of osteochondromas, and the management approaches can vary.
I personally think you should seek a second opinion.
For example, in Taipei, you can consult with Director Chen Tian-Hsiung or Director Chen Wei-Ming at Taipei Veterans General Hospital, Professor Yang Rong-Sen at National Taiwan University, or Dr.
Shi Hsing-Nong or Dr.
Shi Li-Yuan at Linkou Chang Gung Memorial Hospital, as well as Dr.
Feng Yi-Ching at China Medical University in Taichung.
In summary, finding a specialist in bone tumors at a medical center may better address your concerns.
2.
For related issues, it is more effective to communicate in person during an outpatient visit, as this allows for more accurate responses based on individual cases.

Wishing you all the best,
Orthopedics, Li Wen-Lin

Reply Date: 2008/03/15

More Info

Osteochondromas are benign bone tumors that typically develop during childhood or adolescence. They are characterized by an outgrowth of bone and cartilage, often appearing as a hard bump near the joint, such as the knee. In your case, it seems you have been diagnosed with osteochondromas on both tibial bones, which is relatively uncommon but not unheard of.
To address your concerns regarding surgery and the management of knee pain associated with these growths, let’s break down your questions:
1. Is this considered multiple osteochondromas?
Yes, if you have osteochondromas on both knees, it could be indicative of multiple osteochondromas, especially if they are hereditary. This condition can be associated with a genetic disorder known as hereditary multiple exostoses (HME), which can lead to the development of multiple osteochondromas throughout the body.

2. Should you consider surgery?
The decision to undergo surgery should be based on several factors, including the severity of your symptoms, the size and location of the osteochondromas, and their impact on your daily activities. Since you mentioned experiencing pain during physical activity and difficulty standing up after squatting, it may be beneficial to consider surgical intervention. Surgery can help alleviate pain, improve function, and prevent further complications.

3. Will the osteochondromas grow back after surgery?
While surgery can effectively remove the osteochondromas, there is a possibility that they may recur, especially if they are hereditary. However, surgical removal can often provide significant relief from symptoms and improve your quality of life. Discussing the likelihood of recurrence with your orthopedic surgeon can provide you with a clearer understanding based on your specific case.

4. Will there be any long-term effects after surgery?
As with any surgical procedure, there are potential risks and complications, including infection, nerve damage, or stiffness in the knee joint. However, many patients experience significant improvement in their symptoms post-surgery. Your surgeon will likely provide you with a rehabilitation plan to help restore function and minimize stiffness.

5. What is the recovery period like?
Recovery time can vary depending on the extent of the surgery and your overall health. Generally, patients can expect to begin weight-bearing activities within a few weeks post-surgery, but full recovery may take several months. Physical therapy is often recommended to strengthen the knee and improve mobility.

In summary, given your symptoms and the impact on your daily life, surgery may be a reasonable option to consider. It is essential to have a thorough discussion with your orthopedic surgeon about the risks and benefits of the procedure, the likelihood of recurrence, and the expected recovery timeline. They can provide personalized advice based on your specific situation and help you make an informed decision. Remember, the goal of surgery is not only to relieve pain but also to enhance your overall function and quality of life.

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