Steve’s Knee

Past

1. Is it possible to tell if the current condition was caused by ‘wear and tear’ or injury (i.e., did worn cartilage cause the sudden knee pain whilst I was out running or did a mis-step whilst running cause an injury to the knee cap/cartilage)?
2. Could the problem have been caused by an abnormal knee cap positioning for another reason (posture, hips, shoes, etc.)?

Present

3. How bad is the situation?  Is the diagnosis Chrondromalacia Patella? If so, is it stage 1, 2, 3 or 4?
4. Will the situation stay the same or get worse, i.e., progress through the stages?  If so, how quickly is this likely to happen?
5. Is there any sign of current abnormal knee cap positioning?
6. Are there any fragments of cartilage that could be removed with arthroscopy?
7. How can I tell if the muscle wastage has been reversed?
8. Could taping, shoe inserts, support devices, steroid injections, topical gel or anything else help with the day-to-day pain? (I’m am against taking ibuprofen on a regular basis).
9. What is the likely situation with my other knee?
10. Are there any potentially additional remedies if I went for private treatment versus the NHS?  
11. Can I have a copy of the MRI and analysis?

Future

11. Is any running recommended?  If yes, should I use an ice pack after every run?
12. What cardio-vascular exercises can I do that will not further damage the cartilage? Cycling, swimming, physical training all seem to involve significant stress on the knee.
13. What can I do to prevent/slow further degradation to the cartilage?
14. What are my options if the pain becomes unbearable?
15. Would realigning the position of the knee cap release pressure on the cartilage?
16. Can I expect to need a knee replacement sometime in the future?