Tag Archive for: Knee pain

Knee Osteotomy

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The knee is the likeliest joint in the body to develop arthritis, and it can significantly impact your life. Activities you once participated in easily can suddenly be difficult and can cause significant pain. It is a major cause of lost work time and a serious disability for many people. When other treatments no longer offer relief, a knee osteotomy can slow pain, help slow the deterioration of cartilage in the knee, and may delay your need for knee replacement surgery for many years. Osteotomy of the knee has been used for decades to improve pain and function. But if you are suffering from pain or instability in the knee now, you shouldn’t wait another minute to see the orthopedic specialists at the Colorado Center of Orthopedic Excellence in Colorado Springs, Colorado.

OVERVIEW

A knee osteotomy is an operation that surgeons use to treat the pain and instability that can occur when there is damage or arthritis in part of the knee joint. Knee osteotomy is used when a patient has early-stage osteoarthritis that has damaged just one side of the knee joint. By shifting weight off of the damaged side of the joint, an osteotomy can relieve pain and significantly improve function in an arthritic knee.  Knee osteotomy is particularly useful when arthritis develops in younger and middle-aged patients. There are no specific age limits but as a guide it is most commonly performed and most effective in thin, active 40–50-year-olds, with osteoarthritis affecting one compartment of the knee joint, including those who play sports regularly.

KNEE ANATOMY

The knee is the largest and strongest joint in the body. It is made up of the lower end of the femur (thighbone), the upper end of the tibia (shinbone), and the patella (kneecap). The ends of the three bones that form the knee joint are covered with articular cartilage, a smooth, slippery substance that protects and cushions the bones when bending and straightening the knee. Shaped like a hinge, this highly complex knee joint allows one to stand, sit, squat, jump, and maintain balance. Two wedge-shaped pieces of cartilage called meniscus act as “shock absorbers” between the thighbone and shinbone. They are tough and rubbery to help cushion the joint and keep it stable. Like all joints, the knees also contain muscles, ligaments, and nerves. Damage to any of these supportive structures causes instability of the knee joint.

ABOUT KNEE OSTEOARTHRITIS

Osteoarthritis (OA) of the knee is the degradation of cartilage in the knee. Exactly why knee arthritis causes knee pain can vary from person to person and is not always clear. Factors that are considered include inflammation as a result of a breakdown of knee cartilage, abnormal joint stress that strains the knee joint capsule, nearby ligaments, and other surrounding support structures such as tendons, or bone pain caused by mechanical stress. Osteoarthritis of the knee is very common. Approximately 46% of people will develop it during their lifetimes. Women are more likely than men to develop osteoarthritis of the knee. Osteoarthritis can develop when the bones of the knee and leg do not line up properly. This can put extra stress on either the inner (medial) or outer (lateral) side of the knee. Over time, this extra pressure can wear away the smooth articular cartilage that protects the bones, causing pain and stiffness in the knee. In some cases, knee osteoarthritis may remain stable for a long time. However, at least 1 in 7 people with osteoarthritis develop an abrupt progression to the advanced stage, where it can rapidly complete the destruction of the knee cartilage within a few months. It is difficult if not impossible today to predict how fast the evolution of knee osteoarthritis will be.

WHAT IS A KNEE OSTEOTOMY?

Osteotomy literally means “cutting of the bone.” When early-stage osteoarthritis has damaged just one side of the knee joint, or when malalignment of the knee causes increased stress to ligaments or cartilage, a knee osteotomy may be performed to strategically cut and reshape either the tibia (shinbone) or femur (thighbone) to relieve pressure on the joint. The procedure has three goals: transfer stress from the arthritic part of the knee to a healthier area, correct poor knee alignment, and prolong the life span of the knee. As part of the arthritic process, the shape of the legs can even change to be either “bow-legged” or “knock-kneed.” By shifting weight off the damaged side of the joint, an osteotomy can relieve pain and significantly improve function in the arthritic knee. For the surgery to be successful, the side of the knee where the weight is being shifted should have little or no arthritis. A doctor may also use a knee osteotomy to repair a broken knee that did not heal properly.

Read more about knee osteotomy on our new Colorado Springs Orthopedic News Site – Colorado Springs Orthopedic News. Schedule an appointment with a knee specialist today.

Lateral Collateral Ligament Tear

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Consider how important the simple movement of just walking is, then imagine how disabling a lateral collateral ligament tear can be if it causes knee pain or causes your knee to give way. Your lateral collateral ligament (LCL) is a thin band of tissue running along the outside of the knee that helps keep it stable. If left untreated, an LCL tear may be prone to further injuries over time. That’s why it’s important to visit the orthopedic specialists at the Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado, as soon as possible before the injury takes a toll on the surrounding tissues.

OVERVIEW

The lateral collateral ligament is one of the more commonly injured ligaments in the knee. In the United States, 25% of the patients who present to the emergency room with acute knee pain have a collateral ligament injury. Adults aged between 20-34 and 55-65 years old have been shown to have the highest incidence. An LCL tear tends to happen more often in men and boys than women and girls. 40% of LCL tears occur in sports. The risk of having one is higher if there has been a previous LCL tear, and it is possible to tear the same lateral collateral ligament again.

ABOUT THE KNEE

The knee is the joint that connects the thigh to the lower leg. It’s the biggest joint in the body. Like all joints, the knees are part of the skeletal system. The knees also contain cartilage, muscles, ligaments, and nerves. The knees help support one’s weight and let the legs bend and move. Almost any movement that uses the legs relies on the knees — the knees help when walking, running, and jumping. Three bones make up the knee joint—the thighbone (femur), the kneecap (patella), and the shinbone (tibia). Ligaments are thick, strong bands of tissue that hold the bones together. Collateral ligaments are on the side of the knee.

WHAT IS A LATERAL COLLATERAL LIGAMENT TEAR?

An LCL tear is a strain or tear to the lateral collateral ligament. These knee injuries are categorized into three grades:

  • Grade I: This is an incomplete tear of the LCL. The tendon is still in continuity, and the symptoms are usually minimal. Patients usually complain of pain with pressure on the LCL and may be able to return to their sport very quickly. Most athletes miss one to two weeks of play.
  • Grade II: Grade II injuries are also considered incomplete tears of the LCL. These patients may complain of instability when attempting to cut or pivot. The pain and swelling are more significant, and usually, a period of three to four weeks of rest is necessary.
  • Grade III: A grade III injury is a complete tear of the LCL. Patients have significant pain and swelling and often have difficulty bending the knee. Instability, or giving out, is a common finding with grade III LCL tears. Grade III LCL tears commonly require surgical reconstruction.

Read more about Lateral Collateral Ligament Tears on our new Colorado Springs Orthopedic News Site – Colorado Springs Orthopedic News. Schedule an appointment with a knee specialist today.

Osgood-Schlatter Disease

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No one should have to live with intense pain or discomfort. Least of all, children. Osgood-Schlatter disease is the most common cause of knee pain in children and young adults who are still growing. It is considered an overuse injury of the knee that causes a painful bump and swelling on the shinbone below the knee. Most people have probably never heard of Osgood-Schlatter disease, and the symptoms may resemble other conditions of the knee. Getting a proper diagnosis can help prevent complications that can occur if not diagnosed correctly. At the Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado, you can trust that your child will get the best care and treatment to alleviate their pain and allow them to do the things they love.

OVERVIEW

Osgood-Schlatter disease, also known as osteochondrosis or traction apophysitis of the tibial tubercle, is a common cause of anterior knee pain in the skeletally immature athletic population. Sometimes it is more simply referred to as growing pains or jumper’s knee. The Osgood-Schlatter disease typically affects kids during their preadolescent growth spurt: in the tweens (8 to 13) for girls and the early teens (10 to 14) for boys. It tends to affect boys more often than girls. The age at which the condition occurs can vary by sex because girls experience puberty earlier than boys.

ABOUT THE KNEE & GROWTH PLATES

The knee is the joint where the bones of the lower and upper legs meet. The largest joint in the body, the knee, helps support the body’s weight. It moves like a hinge, allowing legs to bend and move. Almost any movement that uses the legs relies on the knees, allowing one to sit, squat, walk, run, and jump. The knee consists of three bones: the femur (thigh bone), the tibia (lower leg bone), and the patella (kneecap). Growth plates, also called physis or epiphyseal plates, are one-way that bones grow. There are usually two growth plates in each long bone. They add length and width to the bone helping determine the future length and shape of the mature bone. During the growth period, these growth plates can become swollen or damaged. This is especially true in the growth plates surrounding the knees.

WHAT IS OSGOOD-SCHLATTER DISEASE?

During the growth spurts of adolescence, certain muscles and tendons grow quickly and not always at the same rate. With physical activity, differences in the size and strength of the quadriceps muscle can put more stress on the growth plate near the top of the shinbone. The growth plate is weaker and more prone to injury than other parts of the bone. As a result, it can become irritated during physical stress and overuse caused by repetitive movements in certain sports that involve running, jumping, or twisting, including football, soccer, basketball, volleyball, gymnastics, figure skating, or ballet. The irritation can result in a painful lump below the kneecap, referred to as the Osgood Schlatter’s bump. Usually, just one knee is affected, but for 20% of people with Osgood-Schlatter disease, both knees are affected. If not assessed and treated, Osgood-Schlatter disease can follow adolescents into adulthood.

Read more about Osgood-Schlatter Disease on our new Colorado Springs Orthopedic News Site – Colorado Springs Orthopedic News. Schedule an appointment with a knee specialist today.

Runners Knee – Patellofemoral Syndrome

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The knee is one of the body’s most important physical features. You could not move your leg in any direction or perform routine actions such as standing, bending, or walking without it. Additionally, the knee supports the upper body’s weight and helps you remain upright. Considering the knee bears so many heavy responsibilities, it should not be surprising the knee suffers many injuries. One such occurrence is a condition known as runner’s knee, which in medical terms is called patellofemoral pain syndrome or PFPS. There are many causes and many complications that could affect your everyday life, so it is important to get it treated right away. The place to start and where you can trust you’ll get the best care is at the Colorado Center of Orthopaedic Excellence in Colorado Springs, Colorado.

OVERVIEW

Pain at the front of the knee is one of the most common knee problems. It is often a sign of overuse. In other words, the knee might have been exposed to too much or too frequent strain without being able to adapt to it fast enough. Patellofemoral pain syndrome is a broad term to describe pain in the front of the knee and around the kneecap. Although it can occur in non-athletes, it is often called “runner’s knee” because it is most common in people who participate in sports.

ABOUT THE KNEECAP

The kneecap (patella) connects muscles in the front of the thigh to the shinbone (tibia). As one bends or straightens the leg, the kneecap is pulled up or down. The movement of the kneecap is accommodated by a V-shaped notch (femoral groove) at one end of the thighbone (femur). The medial patella femoral ligament (MPFL)—located on the inside (medial side) of the knee—helps hold the kneecap in place and stop it from sliding/popping off the outer side (lateral side) of the knee. Several things can stop the patella from moving properly, all of which increase the forces and friction going through the kneecap, causing runner’s knee.

WHAT IS RUNNER’S KNEE?

Runner’s knee is one of the most common causes of front knee pain and accounts for approximately 25% of all knee injuries seen in sports injury clinics. While it is true that this is any injury that happens to virtually anyone, some risk factors may indicate the likeliness of developing problems.

Read more about Runner’s Knee on our new Colorado Springs Orthopedic News Site – Colorado Springs Orthopedic News. Schedule an appointment with a knee specialist today.

Suffering from knee pain? Where it hurts can be a clue for diagnosis

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When you have knee pain, even the basics of everyday life can be difficult. Our knees are essential to standing, sitting, walking and so much more. If you’re an athlete, there’s not a sport out there that doesn’t require strong, healthy knees.

Your knee is also one of the most complicated joints in your body. Knee pain comes in many forms and from many places. If your knee pain is chronic or severe, you should see an orthopedic specialist who can diagnose and treat many types and sources of knee pain.

A good orthopedic specialist will want to hear about the type and location of your pain, any event that might have caused the pain, as well as your activity level and lifestyle. They will do a physical evaluation and may order imaging such as an x-ray or ultrasound.

All-over Pain
Some diseases and injures calls pain throughout the knee, rather in that one specific spot. The pain can be dull and achy or sharp and severe. Common examples include:

Arthritis
Rheumatoid arthritis (RA) or Osteoarthritis (OA) both damage the cartilage in your knee, and the result is painful bone-to-bone contact that can deliver some serious ‘all-over’ pain, swelling and stiffness.

Torn Anterior Cruciate Ligament (ACL)
The ACL, which connects the tibia and the femur, is fairly well-known part of the knee – maybe you have torn yours or know someone who has. When it tears, many people report hearing a pop or snap and the pain which comes on quickly, is often felt in the middle or center of the knee.

A Bruised Knee
If your knee is hit hard during a contact sport, an accident, or a fall, it can bruise and result in all over or “inner” knee pain. You may also have swelling or difficulty bending your knee.

Knee Dislocation
A knee dislocation is a very serious and painful injury and the pain is not limited to one part of the knee. When the shin and thigh bone are separated from one another. Dislocations are rare and typically occur as the result of a severe impact such as a sports collision or a car accident.

Pain on inside of knee
If you have pain on the inside of your knee, it could be the result of any number of injuries including:

An MCL (Medial Collateral Ligament) Injury
Your MCL stabilizes your knee joint and runs along the inside of your knee. It can be sprained or torn by stretching too far, both of which can cause pain on the inside of your knee.

Injury to the Medial Meniscus
Your shin and thigh bones are cushioned by two pieces of cartilage called meniscus. These menisci can fold, become worn, or tear if your knee rotates too far or has too much pressure. You may feel pain on the inside of your knee or may simply be unable to straighten your knee fully.

Bursitis
When the fluid-filled sacs (the bursa) get irritated and swollen, this cushioning tissue may be a source of pain rather than a joint protector, but often resolves with rest and ice.

Pain on outside of knee
Different diagnoses are more likely if you have pain on the outside of your knee, such as:

Iliotibial Band (“IT Band”) Syndrome
The “IT band” ligament runs along the outside of your thigh and can become swollen and inflamed as it rubs against the bone. The feeling can include tenderness or burning on the outside of your knee. IT Band Syndrome is common in long-distance runners and cyclists.

Injury to the Lateral Collateral Ligament (LCL)
The ligament that runs across the outside of your knee is called the Lateral Collateral Ligament (LCL) and it helps to stabilize your knee. When torn or strained, you’re likely to feel instability and naturally feel pain on the outside of your knee.

Pain on the front of the knee
Pain on or near the kneecap is common for athletes or anyone who does a lot of running or jumping.

Patellar Tendonitis (aka Jumper’s Knee)
Wear and tear on the patellar tendons or irritation from overuse can result in tendonitis- which is inflammation of the tendons.

Runner’s Knee
Runner’s knee isn’t just for runners, although it does occur in athletes – including runners and especially women. The pain generally radiates around the kneecap and may be worse after bending it. Many people with Runner’s knee may be used to hearing snaps and pops when they squat or go downstairs.

Pain behind knee
If it hurts in the back of your knee, there are many possible causes. Several common causes include:

Baker’s Cyst
One of the most common causes of knee pain behind the knee. Baker’s cyst is an inflamed burse sac. There are bursa sacs all over your body, but an inflame bursa sac is known by this name when it’s behind the knee specifically.

Injury to the posterior cruciate ligament or PCL
Similar to the ACL, the PCL helps connects the shin and thigh bones and keeps the knee stable, but it is injured far less often. Injuries to the PCL are typically the result of a collision or other trauma.

Among others, runners’ knee, meniscus tears, ACL tears and arthritis can also cause pain behind the knee.

No matter where your pain is, be sure to see a qualified orthopedic specialist to fully diagnose your knee. Our team includes physicians, physician assistants, orthopedic surgeons, physical therapists, and our athletic trainer. We diagnose and treat a wide range of orthopedic conditions from injury to wear and tear. Our physicians help patients of all ages and activity levels. Make an appointment today.

Patellar Tendonitis – Are you sidelined with pain in your kneecap?

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Do you participate in a sport like basketball or volleyball where high impact running, and jumping is common? If you have persistent pain or swelling at the base of your knee you could have one of the most common knee injuries among athletes – patellar tendonitis.

Depending on the severity of your injury, the pain may only occur during or after exercise, but over time it may begin to impact your day-to-day activities. And, because it can develop so gradually over time, it is not always easy to recognize. But if these symptoms sound familiar, don’t wait until it hurts to sit or walk to be evaluated and diagnosed. A sports medicine specialist can determine if you have patellar tendonitis and provide treatment recommendations for recovery.  

What is patellar tendonitis?

The patellar is the kneecap and the patellar tendon connects your kneecap to your shin bone. Patellar tendonitis is inflammation from a repetitive motion injury often seen in athletes who do a lot of running and jumping, such as with basketball, track and volleyball. For that reason, it’s sometimes referred to as “jumper’s knee,” and it’s especially prevalent in professional volleyball players. It’s most common among young people – in their twenties and thirties, and those who are taller or carry more weight are at higher risk.

Did you know that running puts as much as three times more force on your knees than walking does? On its own, this actually isn’t a bad thing. In fact, research shows that, for healthy runners, the knee can actually strengthen under increased force, and the tiny tears that stain causes in your tendon typically heal quickly and go unnoticed. But the aggregate impact of frequent jumping or carrying excess weight while running puts even more force on the knee, and the body can’t keep up with the number and severity of small tears in the tendon. It weakens over time, causing tendonitis.

How is patellar tendonitis diagnosed?

In addition to a physical examination and key questions about the nature and severity of your pain, your sports medicine specialist will evaluate your range of motion, and may recommend imaging such as an MRI, x-ray or ultrasound to confirm tendonitis or eliminate other injuries including bone fractures or soft-tissue damage.

What treatment is available for patellar tendonitis?

Treating patellar tendonitis early can ensure a full – and faster – recovery. Treatment will depend on several factors including the severity of the injury, your activity level and age, among other factors.

Getting your pain under control is always a first priority – usually accomplished with rest, ice and anti-inflammatories like Advil. And this regimen typically also resolves minor cases of patellar tendonitis too. Modifying your activities to minimize impact and wearing a brace that stabilizes and straightens the knee will also support recovery.

Many patients will need to modify their activities for a period of time – such as trading running and jumping for swimming, biking or other low impact activities – to minimize heavy impact on the knee. Others may need to add physical therapy exercises to their routine to build strength and flexibility in the surrounding area and support long term joint health.

Kinesiology taping (aka KT tape) can also help to stabilize the patellar tendon and reduce pain. Using a single piece of tape applied directly across the patellar tendon, many athletes are able to maintain range of motion and activity levels using these techniques

When is surgery needed?

In the most severe cases, the patellar tendon can become completely detached from the kneecap which requires surgery to repair. Surgery is generally only considered when all other treatment options are exhausted. In some cases, arthroscopic surgery can be used, which minimizes the incision size and generally has a faster recovery time.

Patellar tendonitis is common among athletes at all levels, and sports medicine specialists will work with each athlete to determine the best treatment options to help athletes return to play as quickly as possible while preventing re-injury and improving your body’s response to stress.

Our sports medicine specialists use cutting-edge diagnostic and treatment methods to eliminate pain and improve range of motion so the next time you spike the ball, dunk a basket, or run toward the finish line, you will feel just as good or better than you did before your injury occurred.

Types of Knee Implants

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The types of knee Implants used in total knee replacement surgery are highly individualized, and there is no single type or size that fits all. Knee implants vary depending on design, materials, and fixation.

The choice really depends on what the surgeon thinks is the best type of knee implant for you, with careful consideration of factors such as age and lifestyle.

Knee Replacement Prosthetics

Implants for knee replacement surgery have several components, such as femoral, tibial, and patellar prosthetics. The femur is your upper leg bone, the tibia is your lower leg bone, and the patella is your kneecap. Any or all of these can be replaced with prosthetic materials. 

The area of your knee that needs to be replaced will determine the type of prosthesis your surgeon will use in your knee implant surgery. Let’s take a look at a couple of the options in a knee replacement surgery:

Fixed-Bearing Knee Implants 

This is the most commonly recommended knee prosthesis. Fixed-bearing implants have the tibial section made of a polyethylene cushion, and this is fixed to a metal base. This allows the upper femoral component to easily glide over it during movement.

Fixed-bearing implants are long-lasting and effectively restore a good range of motion. However, excess weight or excessive physical activity can cause it to loosen or wear down quickly – although this is very unlikely.

Mobile-Bearing Knee Implants

This type of rotating-platform knee implant is usually recommended to younger, physically active, or overweight patients. It is typically designed for longer wear and performance with its bearing surface.

The polyethylene insert in the tibial component (top of the lower leg bone) has the ability to rotate inside the metal tibial tray. This allows a greater degree of movement to the medial and lateral side of the knee.

Due to their greater mobility than fixed-bearing implants, this type of knee prosthetic needs more support from the existing knee ligaments – they need to be strong. 

No studies have shown whether the mobile-bearing or the fixed-bearing type of knee implant is better, so your doctor will determine which type may be best for your knee depending upon what needs to be repaired.

Advanced Orthopedic Care in Colorado Springs

Here at the Colorado Center of Orthopaedic Excellence, our goal is to provide comprehensive orthopedic care under one roof. Our surgeons, podiatrists, physical therapists, occupational therapists, and other medical staff collaborate to treat a wide range of musculoskeletal problems – and provide you with world-class orthopedic care. We have been an official partner of various U.S. Olympic teams, including the Paralympics.

Walking and knee movements are very important to quick recovery after surgery. We recommend exercise to our patients as soon as the day after surgery. The Colorado Center of Orthopaedic Excellence offers physical therapy and rehabilitation services right here, so you don’t have to look elsewhere for your post-surgery recuperation. 

If you have any questions about our orthopedic services or you would like to schedule an appointment with one of our physicians or therapists, please call us today at (719) 623-1050 or request an appointment online. We look forward to getting you back in the game!

Why Should You Consider Arthroscopic Knee Surgery

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Have you or a loved one been battling knee pain that just won’t go away? Have you been to the doctor to determine its cause but haven’t had any luck? If this seems familiar, you may have a condition that can be relieved with arthroscopic knee surgery. During an arthroscopy, your surgeon inserts a flexible tube with a tiny camera through a small incision in the skin, which allows the physician to look in and around the knee joint for potential problems.

Arthroscopic surgery is a way to diagnose and treat a variety of knee issues. Below are some examples of conditions treated with arthroscopic knee surgery:

·       ACL, PCL ligament issues – The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) serve the important role of holding the knee in place. If these ligaments are torn, arthroscopic surgery can fix them.

·       Cartilage issues – Cartilage is a connective tissue that exists between joints in the body. If your cartilage is torn, an arthroscopy can treat it.

·       Bone issues – It’s possible your knee pain is caused by an out-of-place or fractured bone in the knee. This can cause a lot of pain and may require surgery. An arthroscopy can fix a variety of bone issues.

Knee pain can be caused by a variety of reasons and it’s important to figure out what is behind your symptoms. Treating the pain without locating its source is only half the battle. When the cause of your pain is difficult to determine, arthroscopic surgery can be used to visually identify a problem. A diagnosis and fix may be done in the same procedure.

There are many reasons to consider arthroscopic knee surgery.

·       To identify the cause of your knee pain. Arthroscopic surgery is used to not only treat a variety of knee issues but also find the reason behind symptoms. An arthroscopy may be called for when other diagnostic methods fail to identify a cause. In situations like these, arthroscopic knee surgery can figure out the cause and, in many cases, it can fix the issue right then and there.

·       It’s minimally invasive. Arthroscopic surgery is far less invasive than more traditional knee surgeries that involve opening up the knee and cutting through muscles, tendons, and ligaments to access the joint. An arthroscopy is performed using a smaller incision, and results in far less tissue trauma and scarring in the surgery area.

·       Recovery is faster. Because arthroscopic surgery is less invasive, this means that there is a shorter recovery time needed after the surgery. You can get back to your regular routine much quicker than you would after other types of knee surgeries.

If you are experiencing knee pain and want to find a solution to it, it’s important to speak to an orthopedic surgeon who specializes in joint and bone issues and will be able to diagnose and treat your knee pain. Your surgeon will lay out the options to fix your knee problems and will be the best person to identify whether arthroscopic knee surgery is right for you.

The Colorado Center of Orthopaedic Excellence can diagnose and treat your orthopedic issue. We’d love to discuss your treatment options, including arthroscopic knee surgery. Call (719) 623-1050 to make an appointment with one of our highly trained doctors.

Weak in the Knees: Regaining Strength with Knee Ligament Reconstruction

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ACL injuries account for 40% of all sports injuries.1 According to a study by researchers at the Hospital for Special Surgery (HSS), there has been an epidemic of ACL damage among young athletes – with many of these patients requiring subsequent surgeries later in life.2 So, why is the Anterior Cruciate Ligament so susceptible to damage? 

Located at the center of our knees, this ligament – or band of tough, elastic connective tissue, holds great responsibility. It offers stability to the joint – especially when subjected to high-intensity activities that require weaving, pivoting, or kicking.3 Athletes that experience a harsh collision or awkward landing, may lose their full range of movement and experience pain, swelling, and instability.4 If your ACL discomfort isn’t responding to the RICE method of rest, icing, compression, and elevation, or activity limitations – or you simply can’t afford much more time on the sidelines, you may be a candidate for knee reconstruction. 

Because patients with a torn ACL are at risk for secondary complications in the future, the American Academy of Orthopaedic Surgeons recommends ACL reconstruction.4 Executed by a physician who specializes in surgical procedures of the bones and joints – an orthopedic surgeon, reconstruction surgeries are suggested for those who are young and active, plan on continuing high-impact sports, or have multiple damaged ligaments.5

A torn ACL shouldn’t be sewn back together but rather grafted by harvesting tendons from another area of the leg, and then fusing this new tissue to it.1 Your surgeon will either collect tissue from your own body (autograft), or a donor (allograft), and it can be sourced from a variety of areas. The strips are typically “borrowed” from the hamstring tendons, or the patellar tendon – which runs from the bottom of the kneecap to the top of the shin6; the latter is considered the “Gold Standard” for ACL repair.

Consider the pros and cons of any surgery before going under the knife. Patellar Autografts have the lowest rate of failure, but a greater incidence of post-op stiffness and pain behind the kneecap. According to a study published by the National Institutes of Health, hamstring tendon grafts offer lower cost and higher reliability.8 Additionally, HT grafts allow for smaller incisions and faster recovery.4   

Your physician will examine your knee to select the best course of treatment for your condition. Be patient, as some doctors recommend bracing the knee so it can heal a little prior to the procedure.

Arthroscopy is a minimally invasive procedure that allows your surgeon to get a better view of the damaged knee using a small incision – and even smaller arthroscope, or camera. Through this process, they access the damage to the ligaments and tissues of the knee.7

The torn ligament will be removed, and the graft will be cut to the right size and inserted in its place. If your surgeon suggests a four-stranded (quadruple) hamstring graft, they will bundle several tendons and muscles, together. This often results in extra stability for the knee. Holes will be drilled in the tibia (the leg bone) and the femur (the thigh bone) to place the graft. Sutures will attach the graft into place, while screws will be required to keep bone plugs secure. A tube may be placed to remove any excess fluids that build up following the surgery.9 It will take approximately six weeks for the graft to completely fuse with the bone.

Today, most ACL reconstruction is completed on an out-patient basis, which means you may be at home the very same day. Neuromuscular training and physical therapy will be a vital aspect of regaining strength and motion post-operation. Some doctors may recommend the use of a CPM – or continuous passive motion machine; this device mimics a cycling movement, to improve circulation and decrease inflammation while you rest.10 A full return to athletics will take at least 4 to 6 months, with high-intensity sports taking as long as 1 year. 

One of the most important factors with any surgery is doing due diligence. You’ll want to choose a board-certified orthopedic surgeon with extensive experience with injuries of the knee. Dedicated to providing personalized and comprehensive care, the Colorado Center for Orthopaedic Excellence offers a full range of orthopedic services – from surgery to athletic training, and is a great resource for you on your road to recovery. For more information about ACL reconstruction, call 719-623-1050.

      

1Nhs.uk/conditions/knee-ligament-surgery/

2Sciencedaily.com/releases/2015/05/150501103455.htm

3Physio-pedia.com/Anterior_Cruciate_Ligament_(ACL)_Reconstruction

4Orthoinfo.aaos.org/en/treatment/acl-injury-does-it-require-surgery/

5Mayoclinic.org/tests-procedures/acl-reconstruction/about/pac-20384598

6Nhs.uk/conditions/knee-ligament-surgery/what-happens/

7Medlineplus.gov/ency/article/007208.htm

8Ncbi.nlm.nih.gov/pmc/articles/PMC4295687/

9Houstonmethodist.org/orthopedics/where-does-it-hurt/knee/patellar-reconstruction-acl/

10Mykneeguide.com/the-hospital/cpm-machine

Reasons to Consider Arthroscopic Knee Surgery

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Have you or a loved one been battling knee pain that just won’t go away? Have you been to the doctor to determine its cause but haven’t had any luck? If this seems familiar, you may have a condition that can be relieved with arthroscopic knee surgery. During an arthroscopy, your surgeon inserts a flexible tube with a tiny camera through a small incision in the skin, which allows the physician to look in and around the knee joint for potential problems.

Arthroscopic surgery is a way to diagnose and treat a variety of knee issues. Below are some examples of conditions treated with arthroscopic knee surgery:

·       ACL, PCL ligament issues – The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) serve the important role of holding the knee in place. If these ligaments are torn, arthroscopic surgery can fix them.

·       Cartilage issues – Cartilage is a connective tissue that exists between joints in the body. If your cartilage is torn, an arthroscopy can treat it.

·       Bone issues – It’s possible your knee pain is caused by an out-of-place or fractured bone in the knee. This can cause a lot of pain and may require surgery. An arthroscopy can fix a variety of bone issues.

Knee pain can be caused by a variety of reasons and it’s important to figure out what is behind your symptoms. Treating the pain without locating its source is only half the battle. When the cause of your pain is difficult to determine, arthroscopic surgery can be used to visually identify a problem. A diagnosis and fix may be done in the same procedure.

There are many reasons to consider arthroscopic knee surgery.

·       To identify the cause of your knee pain. Arthroscopic surgery is used to not only treat a variety of knee issues but also find the reason behind symptoms. An arthroscopy may be called for when other diagnostic methods fail to identify a cause. In situations like these, arthroscopic knee surgery can figure out the cause and, in many cases, it can fix the issue right then and there.

·       It’s minimally invasive. Arthroscopic surgery is far less invasive than more traditional knee surgeries that involve opening up the knee and cutting through muscles, tendons, and ligaments to access the joint. An arthroscopy is performed using a smaller incision and results in far less tissue trauma and scarring in the surgery area.

·       Recovery is faster. Because arthroscopic surgery is less invasive, this means that there is a shorter recovery time needed after the surgery. You can get back to your regular routine much quicker than you would after other types of knee surgeries.

If you are experiencing knee pain and want to find a solution to it, it’s important to speak to an orthopedic surgeon who specializes in joint and bone issues and will be able to diagnose and treat your knee pain. Your surgeon will lay out the options to fix your knee problems and will be the best person to identify whether arthroscopic knee surgery is right for you.

The Colorado Center of Orthopaedic Excellence can diagnose and treat your orthopedic issue. We’d love to discuss your treatment options, including arthroscopic knee surgery. Call (719) 623-1050 to make an appointment with one of our highly trained doctors.