Orthopaedic Topics

Our patients are very important to us.  As a result, we continually provide our patients with information about their injury or on the care they are receiving.  We have listed, below,  a series of topics which may be of interest  to you.  

If you require further information, please contact us, or call our office for an appointment.

ACL Reconstruction

What is the ACL?

The anterior cruciate ligament (ACL) is a stabilizing ligament that connects your thighbone to the shinbone.  Ligaments are tough, non-stretchable fibers that hold your bones together

An anterior cruciate ligament (ACL) unravels like a braided rope when it’s torn and does not heal on its own. Fortunately, reconstruction surgery can help many people recover their full function after an ACL tear. 

What happens during the procedure?

Surgical treatment of the torn ACL usually involves an arthroscopic surgical reconstruction of the injured ligament.  Although a number of different types of tissue have been utilized to reconstruct the ACL, the most common type of ACL reconstruction involves harvesting the central third of the patellar tendon with a bone block at each end of the tendon graft. After performing a diagnostic arthroscopic examination of the knee, the central third of the patellar tendon is harvested.

The remaining tendon is then repaired. After harvesting the tissue, drill guides are used to place holes into the tibia (bone below the knee) and femur (bone above the knee). By placing the drill holes at the attachment sites of the original ligament, when the graft is pulled through the drill hole and into the knee, it will be placed in the same position as the original ACL.

After pulling the graft through the drill holes and into the joint to replace the torn ACL, the graft is then held in place with bioabsorbable screws or metallic screws.

Click here to view an animated overview of the procedure.

For additional information visit:
AAOS Online Service Patient Education Brochures

 

Knee Arthroscopy

What is knee arthroscopy?

Knee arthroscopy is a procedure in which the doctor examines your knee with an instrument called an arthroscope. An arthroscope is a tube with a light on the end that is inserted in your knee and projects an image of the inside of your knee onto a TV monitor. The arthroscope is about the diameter of a pencil.

This procedure is used to diagnose the cause of pain, swelling, tenderness, or weakness in your knee.

What happens during the procedure?

The doctor will give you a general, regional, or local anesthetic. A general anesthetic will relax your muscles and make you feel as if you are in a deep sleep. Both local and regional anesthetics numb part of the body while you remain awake. All three types of anesthesia should keep you from feeling pain during the operation.

The doctor will then insert the arthroscope, a tube containing a saltwater solution, and a probe instrument into the lower part of your knee. He will then inject fluid into the knee.

Your doctor may find loose material in the knee, or a tear in the cartilage or ligaments. Sometimes the doctor can repair the tears and remove loose pieces of cartilage using small instruments and the arthroscope. If the problem cannot be fixed by this procedure, the doctor may recommend open knee surgery.

After the procedure the doctor will close the small openings with one or two stitches or sticky tape.

Click here to view an animated overview of the procedure.

For additional information visit:
AAOS Online Service Patient Education Brochures

 

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Knee Replacement

Symptoms

The symptoms of a degenerative knee joint usually begin as pain while bearing weight on the affected knee. You may limp and the knee may become swollen with fluid. The degeneration can lead to a reduction in the range of motion of the affected knee - the knee bends less than normal and may lose the ability to completely straighten out. Bone spurs will usually develop and can be seen on xray. Finally, as the condition becomes worse, the pain may be present all the time and may even keep you awake at night.

Diagnosis

The diagnosis of a degenerative knee starts with a complete history and physical examination by your doctor. Xrays will be required to determine the extent of the degenerative process and may suggest a cause for the degeneration. Other tests may be required if there is reason to believe that other conditions are contributing to the degenerative process. Blood tests may be required to rule out systemic arthritis (such as Rheumatoid Arthritis) or infection in the knee.

Knee Replacement Surgery

In knee replacement surgery, the damaged bone and cartilage are replaced with metal and plastic surfaces that are shaped to restore knee movement and function. The new artificial knee is called a prosthesis.The prosthesis is generally composed of two metal pieces fitted onto the ends of the tibia (shin bone) and the femur (thigh bone) and a plastic piece inserted between them to act as a bearing. Stainless steel, cobalt or chrome alloys or titanium may be used for these components. Durable, wear resistant polyethylene (plastic) is used for the bearing.  A plastic bone cement may be used to anchor the prosthesis into the bone. Some joint replacements also can be implanted without cement when the prosthesis is designed to fit and lock onto the bone directly.

Click here to view an animated overview of the procedure.

For additional information visit:
AAOS Online Service Patient Education Brochures

 

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Ankle sprain

What causes an ankle sprain?

A sprain is caused by twisting your ankle. Your foot usually turns in or under but may turn to the outside.  An ankle sprain is an injury that causes a stretch or tear of one or more ligaments in the ankle joint. Ligaments are strong bands of tissue that connect bones at the joint.

Sprains may be classified as mild, moderate, or severe.

Most sprains occur on the outside part of the ankle, but they can occur on the inside as well.

What are the symptoms?

Symptoms of a sprained ankle include:

• mild aching to sudden pain

• swelling

• discoloration

• inability to move the ankle properly

• pain in the ankle even when you are not putting any weight on it.

How is it diagnosed?

To diagnose a sprained ankle, the doctor will review how the injury occurred and consider your symptoms. He or she will examine your ankle carefully. X-rays may be taken of your ankle.

For additional information visit:
AAOS Online Service Fact Sheet, Sprained Ankle

 

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Achilles Tendon Injuries

What are some of the causes?

Achilles tendonitis can be caused by:

• overuse of the Achilles tendon

• tight calf muscles

• tight Achilles tendons

• lots of uphill running

• increasing the amount or intensity of training, sometimes along with switching to racing flats, racing shoes with less heel lift

• over-pronation, a problem where your feet roll inward and flatten out more than normal when walking or running

• wearing high heels at work and then switching to a lower heeled workout shoe.

Violent stretching of the Achilles tendon can cause it to rupture.

What are the symptoms?

Achilles tendonitis causes pain and may cause swelling over the Achilles tendon. The tendon will be tender and may be swollen. You will have pain when you rise up on your toes and pain with stretching of the tendon. The range of motion of your ankle may be limited.

When it tears or ruptures, you may feel a pop. If there is a complete tear, you will be unable to lift your heel off the ground or point your toes.

For additional information visit:
AAOS Online Service Fact Sheet, Achilles tendon

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Hip Replacement

What is a total hip replacement?

A total hip replacement is a procedure in which the doctor removes a painful hip joint and inserts an artificial joint.

When is it used?

This procedure is done when your hip is painful, usually from arthritis, and other treatments have not worked.

Alternatives to this procedure include:

• using acetaminophen, aspirin, or other medications for the pain and inflammation

• limiting activity and using a walking aid such as a cane or walker

• avoiding activities that make the pain worse, such as climbing stairs or walking long distances

• using heat packs to relieve pain

• having the hip joint fused together

• choosing not to have treatment while recognizing the risks of your condition.

You should ask your doctor whether any of these choices would be of benefit to you.

Click here to view an animated overview of the procedure.

For additional information visit:
AAOS Online Service Patient Education Brochures

 

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