Soccer player tore knee cartilage, wants to skip some rehab!

October 27th — admin

I’m 23-years old. I tore my knee cartilage clear down to the bone in a soccer match. The surgeon tells me I’ll be on a machine to make my knee move for six weeks after an operation to repair the damage. I don’t have that kind of time for rehab. Is there any way around this restriction?

Right now the standard rehab after microfracture for full-thickness cartilage tears is to avoid weight-bearing and use continuous passive motion (CPM). CPM uses a device to slowly move the knee through its range of motion. It’s usually used for six to eight hours a day for up to eight weeks after microfracture.

Microfracture is one way to enhance healing. Tiny holes are made in the bone just beneath the cartilage. Fibrocartilage fills in where the cartilage is torn and pulled away from the bone.

Researchers are calling the standard rehab procedure into question. Studies show no difference in results with or without the use of CPM. Likewise, putting weight on the leg isn’t a problem either. Up until now the theory was that pressure through the joint would disrupt the healing process.

Ask your doctor to review the latest studies on this rehab method. With close supervision you may be able to bypass the six weeks’ restriction and return to sports sooner.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Teenage daughter constantly snaps her hip – is this normal?

October 26th — admin

My daughter is going through puberty and many things are changing about her body. Yesterday, she showed me how she can pop or snap her hip everytime she lifts her leg. Is this normal? What’s causing it?

Your daughter may have a common condition called snapping hip syndrome. It’s seen most often in ballet dancers who over train their hip flexor muscles. The tendon flips back and forth over a bump on the bone causing a snap or pop that can be heard and/or felt.

Sometimes this problem occurs in response to true hip joint problems. There could be a hip fracture, tear of the hip cartilage, or fragment of tissue or bone caught inside the joint. Usually this type of problem is much more painful than the tendon snapping over bone.

Ballet dancers seem to have this problem more than any other group of individuals or athletes. They may have hip pain that will only go away when the hip is moved in such a way that a snap or pop occurs. Or they may be pain free but feel and hear the snap whenever the leg is lifted or flexed more than 90 degrees.

It may not be normal, but it is a typical response to the specific activity of repetitive hip flexion.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Will heat treatment to shrink loose joints work on my daughter?

October 25th — admin

I’ve heard there’s a heat treatment to shrink loose joints. My 13-year old daughter has very loose joints. Sometimes it’s a problem when she’s trying to do something in gymnastics that requires strength and stability. Could this treatment help her?

There is a treatment method called thermal capsulorrhaphy used to treat shoulder instability. Usually the patients have injured the soft tissues around the joint or the cartilage around the shoulder socket.

The laser or radiofrequency energy heats the tissue up enough to damage some of the cells. As the tissue cools down, it contracts or tightens up. The process of healing the damaged tissue brings about more normal cells to replace the “loose” ones.

Immature or undeveloped tissue doesn’t shrink like adult tissue. The bonds that form and hold the cells together aren’t strong enough to withstand the heat. The proteins “melt” turning the tissue into jelly. The end result is an unstable rather than a “tight” joint.

Just the opposite happens in older adults. There are so many cross-links in aging tissue (that’s what makes us stiff), shrinkage is very limited. It’s unlikely this treatment would be recommended for your daughter. She may benefit more from a strengthening program. A physical therapist may be the best one to assess the stability of her joints and advise you.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Why won’t torn cartilage in knee heal on its own?

October 22nd — admin

I have a torn cartilage in my right knee. The doctor tells me I need surgery because it won’t heal on its own. Why won’t it heal?

Some people consider this a “design flaw” in the human body. Cartilage anywhere in the body doesn’t have a big blood supply. We say it’s not highly vascularized. This means when it’s injured or damaged in anyway it heals very slowly or not at all.

The cartilage doesn’t have a way to heal itself. The result is often worse symptoms for the patient and joint degeneration. Surgery is done to repair the damage and bring blood to the area to speed up the healing cycle.

Cartilage has several layers. The deepest layer just before the bone is called the tide mark. Just below the tide mark layer are stem cells that can grow into fibrocartilage. This kind of cartilage isn’t exactly the same as the cartilage on the surface of the joint, but it’s better than nothing!

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Football player’s shoulder gives way – catch it before it dislocates

October 20th — admin

Our son is a high school football player. When he plays offensive lineman he complains afterwards of shoulder pain. He says when he uses his arms in the blocking position and comes up against another player, his left shoulder “gives way.” Is this something we should talk to the coach about?

It’s possible your son is having some shoulder instability. The head of the humerus, a round ball at the top of the upper arm bone may be moving backwards out of the joint. This is called subluxation if it’s not fully dislocating.

Repetitive loading in the blocking position can put the shoulder at risk for instability from dislocation. You should talk with the coach or trainer but the best thing may be to see an orthopedic surgeon. X-rays, scans, and special tests may be needed to accurately diagnose the problem.

A special rehab program designed for this problem should be tried before jumping into surgery. Most of the time there’s a muscle imbalance that can be overcome with the right kind of strength training. The joint itself may have to regain its full joint sense of position called proprioception. The physical therapist will also address this problem during rehab.

Early detection and intervention are the keys to getting back on the field and staying there without further injury. Don’t put this off when it may be a small problem and before surgery or other invasive treatment is needed.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Does taping the kneecap really reduce pain of PFPS?

October 19th — admin

Does taping help with the painful symptoms of patellofemoral pain syndrome? I’m trying to find a way to stay active despite the pain.

Taping the kneecap in place is often suggested as a treatment method for patellofemoral pain syndrome (PFPS). This helps keep the kneecap (patella) in good alignment as it moves up and down.

Many studies have been done to see if taping works for PFPS. Some show no effect while many others say taping reduces pain right away. Still other research shows taping works no matter how it’s applied.

This last finding suggests it’s not the position of the patella (knee cap) that makes a difference. Perhaps the taping improves the patellofemoral joint position sense called proprioception. Or maybe it helps the muscle contract more fully pulling the kneecap back into proper alignment.

If taping doesn’t work, there are other treatment choices that can be tried.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Thigh pain may not be a result of recent total hip replacement

October 19th — admin

My mother has been complaining of thigh pain after her total hip replacement. Could this be caused by a problem with the new hip? Or is something else going on?

Thigh pain can be caused by a wide range of problems. Pain can be referred to the thigh from a problem in the abdomen, low back, hip, or knee. For example, kidney stones, tumors, or blood clots can cause thigh pain.

But muscle strains, bursitis, pressure on the nerve, and hernias can also cause thigh pain. It is also possible that a problem with the implant can send pain to the thigh. Loosening of the implant, infection, and wear debris from the implant can cause thigh pain.

A simple X-ray can help show what might be going on. First, the radiologist will look for fractures. Rotation of the femur (thigh bone) indicates loosening of the implant. The X-ray can also show subsidence or sinking of the implant down into the bone.

Don’t put off having this problem checked. Early diagnosis and treatment can prevent more serious problems later. It could be something as simple as muscle weakness or even a problem with posture. If this is the case, a physical therapist can help your mother with a program of exercise and posture awareness. More serious problems can be addressed by the surgeon.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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Young adult reconsiders hip replacement surgery

October 18th — admin

I’m a 42-year old active male with serious hip pain. When I was 36, I saw a surgeon who told me I’m too young for a hip replacement. Has anything changed in the last six years? I’m still suffering and would really like to remain active.

Improved diagnostic imaging may be what has changed the most. The use of thin-cut CT scans gives a 3-D view of the hip joint. Combined with magnetic resonance arthrography (MRA) and X-ray, surgeons can better see what is the problem. Understanding the cause of painful symptoms helps the surgeon plan a more effective treatment.

By the way, MRA is the injection of a contrast agent (dye) directly into the joint space. Then MRI pictures are taken. The technique helps show the shape and depth of the joint space. The dye will seep into any areas where the cartilage is torn or pulled away.

There are two main reasons why young adults have hip pain. Abnormal loading and pinching called impingement can result in pain and loss of motion. A shallow hip socket called dysplasia can do the same thing. In many cases, the surgeon may be able to repair and realign the hip.

It may be time to go back for a second look or a second opinion about your particular situation. New advances in the diagnosis and treatment of hip pain in young adults may put a different spin on your case.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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TV method for reducing dislocated shoulder often painful, ineffective

October 1st — admin

Our 14 year old son dislocated his right shoulder after falling off his mountain bike. He had to have anesthesia to put the joint back in place. Can’t they do this without surgery like you see on TV shows like ER or Scrubs?

Not all TV drama is real or accurate. Screen writers do try to research conditions, illnesses, and medical procedures and present them accurately.

In the case of shoulder dislocation, there are several ways to “reduce” or put the joint back in place. The most common method of shoulder reduction after dislocation is the traction counter-traction technique. The doctor pulls on the hand of the dislocated arm.

At the same time, pressure is applied into the armpit in the opposite direction. This method of shoulder reduction is often painful and doesn’t always work.

Using sedation such as general anesthesia relaxes the muscles around the joint. This allows the head of the humerus to slide over the rim of the socket and slip back into the joint.

What you saw on TV could have been the traction-counter traction method of reduction. Another way to do this is an old method called the Milch technique. The Milch method is a safe and easy way to reduce a dislocated shoulder joint. The patient’s arm is moved by the doctor or examiner into a position of 90 degrees of abduction and flexion as if to put the hand behind the head.

The head of the humerus slips back over the rim of the socket and fits back into the joint. No anesthesia and no surgery is required. Because it’s not a recent discovery and because it’s an old method, all doctors today may not know about the use of the Milch method to avoid surgery for shoulder dislocation.

For more information on this subject, call The Zehr Center for Orthopaedics at 239-596-0100 or visit www.zehrcenter.com.The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

Posted in Shoulders. Tags: , , , , . No Comments »
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