Orthopedic surgeons see all kinds of injuries in the athletic population. One of the less common but very challenging areas of injury to evaluate is the hip. Hip pain can be coming from the hip itself, of course. But it could also originate in the spine or knee.The medical diagnosis is based on an understanding of what happened, how it happened, clinical presentation (signs and symptoms), and the results of specific tests. It’s really a differential diagnosis meaning the physician sorts through all the possible problems that could be present. Using the information collected so far, the doctor rules out those that don’t fit the description. Then further tests are done until the final diagnosis is made.Some of the most common choices in the differential diagnosis include: hip pointer, greater trochanter bursitis, iliotibial band syndrome, snapping hip syndrome, tendon tears, and meralgia paresthetica. Let’s take a closer look at each of these conditions.Athletes who collide with others or who take the force of a helmeted head into the lateral hip can end up with a hip pointer. This injury or contusion is visible as blood under the skin leaves a large bruise. It is treated with a leave it alone approach. Ice, rest, and compression help the body complete its natural course of healing.Bursitis is best treated by finding out what is causing the friction in the first place and dealing with that problem. It could be tight, inflexible muscles, tendons, or fascia. Stretching, strengthening, and manual therapy under the supervision of a physical therapist may be advised. Or it could be a postural or alignment problem such as a leg length difference, unsupported flat feet, or even broken down running shoes.Sometimes a tendon (e.g., the iliotibial band along the outside of the leg) snaps over the bone underneath. This condition is called iliotibial (IT) band syndrome or snapping hip syndrome. The IT band can be so tight that movement causes a pop that can be seen and heard. The athlete is taught how to avoid those movements and how to stretch the involved soft tissues. In chronic cases that don’t respond to physical therapy, surgery to release or lengthen the tight tissue may be needed.That brings us to lateral hip pain caused by tendon tears. The tendons involved most often are from the buttock muscles (gluteus medius and gluteus minimus). Because of the way these muscles attach to the greater trochanter (part of the femur or thigh bone), tendinitis of the gluteal muscles can look just like bursitis or iliotibial band syndrome.And finally, meralgia paresthetica must be considered whenever there is numbness along the front and side of the thigh. Meralgia paresthetica is caused by entrapment of the lateral femoral cutaneous nerve. This nerve can get pinched or compressed by tight clothing, after surgery to remove bone from the pelvic crest, a large belly associated with obesity, or in association with diabetes.There are some more serious types of problems that can affect the hip. Bone fractures, infections, and tumors head the list and are part of the differential diagnosis. Fortunately, these are rare and not easily overlooked when present.Once the physician diagnoses the problem, then an injury-specific treatment plan can be determined and carried out. With the exception of the more serious problems, most of these hip conditions are considered self-limiting meaning they will eventually go away in time. Treatment is first with conservative (nonoperative) approaches. The most common plan of care is for oral anti-inflammatory drugs, rest, and physical therapy. The therapist will work on correcting postural issues or malalignment, stretching and/or strengthening, and modification of aggravating activities or movements.Of course, fractures, infections, and tumors are dealt with in a different way. Treatment is also injury-specific but may include surgery, immobilization, antibiotics, and so on. You are on the right track to see an orthopedic surgeon and get a diagnosis. The rest will fall into place from there.

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 a 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.

There may not be an easy, straightforward answer to this question. Let’s go over some of the considerations.

If the tendon graft is taken from the same leg, then only one leg is affected. The patient can shift the weight off that leg during the early days after the surgery.

Repairing the knee with donor tissue from the other leg means both sides are affected. There have been a few cases reported of problems developing from overload of the donor side.

This is more likely during the first 24-hours when the patient is still under the influence of anesthesia and drugs to limit pain. Without complete sensation, the patient can put too much load on the donor leg. The result can be an avulsion fracture. The remaining (weakened) patellar tendon pulls away from the bone.

On the plus side, taking donor tissue from the other leg leaves less trauma to the reconstructed knee. Rehab can progress along much faster.

Most surgeons use donor tissue from the same side. Talk to your surgeon about his or her preferences and reasons for choosing one over the other.

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 a 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.

Knee pain, swelling, and giving way two years after ACL repair are signs and symptoms that the joint is unstable. If you haven’t gone back to your orthopedic surgeon, now would be a good time to make an appointment.

It may be a simple case of muscular weakness or imbalance. Sometimes such problems can be taken care of with a rehab program. In other cases there may be other (unknown) damage to the joint. Perhaps there’s a torn meniscus or some osteoarthritis developing.

Worst-case scenario: the repaired ACL may have failed. Further testing is needed to find out what’s wrong. The chances are good that treatment is available that can get you back to the activities you like.

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 a 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.

Not necessarily. It’s true that the longer a person waits, the greater the risk of the knee becoming unstable. Once the anterior cruciate ligament (ACL) is torn, there is greater strain on the other soft tissue structures in and around the knee.

Studies have shown that repair of ACL tears can be successful whether done right away or years later. If you’ve spent the last two years in rehab you may even have a better chance of good recovery. The exercises may have increased your strength. This can give you a “leg up” in recovery, so-to-speak.

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 a 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.

If the tendon graft is taken from the same leg, then only one leg is affected. The patient can shift the weight off that leg during the early days after the surgery.

Repairing the knee with donor tissue from the other leg means both sides are affected. There have been a few cases reported of problems developing from overload of the donor side.

This is more likely during the first 24-hours when the patient is still under the influence of anesthesia and drugs to limit pain. Without complete sensation, the patient can put too much load on the donor leg. The result can be an avulsion fracture. The remaining (weakened) patellar tendon pulls away from the bone.

On the plus side, taking donor tissue from the other leg leaves less trauma to the reconstructed knee. Rehab can progress along much faster.

Most surgeons use donor tissue from the same side. Talk to your surgeon about his or her preferences and reasons for choosing one over the other.

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 a 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.

A few studies have been done showing how rehab can be done at home. Most researchers advised patients to have some supervision by a physical therapist. They reported a need for quality education before and after the operation.

Patients at home need good handouts with detailed instructions about the exercises. Patients must be motivated to do their own program for it to work. Not all patient types have been studied. Most studies have included athletes. A recent study from Canada only included athletes with chronic ACL tears. Anyone with a recent injury wasn’t included.

Talk to your surgeon about your options. There may be a way to work out a program with some supervision that cuts down the number of trips you make. It’s important to follow some kind of rehab program to prevent joint problems later.

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 a 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.

Incomplete healing of a torn mensicus is usually found by having a second arthroscopy.

The surgeon makes one or more puncture holes in the skin and inserts a long, thin needle called a cannula into the joint.

Tiny tools can be passed through the cannula including a miniature TV camera to take a look inside the joint. What the surgeon sees as an incomplete healing of meniscal tears is a cleft or gap at the site of the tear. It may go down 10 to 50 percent of the thickness of the meniscus.

A gap of more than 50 percent is a nonhealed repair. A second operation is often needed in such cases.

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 a 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.

There are several benefits to this type of surgery. First of all, only a few small puncture holes are needed to slip the surgical tools into the joint. No large scars are needed. The back of the knee doesn’t have to be opened to tie the sutures. Healing time is shorter.

There’s less risk of damaging nerves or blood vessels with arthroscopy. The risk of infection is also less. The disadvantages may be just coming to light.

The first long-term studies are being reported. After about 10 years of using special devices that allow for an all-inside or all-arthroscopic repair, it’s clear that the repair is incomplete for many patients. A second operation may be needed to repair or remove the re-injured meniscus.

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 a 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.

If you are satisfied with the results then you have nothing to regret or wonder about.

Researchers agree the two methods have equally good results. There may be complicationsfrom time to time. These differ between the two types of repair.

The hamstring graft is a little nicer looking cosmetically. It gives a strong graft fixation early on. The hamstring may not be able to tolerate motion right away.

The patellar graft seems to help athletes get back into high-level action more often. There are still some problems with kneeling and quadriceps muscle weakness after a patellar tendon graft.

Overall patients report satisfaction with function and results after either type of graft repair.

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 a 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.

Simply put he’s having trouble straightening his knee all the way or with full strength. This is a common problem with ACL repairs using the patellar-tendon graft.

A small piece of tendon from below the kneecap along with a piece of bone on either sideof it can be harvested and used to replace the torn ACL. The quadriceps muscle along the front of the thigh straightens the knee. It’s attached to the patellar tendon. Removing apiece of the tendon can disrupt the way the muscle pulls.

This problem is usually taken care of with a good rehab program. The fact that your son is aware of the deficit is a good sign that his rehab team is working on it.

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 a 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.