Tibial plateau fracture may lead to total knee replacement

January 26, 2010 — admin

What is a tibial plateau fracture and what’s the final outcome with proper treatment?

The tibia is the lower leg bone between the ankle and the knee. The tibial plateau is at the top of the tibia. It’s the surface where the upper leg bone rests on the tibia. In other words, the tibial plateau is the bottom surface of the knee joint.

A fracture in this area can be treated with or without surgery. This depends on how severe it is and whether or not there is another injury with it. A torn ligament or a second fracture may also require surgery.

Over the years, studies have shown that tibial plateau fractures result in arthritis. A total knee replacement (TKR) may be needed. The final outcome isn’t as good for patients receiving a TKR without a previous fracture. The operation can be very complex.

Results are good when the doctor is aware of these problems and plans carefully.

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 women athletes suffer more ACL injuries than men

January 18, 2010 — admin

I’ve been following college basketball. I notice the women seem to have twice as many ACL injuries as the men. Why is this? Do men have some training secrets that women don’t know?

It is a well-known fact that women athletes suffer more ACL injuries than men in the same sport. The reason for this remains unknown. Although many possibilities have been suggested, no one factor or combination of factors has been identified.

One group of researchers decided to measure the effect of muscle contraction on the knees. They looked at how stiff the knee becomes when the muscles contract in men and women. Knee stiffness protects the ACL. By tightening up the knee, the bones can’t slide enough to tear the ligaments inside.

Surprisingly, the researchers found that men are able to tighten the knee joint to three times its normal stiffness. Women can only double the stiffness. This difference does not appear to be caused by muscle strength, body weight, or height. It may be that men use the muscles around the knee differently than women.

The study also showed that men use the hamstring muscles on the back of the thigh more than the quadriceps muscles in front to get this much knee stiffness. It may be that women can train the hamstrings to react faster and with more force to help protect the knee from injury. Further studies are needed in this area.

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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Surgery preferred for double-ligament knee injury

December 29, 2009 — admin

I frequently read in sports journals about the two main ligaments in the knee. I understand the anterior cruciate ligament is the one that’s most often injured. Is it possible to tear both ligaments at the same time?

Yes. High-velocity or high-energy accidents in contact sports can cause damage to both ligaments in the knee. This can also happen in car accidents if the knee impacts the dashboard. Injuring both ligaments makes the knee very unstable. This causes problems walking and using the knee.

With this much damage, surgery is the preferred treatment. The surgeon will repair as much as possible at one time, but these are time-consuming operations. Sometimes a second surgery is needed to finish the repair. The first and most important surgery is to repair the posterior cruciate ligament and surrounding structures. These must be repaired at the same time because these tissues work together to help stabilize the knee.

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. For more information on this subject, visit www.zehrcenter.com.

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Splinting, bracing, wrapping injured knees is controversial treatment

December 18, 2009 — admin

I often see people wearing braces on their knees. I hurt my knee in a skiing accident last week. Should I be wearing a brace?

The use of splints, elastic bandages, neoprene sleeves, and various braces for knee injuries is controversial. When to wear these devices and for how long are subjects of current research.

 

A proper diagnosis is the first step in knowing how to treat an injury. For example, elastic ace wraps are used for sprains to help reduce swelling in the first 24 hours. Knee support is sometimes recommended for anterior cruciate ligament injuries, especially if surgery is delayed. Talk with your doctor to find out whether extra support is necessary in your case.

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. For more information on this subject, visit www.zehrcenter.com. 

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Is postponing surgery for torn ACL the right move?

December 15, 2009 — admin

I recently tore the anterior cruciate ligament in my right knee. The doctor told me I need surgery to repair the tear, but he seems to be in no hurry to operate. Shouldn’t this kind of surgery be done right away?

Your doctor may be waiting for the inflammation to calm down. When a ligament is torn or partially torn, the body responds immediately to help the healing process. Sometimes this results in a lot of swelling in the area, with a loss of knee motion.

Your doctor may have you start a physical therapy program before surgery. Physical therapy is used to help reduce pain and swelling and improve knee motion and strength. Once the initial healing reaction has calmed down and you have your motion back, surgery can be scheduled. Research shows improved results when ACL surgery is postponed until these goals are achieved.

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. For more information on this subject, visit www.zehrcenter.com.

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Knee surgery vs. physical therapy for torn ACL

December 7, 2009 — admin

My skiing buddy and I both had knee injuries in competition last month. It turns out we had the same injury–a torn anterior cruciate ligament. He went on to have knee surgery. My doctor said my knee will get better with physical therapy. Shouldn’t I have the same treatment as my friend?

Not necessarily. It’s likely your friend’s ACL was severely damaged. Your doctor may have determined that your ligament was only mildly torn or stretched out. In that case, physical therapy treatments can be used to help improve your knee function.

Your doctor and physical therapist will watch to see if you get full knee motion and strength. If your pain and swelling go away and your knee feels stable and strong, you may be able to return to competition without knee surgery.

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. For more information on this subject, visit www.zehrcenter.com.

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Feeling unsteady after knee surgery? This may be why.

December 2, 2009 — admin

Six months ago, my doctor reconstructed my torn ACL using a piece of the tendon and bone from below my kneecap. I completed physical therapy and still feel like the knee isn’t going to hold me. My doctor says the surgery was a success and the knee is as “tight,” if not tighter, than before my injury. If that’s the case, why do I feel so unsteady on the leg?

There are several tests physicians use to check the integrity or strength of the repaired ligament. One of these is the pivot-shift test, in which the doctor applies pressure to the lower leg just below the knee. A “tight” joint will not shift or move with this test.

Your sense that the leg is not steady or stable enough to hold you may be caused by muscle weakness. When the replacement tissue for the torn ligament is taken from below the kneecap, the quadriceps muscle on the front of the thigh may lose strength. You may need some additional strengthening exercises. Contact your physical therapist for a follow-up evaluation.

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. For more information on this subject, visit www.zehrcenter.com.

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Which knee ligament is really torn – ACL or MCL?

November 18, 2009 — admin

It has been 20 years since I was diagnosed with a partial tear of my medial collateral knee ligament. My knee gives out every once in a while, keeping me from the activities I enjoy. I just turned 63, and I like to keep active by skiing and playing golf. Should I have the ligament replaced?

It is questionable whether you merely tore your medial collateral ligament (MCL) when you were first hurt. Had you only injured the MCL, chances are it would have scarred down and not given you much trouble.

From what you describe, it is more likely that you also stretched or tore the anterior cruciate ligament (ACL). In either case, you might not be a candidate for ligament surgery given your age. Instead, a surgeon specialist will probably want to have you use a brace and do exercise treatments. If these aren’t helpful, surgery might be a last resort.

Age is one factor your surgeon will consider. So is activity. Your surgeon may treat you as he or she would a younger patient, given your level of activity.

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. For more information on this subject, visit www.zehrcenter.com.

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I tore my ACL playing soccer. How do these injuries happen?

November 6, 2009 — admin
Having played soccer since I was eight, I’m a seasoned player in excellent shape. But last month, I tore the anterior cruciate ligament in my knee during my last high school game. I still don’t know what happened. One minute I was after the ball, the next minute I was down on the field and unable to get up. How do these injuries happen?

 
Most ACL injuries occur when the knee is perfectly straight or slightly bent. This type of injury can happen when a player is running, jumping, or standing still. In soccer, the ACL is most likely to be injured when a player is running and changing directions quickly, stopping suddenly, or twisting the body over the foot. Jumping and landing on the foot with the knee twisted can also cause problems.

New technology has allowed researchers to measure the strain placed on the ACL. One important discovery has been that stopping suddenly (rapid deceleration) puts a high level of strain on the ACL. This occurs when the foot makes contact with the ground and the leg is at its straightest. Doctors and physical therapists are working together to develop an exercise program that will prevent these types of injuries.

 

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. For more information on this subject, visit www.zehrcenter.com.

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Why do I need physical therapy before knee surgery?

October 9, 2009 — admin
I am facing knee surgery for a torn anterior cruciate ligament (ACL). When I went to see a knee specialist, I felt rushed. I was told I needed surgery right away. My family doctor thinks I should have some physical therapy before surgery, but the specialist is adamant that I have surgery right away. Is it usually helpful to have some PT before having surgery?

 
Some doctors prescribe up to 12 physical therapy visits before scheduling ACL surgery. Doing some physical therapy first can help prepare you for the surgery. The visits help by getting control of the swelling, restoring knee movement, and improving knee stability. Getting the swelling down before surgery may keep scar tissue from developing after surgery. Improving knee movement and joint stability before surgery can also affect your progress after surgery. Your physical therapist can use the visits before surgery to answer your questions. He or she can train you to use crutches, and go over the exercises you’ll do after surgery.

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. For more information on this subject, visit www.zehrcenter.com.

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