Arthroscopy may be answer to cyst removal at knee joint

February 8, 2010 — admin

I’ve had the fluid removed from a cyst behind my knee twice now. Why does it keep coming back?

Doctors think there are several reasons for this. First, the cysts have thick walls with twisted, deep roots. The body can’t dissolve or absorb this tissue. There’s also a valve between the cyst and the joint. This opening allows fluid to move from the joint into the cyst.

Often other damage in the knee adds to the problem. A new study by two doctors in South Korea report better results for cyst removal using arthroscopy. A special tool with a tiny TV camera is inserted into the cyst. The fluid is taken out. Then the cyst wall is removed with a motorized shaver. Any other damage in the joint is repaired at the same time. They’ve had 100 percent success in treating cysts this way.

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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Knee surgery video reveals lots of tools in use, but how?

February 3, 2010 — admin

I had some pretty fancy surgery done last week inside my knee joint. The doctor gave me a video of the entire operation. What I can’t figure out is how they got all those tools I saw on the video inside my knee. What can you tell me?

It sounds like your surgeon used an arthroscope to enter the joint. This long, slender tool pokes through the skin and tissue right into the knee joint. A tiny TV camera on the end allows the physician to see inside the joint.

There’s a special part of the arthroscope called a cannula. The cannula can be a rigid or flexible tube. It’s used to drain fluid or guide other instruments into the joint.

New tools have been made for arthroscopic surgery. There are forceps, shavers, measuring rods, and even tiny drills that can pass through the cannula. Once inside, the doctor uses special foot pedals and hand held devices to guide the camera and operate the tools. Frayed tissue can be shaved smooth. Torn cartilage can be sewn or glued back down. Bone chips can be removed and so on.

You can watch a total knee replacement surgery and get more information on Dr. Zehr’s Web site.

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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Arthroscopic procedure to relieve frozen shoulder pain described here

January 20, 2010 — admin

I’m going to have an arthroscopic release of a frozen shoulder next week. Can you tell me what is done during this operation?

The basic steps to this operation are the same from patient to patient. There may be some small differences based on what the doctor finds during the procedure.

First you will be anesthetized or put to sleep (some patients have a nerve block and remain awake but feel no pain). The doctor will gently mobilize the shoulder joint. This means while lying on your back, your arm will be lifted and rotated inwardly. This shows the doctor how the back (posterior) half of the joint capsule is moving (or not moving if it’s stuck or bound down).

Then the arm is gently moved out to the side away from the body. This motion is called abduction. Next the arm is rotated outward. This is done first with the elbow bent and then with the elbow straight with the arm down at the side. This gives the doctor information about the front (anterior) half of the joint capsule.

In the final step, the doctor uses a special tool (arthroscope) to look inside the joint for any areas of scar tissue, inflammation, or tears in the capsule. The scar tissue will be released and any rough spots shaved smooth. The doctor may cut and remove the joint capsule from the front and the back. Any other damage will be repaired and space made for all structures to move freely.

Most patients are seen in physical therapy right away. Rehab often continues after discharge from the hospital. A home program is essential.

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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No “drive-through sign” after shoulder surgery is a good thing!

November 24, 2009 — admin

What is the “drive-through sign?” I read the surgeon’s report after shoulder surgery and this is listed.

The surgeon was most likely doing arthroscopic surgery. This means a special tool (an arthroscope) was inserted into the joint to allow the doctor to look inside.

The drive-through sign refers to the ability to pass the arthroscope easily between the humeral head (round ball at the top of the upper arm) and the glenoid cavity. The glenoid cavity is the shallow cup the humeral head fits into. Together the humeral head inside the glenoid cavity forms the shoulder joint.

The location of a positive drive-through is at the bottom of the joint. This is where the lowest part of the glenohumeral ligament is located.

If the arthroscopic probe can move easily through the joint from back to front it’s a positive drive through sign. This sign tells the doctor the shoulder is loose or unstable. After treating the shoulder, the doctor looks to see if the drive-through sign is gone. If it is, this is means the shoulder is tight enough.

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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Dislocated shoulder may require surgery

October 13, 2009 — admin
I dislocated my shoulder. Should I have surgery?

 
Traditionally, doctors have treated dislocated shoulders with slings and physical rehabilitation. Unfortunately, this approach isn’t very effective in preventing repeat dislocations. This is especially true if you’re young. Studies show that athletes under age 25 re-injure their shoulders up to 94 percent of the time.

Surgery to stabilize the shoulder is a more aggressive approach. A new procedure uses an arthroscope– a camera-like device that lets doctors see inside the joint. With this instrument, doctors don’t have to make big incisions in the skin. This makes surgery less invasive. Doctors implant special tacks to hold the shoulder in place.

How effective is this procedure? It was recently tested on cadets at West Point. In this group of young, highly active patients, surgery resulted in stable shoulders 88 percent of the time. These patients had no complications from surgery. They were able to return to all their activities. Twelve percent of the patients had another injury within a year and a half of surgery. Still, this re-injury rate was felt to be small compared to that of patients who didn’t have surgery.

Talk to your doctor about your options for surgery, given your age and history.

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 arthroscopy the best way to diagnose source of knee pain?

October 8, 2009 — admin

My doctor is trying to find the cause of the pain in my knee. What’s the benefit of doing knee arthroscopy instead of MRI?

Knee arthroscopy may be the most common orthopedic procedure done today. It is a highly safe and reliable way to locate the source of knee pain. Researchers estimate that it is accurate over 90 percent of the time. Also, arthroscopy is more readily available to most patients than some other diagnostic procedures, such as MRI. While MRI may be less invasive, it’s also more costly and, in some cases, harder to get. Some doctors worry that MRI may be less accurate than arthroscopy. If both kinds of procedures are available to you, you may want to ask your doctor whether he or she prefers one method over the other. It may be that, in your case, one of the procedures would do a better job of finding the source of your knee pain.

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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Too busy for physical therapy? Rethink surgery!

September 22, 2009 — admin
I recently dislocated my shoulder. I’ve heard about a new surgery available to fix it. Does that mean I won’t need to go through physical therapy? Frankly, I don’t have the time.

 
The surgery you are talking about is arthroscopy surgery, and it’s not all that new. However, it is being looked at more closely as an improvement over the traditional approach of simply placing the shoulder in a sling. Physical therapy is an integral part of the recovery process, regardless of the treatment approach. Since it’s your body, you need to have a say in how it is cared for. That said, many surgeons prefer not to operate if the plan for rehabilitation afterward can’t be agreed upon. Discuss your concerns with your surgeon.

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. 

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