KT-1000 an accurate test for torn ACL

I’m scheduled to have a special test for my knee. It’s called a KT-1000. What is this exactly?

The KT-1000 arthrometer is a small device that’s strapped to the leg during knee examination. It’s used when the doctor thinks there may be a tear in the anterior cruciate ligament (ACL).

The examiner pulls on the uninjured knee and the gauge on the KT-1000 shows how many millimeters of motion occur between the lower leg bone (tibia) and the upper leg (femur). This motion is called a drawer sign. The reading is compared between the injured knee and the normal knee.

If there’s more than three millimeters difference between the knees, the ACL is torn. It’s considered more accurate than an MRI.

If you’d like to see a photo of this tool go to:
http://www.medmetric.com/kt1.htm
or

http://www.ismoc.net/procedures/kt1000.html.

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.

Are stem cells used to grow cartilage?

I’ve heard there’s a way to regrow torn cartilage in the knee. Are they using stem cells to do this?

Not yet. Researchers at Johns Hopkins have tried using stem cells to grow into tissue that’s like cartilage. They are testing a method injecting fluid filled with stem cells into the joint. The liquid hardens into a stable gel when placed under a special light. Stem cells inside the gel start to multiply and form new cartilage. So far only animals have been used in these studies.

In the meantime, doctors have found two other ways to get cartilage to repair itself. The first is called microfracture. Surgeons use a blunt awl (a tool for making small holes) to poke a few tiny holes in the bone under the cartilage. This causes new tissue, mainly scar tissue, to grow and fill in the holes.

The second is autologous chondrocyte implantation. Normal, healthy cartilage cells are taken out of the knee. They are sent to a special lab where more cells are grown from the original cells. The new batch of cells are put into the joint surface where the damage is located.

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.

How old is too old for a total knee replacement?

My 92-year old mother has severe knee arthritis. It seems to me she could sure benefit from a knee replacement. Is she too old?

Maybe not! A recent study from Mayo Clinic reports good results for adults over age 90 getting their first total knee replacement (TKR). They also report on patients ages 90 to 102 who had a repair or replacement of a previous TKR.

Doctors are expecting to see more and more adults in their 90s (and older) outliving the TKR put in when they were in their 70s. Likewise, as more people live longer, first timers in need of a joint replacement may show up in their 90s.

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.

Is Grandma too old for total hip replacement?

My 83-year old grandma is going to have a total hip replacement. We’re all worried that she’s too old for this. What do you think?

Americans are living longer and in better health. This means they are more likely to need a major joint replacement as they reach their 80s. Joint replacements are available for the shoulder, hip, or knee.

These operations do put older adults at increased risk of problems.

Studies of 80-year old (and older) adults compared to younger adults show there is an increase in the number of serious problems that occur. But the overall rate is low, and it’s more likely to happen in elderly patients with other health problems.

Results should be good if your grandmother is in good health and the doctor has approved the surgery.

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.

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

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.

Tibial plateau fracture may lead to total knee replacement

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.

Will I be able to climb stairs after my total knee replacement?

I had a total knee replacement five months ago. I can walk just fine, but I still can’t climb the two stairs in front of my house. Will I ever be able to do this?

Stair climbing is a difficult skill for many people who have had total knee replacement. This is true even one year after surgery. After surgery, the support from leg muscles is only one-third of the strength and force needed to climb stairs.

Bring your concern to your doctor’s attention. A physical therapist can help you begin an exercise program specifically designed to assist you with stairs. If you saw a physical therapist during your recovery from surgery, do not hesitate to contact the therapist and request additional services.

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.

Surgery preferred for double-ligament knee injury

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.

Knee surgery vs. physical therapy for torn ACL

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.

Feeling unsteady after knee surgery? This may be why.

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.