To test my knee, doctors plant my foot flat with my knee bent and pull on the lower leg. Why?

December 6th — admin

I have a bum knee that probably needs replacing. Over the years whenever I see a doctor they always do the same thing: plant my foot flat with my knee bent and pull on the lower leg. What kind of test is this anyway?

You may be describing the anterior drawer test. This is a test for ligament laxity or looseness. The lower leg bone (tibia) slides or glides forward underneath the thighbone (femur). A certain amount of slide or glide is normal. Too much sliding around is a sign that one of the ligaments inside the knee joint may be torn or damaged.

There is a series of tests for knee ligaments. If you’ve had the anterior drawer test, you’ve probably also been tested for side-to-side and rotational motion. All of these movements are needed for normal motion. Too much or not enough joint “play” or laxity can cause problems and put you at risk for future injury.

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.

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Which knee implant is better – plastic or metal?

September 21st — admin

I’m used to walking three to four miles a day even with my painful, arthritic knees. If I have a new joint put in should I go with the plastic or metal implant? Which one holds up best for walkers like me?

Good question…and one that is highly debated in the literature. After decades of using the metal-backed implants surgeons are trying the new all-poly (molded plastic) implants.

They say the metal backed implants can get worn unevenly causing the bone to deteriorate. The implant can loosen, too. On the other hand there’s concern that the polypropylene type won’t hold up under daily use by active adults.

Researchers at the Lenox Hill Hospital in New York City report results of the all-poly implant for a group of active, younger (less than 60 years old) adults. A majority of the patients said that walking distance was unlimited. A smaller number reported walking limited to 10 blocks or less.

Many of these active adults were also involved in swimming, tennis, and golf.

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.

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What is an “incomplete” repair of the meniscus?

July 27th — admin

Three years after a meniscal repair I started having painful clicking in my knee again. The doctor says the repair was “incomplete.” What does that mean? I may have to have another operation to repair the problem.

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.

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Benefits of repairing meniscus with arthroscopy

July 22nd — admin

What’s the advantage of having a meniscus repaired by arthroscopy? Are there any problems with this kind of surgery?

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.

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Thigh muscle won’t contract after total knee replacement surgery

June 30th — admin

A month ago, I had a total knee replacement. I’m working very hard with my exercises, but the thigh muscle just doesn’t seem to contract when I try to straighten or lift my leg. Why is this?

Scientists refer to this as “inhibition.” The muscle along the front of your thigh is the quadriceps. The surgery disrupts this muscle and keeps it from contracting with full force. In other words, the voluntary contraction is inhibited. Pain and swelling in the joint probably add to the problem. A new study supports the use of electrical stimulation and biofeedback to get back the full power of the muscle. You may need a more complete rehab program with a physical therapist to regain this muscle function. It will prolong the life of your implant and reduce your risk of falls.

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 surgery fix trick knee?

June 27th — admin

I have a trick knee that goes out on my every now and then. It’s from a torn ACL from an old football injury. If I have it repaired surgically will that stop it from giving way?

It should but there are no guarantees. It may depend on the condition of the rest of your knee joint. Are the other ligaments okay? What about the cartilage? Are there any signs of advancing arthritis? How much strength do you have in the muscles around the knee joint? These are all important factors.

There are two popular ways to repair a torn anterior cruciate ligament (ACL). One of these methods called the bone-patellar tendon-bone graft has been shown to be 22 percent more stable. In other words, it’s less likely to give way because of joint laxity. The increased graft strength may come from the small piece of bone plug that’s used along with the tendon tissue to make the repair.

The choice of graft material must be made on a case-by-case basis. It’s an educated decision based on the condition of your joint, your activity level, your goals, and the surgeon’s level of expertise.

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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I’m having a total knee replacement. Should I have my kneecap replaced too?

June 9th — admin

I’m going to have a total knee replacement in two weeks. The doctor is going to leave the kneecap alone unless I want it replaced, too. Should I have it replaced?

Patellar replacement called patellar resurfacing may extend the life of the implant. It has been shown to reduce knee pain after surgery. It can also improve function after total knee replacement (TKR).

There seems to be a higher rate of reoperation for patients with patellar resurfacing. Some doctors think resurfacing should be saved for patients with rheumatoid arthritis or severe pain after surgery. A large or thick patella can also keep a patient from having the patella resurfaced.

Overweight patients and those who have had many knee operations are also not advised to have patellar resurfacing done.

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 taking creatine supplements speed recovery after knee surgery?

June 1st — admin

I’ve heard taking creatine supplements can help me get better faster after surgery. I’m going to have a knee replacement later this month. Is it too late to start taking this?

Studies have shown that taking creatine supplements can help patients regain strength after surgery. However, a recent study of patients after total knee replacement didn’t reproduce these findings. In fact, knee and ankle strength went down 30 days after the operation.

This study may be the first to point out the importance of physical activity and exercise when taking creatine. Movement and especially resistance to muscles seem to help the creatine get transported into the muscles for active use.

Taking creatine supplements before and after joint replacement isn’t advised at this time. Talk to your doctor before taking any supplements. Some supplements shouldn’t be taken with other drugs or combined with anesthesia.

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 didn’t new treatment for torn ACL work?

May 24th — admin

I tried a new treatment for a partially torn ACL in my left knee. The doctor used radiofrequency waves to heat it up and shrink it down. It didn’t work. My joint is still too loose. What went wrong?

There are many factors that could cause a failed treatment of this type. The exact shrinkage that takes place depends on how much heat is applied and for how long. Not enough heat may not shrink the collagen fibers. Too much heat can actually kill the tissue, a condition called heat necrosis.

The extent of the damage before treatment is important, too. For example larger tears are less likely to respond to this treatment and more likely to tear again. Smaller tears may respond better but studies show long-term results (five years later) aren’t successful. The collagen shrinkage doesn’t hold, and the ligament becomes lax again.

You may be better off having a surgical repair. There’s less chance for reinjury and degenerative changes in the joint. Talk to your surgeon about treatment options at this point in your recovery.

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 wearing a knee brace prevent an ACL tear?

May 19th — admin

I think I might be prone to knee injuries. Would wearing a knee brace during volleyball practice help prevent an ACL tear?

Anterior Cruciate Ligament (ACL) injuries are a problem for many athletes in noncontact sports. Volleyball players are at increased risk because of the landing, turning, and pivoting required. Female athletes are up to eight times more likely to injure the ACL compared to male athletes.

Many studies have been done trying to find out the specific cause and ways to prevent ACL tears. Researchers have looked at weather conditions, playing surface, and footwear. They’ve examined hormonal differences between boys and girls. They’ve compared anatomy from head to toe as a possible reason for differences in the rates of ACL injuries between the sexes.

So far no single factor has been linked to ACL injuries. Bracing hasn’t been proven to prevent knee injuries either. Balance training and improving the joint’s sense of position seem to have the best record so far in preventing these types of knee injuries.

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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