Would a knee brace help with my arthritis?

April 4th — admin

I’ve gradually started losing knee motion from arthritis. The X-rays show degenerative changes in and around the joint. Would it help to wear some kind of brace or splint at night to hold that knee straight?

Loss of knee extension is called a knee flexion contracture. It means your knee is stuck in a position of flexion and can’t straighten all the way. Without full knee extension, your ability to walk is affected. Not only does it take more energy to walk without full extension, but it slows you down!

Most surgeons would advise a total knee replacement. Preoperative casting or stretch-bracing have been suggested to reduce the knee flexion contracture. The idea is to restore as much motion as possible to make the surgery easier.

There are very few studies to investigate this idea. It’s likely the time it would take to gain a few degrees of motion wouldn’t be worth the extra pain and loss of daily function. Extension can be much more easily restored during surgery.

The surgeon will take the necessary steps to balance the soft tissues and remove any bone spurs affecting motion. Joint motion is checked and rechecked during the operation. Minor adjustments are made in bone structure, joint capsule, and tendon length until full motion is available.

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.

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

How does taping the kneecap relieve pain from PFPS?

April 2nd — admin

Our 16-year old daughter has had constant knee pain from a problem called PFPS. She is seeing a physical therapist who wants to try taping the kneecap. How does this help the problem?

Patellofemoral pain syndrome (PFPS) is a fairly common condition. Girls are affected more often than boys. With the increased participation in sports, PFPS has become a bigger problem than it once was. Pain with knee motion makes it more difficult to stay active in sports.

The patella sits over the knee joint and moves up and down along a track or groove in the femur (leg bone). PFPS causes pain because of the way the patella (kneecap) tracks within the femoral groove as the knee moves.

The quadriceps muscle helps control the patella so it stays within this groove. If part of the quadriceps is weak for any reason, a muscle imbalance can occur. When this happens, the pull of the quadriceps muscle may cause the patella to move more to one side than the other. This in turn causes more pressure on the cartilage on one side than the other. In time, this pressure can damage the articular cartilage.

Taping the patella helps it stay in the groove and move up and down over the knee as it should. Many patients get immediate pain relief with this treatment technique. Taping is usually accompanied by a muscle stretching and strengthening program.

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.

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

Can taping knees affect pain in sports activities?

March 29th — admin

I have been working as a parent volunteer for our girls’ softball team. The coach has been doing some taping of the girls’ knees who have pain during squatting. I notice it seems to help some girls right away. Others don’t really seem to benefit. Why is that?

Taping has been used by many coaches, trainers, and therapists working with athletes who have ankle, knee, or shoulder pain. Taping usually stabilizes a joint and holds it in place. This takes pressure off the joint and nearby structures. It forces the muscles to respond more normally.

Studies definitely show a wide range of responses to taping. It would be very helpful if it were known who could benefit from taping rather than spending time trying out taping on a trial-and-error basis.

Pain during squatting may be caused by a problem called patellofemoral pain syndrome (PFPS). A recent study from Australia found two patient characteristics that may help predict which athletes with PFPS can benefit from knee taping.

The first is the patellar tilt test. The examiner glides the patella toward the outside of the knee, and then tries to lift the outer border of the patella up. In the normal knee, the patella should stay flat and should not lift up. Too much lift means the patella is very mobile and unstable.

The second is the angle of the tibia (lower leg bone). Bowing of the leg past five degrees seems to contribute to the problem of PFPS. Patients with these two positive tests often get immediate pain relief with taping.

The girls on your team who don’t get any pain relief from this type of taping may have some other problem that needs to be identified. Some other form of treatment may work better for them.

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.

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

Does knee repair always require rigorous rehab?

March 27th — admin

I’m planning to have an operation called microfracture to repair an old football injury to my right knee. I’ve been told to expect a rigorous rehab program. I’m not much of an exerciser anymore now that I’m not playing ball. Can I get by without this part?

Microfracture is a method of treating defects in knee cartilage that go clear to the bone. The surgeon drills tiny holes through the cartilage into the bone. This allows the blood from inside the bone to seep into the cartilage layer. Blood clots are formed and start a healing process.

Studies show that results after microfracture are best when the patient follows a four- to six-week postoperative program. The rehab includes protected weight bearing on that leg and continuous passive motion (CPM).

With CPM, your leg is strapped into a machine that slowly bends and straightens your knee. You can expect to spend six to eight hours (or more) each day on CPM. Based on the results of studies done so far, some surgeons consider patients at too great a risk for failure if they don’t want to follow the expected post-op rehab program.

This program is not strenuous, just time consuming. Talk to your surgeon about your concerns and let him or her know your thoughts on the subject. More information about what to expect on a daily basis may help you in your decision-making process.

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.

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

Can knee replacements set off airport security detectors?

March 23rd — admin

I have a brand new knee replacement (this year). When I travel, I notice some airport detectors go off and others don’t. Why is that?

Many people have reported differences not only from airport to airport but even from time to time through the same security detector. To solve this puzzle, Dr. Robert F. Ostrum, Chief Orthopaedic Surgeon at Cooper University Hospital in Camden, New Jersey did a little research on the topic.

He found that airport metal detectors generate a brief magnetic field. When a metal object passes through the detector, the magnetic field is reversed and a sharp electrical spike sets off the alarm. Many other factors come into play as well.

For example, the more metal you have (say from multiple implants) or the larger the pieces (mass), the more likely it is that the detector will sound the alarm. The type of metal can also make a difference. Anything with iron in it or other type of metal that can be magnetized increases your chances of detection.

Detection units can also be set for higher sensitivity. So on high alert days, you are more likely to set off the alarm when you walk through the archway compared to a low-alert status.

Some of the walk-through archways only have a detection device on one side. If your implant is on the opposite side, you are less likely to set off the alarm. The handheld wand detectors are more likely to detect metal implants but these are not used routinely.

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.

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

Is it possible to kneel after a hip replacement?

March 20th — admin

I am going in to have hip replacement surgery. Will I be able to kneel down to work in my garden once my hip heals? What about getting on my hands and knees in the garden?

If your doctor does your surgery from the back part of the hip, called a posterior approach, you need to avoid bending your hip more than 90 degrees. You can kneel down, but try to avoid kneeling directly onto the operated side. If you must kneel, keep your weight even on each side. While kneeling, avoid bending too far forward at the hip because you could bend your hip past the safe limit of 90 degrees.

Do not get onto your hands and knees. This position immediately puts your hip at a 90-degree angle, and the added pressure of your body weight on your hip could force the hip to dislocate out of the socket.

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.

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

Signs of healing in arthroscopic microfracture treatment.

March 13th — admin

Two months ago I had a microfracture treatment to the knee. The surgery was done arthroscopically. I’m supposed to be very careful to do exactly what the surgeon says to avoid displacing the healing tissue. How will I know when it’s healed enough to be safe?

In this procedure tiny holes called are made in the surface of the knee joint. This is called microfracture. The purpose is to release droplets of fat and blood from the bone through the holes into the area of damage or defect.

Tiny clots form filling in and plugging up the holes. A bond forms between the clot, bone, and cartilage. The end result will be a new surface layer of repair tissue where the original defect was present.

The doctor has probably advised you not to put weight on that leg for at least six weeks. By now you are starting to do so and will gradually advance to full-weight bearing. How fast you go depends on the size and location of the lesion. Painful symptoms may also limit you at first.

The surgeon will order repeat MRIs to help assess the status of the healing tissue. Another arthroscopy to look inside the joint isn’t usually required. The MRI will show how much cartilage filling has taken place. The MRI is very sensitive to cartilage and will also show the status of the underlying subchondral bone plate.

Your surgeon will use all of this information to give you guidelines for activity in the weeks and months ahead of your recovery. If you follow his or her advice, you should be very safe.

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.

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

My total knee joint replacement problem is over-stuffing. What is it?

March 1st — admin

For months after my new total knee joint it just seemed like something wasn’t right. I finally got a second (and a third) opinion. Both consulting orthopedic surgeons called my problem “over-stuffing.” What does this mean really?

Creating the perfect total knee replacement requires a very delicate balance between bone, implant, muscles, and ligaments. The surgeon may be working with osteoporotic bone or a joint with a natural extra rotation in one direction or another.

Once the arthritic or damaged bone is removed to make room for the implant, the surgeon must choose the right size and type of prosthesis for each patient. Replacing the anterior or front portion of the femoral bone (thighbone) with an implant that is larger than the bone removed is called over-stuffing. Too much over-stuffing can cause pain and loss of motion (flexion).

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 health care provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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

At 66, should my mother get a rotor rooter or complete knee replacement?

February 8th — admin

My mother is thinking about having an operation to rotor rooter her knee. It seems she may have some torn or loose cartilage causing pain, locking, and difficulty walking. We’re thinking at her age (66 years old), maybe she should just have a knee replacement. What do you suggest?

The orthopedic surgeon is really the best one to advise your mother and answer your questions. He or she has the benefit of knowing your mother’s history and the results of the physical exam. Looking at the joint and leg alignment helps guide the decision. Seeing X-rays of the joint space is also very helpful.

At age 66 your mother is still fairly “young” by today’s longevity standards. If she has severe enough joint damage, then total joint replacement may be the best option. But these days, the goal is to preserve the natural joint for as long as possible.

It sounds like she’s planning to have an arthroscopic debridement. This is a minimally invasive operation. The surgeon makes two or three puncture holes and inserts a long, thin needle (the arthroscope) with a tiny TV camera on the end into the joint. This tool gives a view inside the joint. Tools used to remove loose cartilage or to repair any damaged cartilage are passed through the scope.

Most patients are up and going two or three days later. They wear a knee immobilizer and put partial weight on the leg until they feel up to full weight-bearing. Range of motion exercises are prescribed. Most pain relief occurs within the first six months. Some patients report continued improvement for up to two years after the operation.

It’s a good treatment option for patients with mild osteoarthritis. The ease of recovery makes it worth a try before going to major surgery like a joint replacement.

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 health care provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.

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

What is spontaneous ostenonecrosis and what causes it?

January 19th — admin

What is spontaneous ostenonecrosis and what causes it? My husband has been diagnosed with this problem in his left knee. We can’t figure it out.

You’re not alone in your questions. We know that osteonecrosis is the death of bone tissue. But spontaneous osteonecrosis (SON) is sudden, unexpected, and without known cause.

Some recent reports point to a possible increase in this condition in adults over age 60. At first doctors thought it was linked with arthroscopic surgery to remove a torn meniscus. But then five new cases were reported in patients who had meniscus degeneration but no surgery.

It appears that age-related wear and tear on the meniscus may be the start of the problem. But there are still many questions about what’s going on. For example, in one study of five patients, symptoms of knee pain were identified as medial meniscal degeneration.

At the time of the diagnosis, there were no changes in the bone seen on an MRI. The patients were all treated with physical therapy, exercise, and noninflammatory drugs. Two months later the symptoms increased. A second MRI showed osteonecrosis of the knee.

What happened in those two months between MRIs? Doctors just aren’t sure yet but further studies may offer some insight into SON.

Posted in Knees. Tags: , , , , , , , , , , , , . No Comments »
« Older posts «
Newer posts » »