ROTATIONAL INJURY TO THE KNEE ROTATIONAL INJURY TO THE KNEE
The anterior cruciate ligament of the knee is one of four principal knee ligaments.
However, it seems to be the most important ligament in terms of a sense of well-being and
stability of the knee. When torn, it is now routinely rebuilt utilizing:
a cadaver allograft or portion of the
patellar tendon or hamstrings tendons as a donor source. I utilize an arthroscopically
aided approach in my cruciate reconstructions, and find that with proper postoperative
rehabilitation, the prognosis is quite good for returning to competitive sports.
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Arthritis is a gradual wearing down of the smooth gliding surfaces of the knee joint. When this occurs, raw bone becomes exposed within the knee joint which becomes painful with activity. There is a gradation of treatments available to today's well trained orthopedic surgeon, and treatment protocols should be tailored to the specific conditions, age, and demands of the patient.
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Meniscal Cartilages are the "shock absorbers" between the femur and the tibia
bone at the knee joint. A torn cartilage is the most common condition of the knee
which ends up requiring surgical intervention. This is an outpatient arthroscopic
surgical procedure and patients almost always go home the same day. Patients are
usually allowed to walk on the leg as soon as it feels comfortable, and a short course of
physical therapy is of benefit. Advise on the amount of time away from work is highly
dependent of the nature of my patient's work. For example, an accountant or lawyer
undergoing arthroscopic surgery on a Friday can usually be on the job Monday (if they
really want to), however an unskilled farm laborer under workman's compensation many times
will require much more time to recover before feeling up to returning to the rigors of
walking up and down tomato fields.
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There are a number of various overuse type syndromes affecting the knee. The more
serious conditions frequently are surgical problems and are covered in the topics above.
Other conditions can occur from a multitude of reasons such as poor training practice, old
running shoes, and well as running surface issues. Iliotibial Band Syndrome is an
inflammatory condition affecting the outside of the knee and presents with pain
particularly when running downhill. Pes Anserine bursitis is a similar condition on the
inner half of the knee and would also be classified as an inflammatory disorder.
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Frequently injuries can occur to the articular cartilage of the knee which are focal in nature. Past surgical treatments of these injuries have included drilling of the defect, abrading the defect, or even cutting the bones to change the weight bearing surfaces so as to lessen the forces affecting the cartilage defect. New treatments are evolving and currently the Carticel articular cartilage regeneration is gaining increasing interest amongst orthopedic surgeons. This procedure has been utilized in Sweden for about eight years and has only been clinically introduced into the United States in 1995.