Common Knee Injuries Related to Sports

Common Knee Injuries

The knee is a complex structure with many components that make it vulnerable to a variety of sports injuries. Most people suffer a minor knee problem at one time or another. Knee injuries often occur during sporting activities, too. In 2009, knee injuries were the most common reason for visiting an orthopedic specialist.

Knee Anatomy and Function

The knee joint is the largest joint of the body and the one that is most easily injured. Two cushioning discs call menisci separate the upper and lower bones of the knee. The upper leg bone (the femur) and the bones of the lower legs are connected by ligaments, tendons, and muscles.

The surface of the bones is covered by cartilage, a substance that absorbs shock and provides a smooth, gliding surface. Knee injuries are the result of damage to one or more of these structures. Of the four major ligaments found in the knee, the three that are injured the most are the anterior cruciate ligament (ACL), the medial collateral ligament (MCL), and the posterior cruciate ligament (PCL).

ACL Injury

The ACL is injured when athletes are changing direction rapidly, slowing down when running, or landing from a jump. Individuals who play basketball, football, and soccer and those who ski are particularly at high risk for ACL injuries. If this structure is damaged, you could require surgery to regain full function of your knee. This will all depend on the severity of your injury and your activity level.

Most of the time ACL tears are too severe to be stitched back together. The orthopedic surgeon will have to surgically repair this structure by reconstructing the ligament. Most of the time the doctor will use a tissue graft to repair the ligament. This graft acts as scaffolding for new ligament to grow on. Most of the time grafts are taken from the patellar tendon or the hamstring tendons.

MCL Injury

A direct blow to the outer aspect of the knee commonly causes injuries to the MCL. Those athletes who play football and soccer are at the highest risk. When the knee is forced sideways, the MCL can tear and result in knee pain. Swelling will occur with a MCL injury as well and the knee will become unstable and give way.

When the MCL is torn severely and cannot heal correctly, surgery is necessary. This will involve grafting a piece of tendon to allow the portions of the torn ligament to connect to. Most of the time, however, these injuries can be treated without surgical intervention.

PCL Injury

The PCL is most commonly injured when an athlete receives a blow to the front of the knee. This structure can also be torn or injured if the individual makes a simple misstep on the playing field. Those who participate in football and soccer are at the greatest risk for a PCL injury. This ligament is located in the back of the knee and connects the femur to the shinbone (the tibia).

When an athlete suffers a PCL tear or injury, the orthopedic specialist will most likely recommend surgery. This is done to rebuild the ligament by replacing the torn structure with a tissue graft. During the procedure the doctor will rebuild the PCL. A tendon or other structure is used to replace the torn ligament.

Meniscus Injury

The menisci tear in different ways. The orthopedic specialist depending on how they look, where they occur, and how complex they are classes the tears. Common tears include the parrot-beak, flap, bucket handle, longitudinal, and mixed/complex. Sports-related tears of the meniscus often happen along with other knee injury. Sudden tears can occur when the athlete squats or twists the knee. Direct contact or a sharp blow can also cause meniscus injury.

When a meniscus tear is serious and the symptoms persist with nonsurgical treatment, your doctor may recommend an arthroscopic procedure of the knee. This is one of the most commonly performed surgical procedures where the orthopedic specialist inserts a miniature camera into the knee joint to trim and repair the tear to the meniscus. While he is doing this surgery, other torn structures can be repaired and treated as well.

Anterior Hip Replacement

Our orthopedic surgeons Dr. Watt, Dr. Peterson, and Dr. Downer, now perform total hip replacement and other hip surgeries through a smaller, less-invasive approach. The purpose of the anterior approach is to perform a total hip replacement with less disruption of the surrounding soft-tissues and muscles. When the doctor performs this procedure through smaller incisions, there is less pain and a faster recovery because there is less soft-tissue and muscle dissection.

Anterior hip surgery is not a new idea; in fact, many surgeons have chosen this approach since the 1980s. However, what is new about the anterior hip replacement procedure is the surgeons are using smaller incisions and more specialized instruments to make the surgery less traumatic to the patient. … read more

Rotator Cuff Tears and Repairs

Though shoulder pain is quite common, it is usually not normal. Many shoulders become stiff or inflamed for no apparent reason. However, with a shoulder injury, persistent shoulder pain is often a sign that there might be a structural abnormality about the shoulder.

The most common shoulder tear involves the Rotator cuff, but it takes a thorough clinical exam along with an MRI to properly diagnose.Many rotator cuff disorders can be treated without surgery, but if the injury is severe or does not respond to conventional treatment measures, surgery may be considered. Most of the time our orthopedic specialists recommend surgery if your shoulder doesn’t get better after 3 to 6 months of nonsurgical treatment such as rest, ice or heat, and physical therapy.

The procedure to repair a torn rotator cuff involves reattaching the tendon to the head of the upper arm bone (the humerus). Those patients with a partial tear may need surgery in order to trim or smooth the tendon, or often repair the tendon back to the bone to prevent the tear from propigating. With a complete tear, the surgeon repairs the tendon by stitching the two sides back together.

When is Rotator Cuff Surgery Recommended?

Rotator cuff surgery is a safe and effective way to regain full range of motion to your arm. Our orthopedic specialists perform this type of surgery often, and most patients who are active and use their arms for overhead work or sporting activities greatly benefit from this procedure. Our doctors may recommend surgery if your pain does not improve, as continued pain is the main indication for surgical repair of the rotator cuff. Other signs that this procedure is a good option for you include:

You have a large tear of more than three centimeters.
Your symptoms have persisted for greater than six months.
Your tear was the result of a recent acute injury.
You have major weakness and loss of function of your shoulder area.

What are the Types of Surgical Options?

There are several different options that the orthopedic specialist can do to repair your rotator cuff and alleviate your problems. This will all depend on the size of your tear, the quality of your tendon tissue and bone, and your personal anatomy. These repairs include:

Open Repair: This is a traditional approach to rotator cuff repair. With this procedure, the surgeon makes an incision at the shoulder area and detaches the shoulder muscles to gain better access to the torn tendon. During open repair, the orthopedic specialist will remove bone spurs and repair the torn structure. This option is best when the tear is complex and large or if additional reconstruction is necessary. Usually most open repairs done in our office employ the Mini-open approach described below.

Arthroscopic Repair: Arthroscopy involves the use of a tiny camera (called an arthroscope) inserted into your shoulder joint. The camera will display images on a TV monitor so the surgeon can use these images to guide the scope and tiny instruments to make necessary repairs. Our orthopedic specialists makes several small incisions around the shoulder area to allow the arthroscope to be placed where the doctor needs it to be in order to see and repair the shoulder structures. The shoulder arthroscopic technique is minimally invasive and done on an outpatient basis. There is quicker recovery time and less pain with this procedure.

Mini-Open Repair: Another option our orthopedic specialists utilize includes a mini-open repair technique. The orthopedic specialist makes an incision that is 3 to 5 centimeters long and uses an arthroscope to access and treat the torn rotator cuff and shoulder structures. This procedure avoids the need to detach the deltoid muscle, allowing for quicker recovery time and minimal pain. This procedure is similar to the arthroscopic repair method and generally is quite successful in the correct circumstance.

Common Pediatric Fractures

$common-pediatric-fractures$ Parents often hear the word fracture for the first time and think it is less severe than a broken bone. Fractures, however, are broken bones. The severity of a break depends on the force that caused the fracture, where the fracture is located, and if the break is complex or simple.

If a bone breaks and fragments of it stick out through the skin, this is called an open fracture. These are particularly serious because the skin is broken and the child is at risk for infection. … read more

Anterior Hip Replacement Surgery

Anterior Hip Replacement

Anterior hip replacement is a surgery that has been performed for twenty years. Currently, Dr. Watt is one of only a few orthopedic surgeon performing this technique in the Seattle area. This technique allows the orthopedic specialist to provide you with the same procedure as the standard hip replacement, but with less disruption to the surrounding soft tissues and muscle tissues.

The surgery is performed through a smaller incision and there is less tissue dissection and this allows you to get back on your feet sooner and allows unrestricted motion of the hip immediately after surgery. This guide informs you of what to expect during the hip evaluation, what to be aware of before the surgery, and what you should know about after the procedure.

What to Expect during Hip Evaluation

An orthopedic specialist is a surgeon who specializes in problems that affect the bones and joints. When you go in for a hip evaluation, the doctor will ask you many different questions about your general health, your symptoms, and your expectations. This way he can determine if an anterior hip replacement is right for you.

The evaluation will include careful examination and review of your X-Rays and other preoperative tests. This is done to allow the surgeon to better understand your physical limitations and the exact progression of your hip problem. The orthopedic specialist will take a medical history and perform a detailed physical examination.

This will include range of motion tests of your hips and knees and evaluation of your muscle strength. The doctor will take X-Rays of your hip to evaluate the joint and plan for a new hip if needed.

What to Expect Before your Surgery

Before you undergo an anterior hip replacement, you will have to see your family doctor for a thorough medical evaluation. It is essential that you bring all your medications and supplements to the visit so the doctor can make a note of them and tell you which ones you must stop taking before the surgery.

If you are taking aspirin or anticoagulants, be sure you tell your doctor so he can advise you whether or not to continue these as directed. With this procedure it is usually not necessary to donate your own blood ahead of time.

What to Expect During Surgery

With the anterior approach, the surgeon will be replacing the top of the thighbone and socket through a small incision. Basically, the surgeon will get to the hip by means of a muscle-splitting approach. Rather than removing the muscle, he goes between the muscle tissues.

Because the incision is minimally invasive, you will be back on your feet sooner. The anterior approach to hip replacement has a lower rate of dislocation, too.

What to Expect After your Surgery

Once the surgery is over, you will be monitored in the post-anesthesia recovery room. You will stay there until your blood pressure, pulse, and breathing has stabilized and your pain is under control. You will be asked to move both legs as soon as you wake up and the nurse will help you find a comfortable position to lay in.

To protect you against development of blood clots, you may be asked to do ankle pumping exercises every hour and you will have sleeves on your legs to help prevent blood clots by pumping the blood for you. You will begin to take in regular food and fluids soon after your operation.

There will be a dressing on your surgical site that will be changed and checked frequently. The nurse will have you cough and deep breathe frequently and use an incentive spirometer after your surgery to expand your lungs. Remember, it is normal to have minimal discomfort after the procedure so ask your nurse for pain medication, as you need it.

What to Expect during Recovery

Because the anterior approach to hip replacement is a tissue sparing operation, you will be able to freely bend the hip and bear full weight immediately after surgery. This is done so you can enjoy a much faster recovery than with traditional hip replacement. Isometric exercises begin while you are still in the bed.

These are muscle-tightening exercises done without moving the joint. You will be assisted in doing these a number of times each day during your waking hours.

A physical therapist will work with you to help you move your joints so they remain strong during your recovery. The therapist will document your progress and keep your surgeon well informed of your condition. It is important for you to follow both the therapist’s instructions and the orthopedic specialist’s advice to enjoy a healthy, full recovery.

In patients that are in good shape and good general health before the surgery a discharge from the hospital can be achieved in 2-3 days and frequently patients go home on the afternoon after surgery. Patients are only discharged when they are ready and both the surgeon and therapists feel it is safe.

Common Knee Injuries Related to Sports