Knee Pain-Prevention And Treatment

by Administrator 29. August 2017 09:17

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All About Kneecap Instability

by Administrator 26. July 2017 10:22

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Distal Femur Fracture Of The Knee

by Administrator 21. March 2017 10:34

Fracture refers to a break or a crack in one or more bones in any part of the body. The distal femur is the lower part of the thigh bone that connects to the knee joint. This bone has a shape like that of an inverted funnel and it joins the shin bone (lower leg) to support the body weight and allow movement. They are supported by the quadriceps muscle, hamstring muscles, a group of tendons and ligaments and a thick layer of articular cartilage which acts as shock absorber and prevents the bones from rubbing against each other.

A break in this part of the bone is referred to as the Distal Femur Fracture of the Knee and it is a rare type of injury that affects the elderly and young people who indulge in high impact sports. In some cases the patella or the knee cap also gets damaged along with the femur. The tendons and ligaments may also be damaged in the process. Sometimes the ligaments snap resulting in shortening of the muscle length. Distal Femur Fractures can be categorized as follows:

  • Transverse Fracture-  the break in the bone is observed to be straight across the bone
  • Comminuted Fracture- the bone tends to break into many pieces
  • Intra-articular Fracture- this type of fracture extends into the knee joint and damages the articular cartilage

Causes

  • Osteoporosis- people above the age of 50 years are likely to have weaker bones due to lack of calcium and general wear and tear with age. The weak bones are likely to crack easily
  • A fall from a height or a sudden fall
  • Vehicular accidents that impact the knee joint
  • Sports injuries
  • Direct hit to the knee joint or the thigh

Symptoms

  • Severe pain may set in immediately after the injury and it is generally persistent
  • Swelling, redness and tenderness around the joint and the thigh may be observed
  • Inability to bear body weight
  • Visible deformity may occur with a part of the bone sticking out of a wound in case of open fractures
  • Bruising and discoloration
  • Altered gait
  • Joint instability
  • Limited range of motion

Diagnosis

  • A detailed clinical evaluation by an orthopedic should be conducted immediately
  • The doctor will check for additional damage to other body parts
  • Details of the mode of injury and medical history of the patient are taken into consideration
  • Check for loss of blood supply or nerve sensation in the leg, feet and thigh
  • X-ray imaging helps diagnose the location and severity of fracture
  • The doctor will look for open wounds and infection that may have passed through it
  • MRI and CT scans may be required

Treatment

Distal Femur Fractures can be treated both surgically and non-surgically depending on the severity of the injury. The methods employed include:

  • Mechanical traction of the skeletal framework with weights and pulleys to bring the bone back in its original position. This is also referred to as manual reduction
  • Bones that are stable with a slight crack or break can be treated by placing the leg in a plaster for a few weeks
  • Immobilization- recommended use of a brace or a cast to keep the bone stable and promote healing
  • External fixation- metallic pins and screws may be used to hold the bone in place and these are attached to an external fixator to keep them stable
  • Internal fixation- a surgical method which involves insertion of a metal rod into the femur along with plates and screws to stabilize the broken bone
  • Severely damaged bone may require total replacement of the joint for best outcome
  • Bone graft by using a piece of bone extracted from other joints or artificial bone fillers may be induced to allow the bone to heal and solidify
  • Use of crutches or a walker is recommended post surgery
  • Activity modification and weight bearing needs to be avoided
  • Physical therapy is required to restore movement

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Knee Bursitis: Orthopedic Frisco

by Administrator 25. October 2016 07:44

Knee Bursitis refers to the condition when the bursa, a fluid filled, closed sac becomes inflamed. This bursa acts as cushion that helps reduce friction between the knee tissues. The bursae, the plural for bursa, are located near tendons of primary joints such as elbows, hips, knees and shoulders.

Knee Bursitis occurs mostly due to a direct injury to the front of the knee, while in some cases, it is the result of a bacterial infection, referred to as septic bursitis. Another common cause includes prolonged kneeling.

Causes

  • Also referred to as ‘Housemaid’s Knee’, ‘Roofer’s Knee’ or ‘Carpet Layer’s Knee’, based on the most common patients’ occupation, Knee-Bursitis has the following causes:
  • Due to overuse or an injury, the bursa of the knee fills with flood
  • It is also common in patients of Rheumatoid arthritis, gouty arthritis and pseudo-gout
  • It can also occur due to a bacterial infection
  • Previous injury can damage the bursa and leave it inflame, causing knee bursitis

Symptoms

  • A localized swelling and/or tenderness of the knee is observed
  • A dull pain accompanied by warm sensation and redness
  • Pain and stiffness while walking or kneeling, restricting the motion of the knee
  • In severe cases of Knee Bursitis, difficulty in straightening the knee may be observed
  • Septic bursitis is also accompanied with symptoms like fever and tiredness

Diagnosis

An inflamed bursa along with symptoms like pain, stiffness, tenderness, visibly red knee and warm sensation are all signs of Knee Bursitis. Next step involves distinguishing between a septic or aseptic bursitis. It is necessary for the doctor to first rule out other knee problems like arthritis or gout, fracture etc, before making a ‘Knee Bursitis’ diagnosis.

Treatment

  • Before starting the treatment for Knee Bursitis, the doctor needs to confirm that it is not a septic bursitis.
  • The doctor can treat an aseptic bursitis using anti-inflammatory or pain medications. Along with medications, ice compresses and rest are also recommended.
  • Another way to treat aseptic bursitis is through ‘Aspiration’. This procedure can be carried out at the doctor’s clinic and involves removal of the bursa fluid collected in the knee using a syringe and a sterile needle.
  • Treating the septic bursitis requires careful and thorough examination in order to identify the infection causing bacteria. Accordingly, a course of antibiotics can be resumed.
  • Certain topical medicines like creams, gels and sprays can also be prescribed as a pain-reliever. These can be applied directly on the skin and are good for relaxing the knee muscles temporarily.
  • Upon ending the treatment, the doctor may suggest certain physical exercises to help strengthen the knee. For effective and immediate treatment of Knee Bursitis, contact your orthopedic doctor.


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Knee Sprain: Causes, Symptoms And Treatment

by Administrator 27. June 2016 13:10

The knee joint consists of four major ligaments - Anterior Cruciate Ligament (ACL), Posterior Cruciate Ligament (PCL), Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL). Injury to any of these ligaments is termed as a knee sprain. It may either involve minor stretching of the ligament or it may get completely torn and detached from the bone. This may eventually result in severe instability of the joint.

Causes

  • Sudden twisting of the knee
  • Stretching the knee beyond its range of motion
  • Falling on the knee
  • Sports injury
  • Bending the knee backwards
  • Car accident
  • Extreme force that pushes the knee inwards

Symptoms

  • Pain and inflammation
  • Bruising and stiffness
  • Inability to walk properly
  • A popping sound emanates from the knee at the time of injury
  • The knee may give out when trying to stand
  • Discoloration around the knee
  • Inability to participate in sports activities

Diagnosis

  • The doctor may note down the medical history of the patient along with the symptoms and cause of injury.
  • The doctor may check for inflammation and signs of deformity
  • The strength of the ligaments and range of motion of the knee will also be tested
  • Further diagnostic tests such as X-rays may be conducted to identify a fracture or severe ligament damage
  • Magnetic Resonance Imaging (MRI) or arthroscopy may also be required in some cases

Treatment

  • Resting the injured joint and keeping the leg elevated above heart level
  • Application of ice packs to the injured area may help in reducing inflammation
  • An elastic bandage may be used to compress pain and swelling
  • The doctor may suggest wearing a knee brace to provide support to the joint and allow it to heal completely
  • Non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to provide relief from swelling

Surgical treatment

Surgical intervention may be required in case of severe sprains. The doctor may perform knee reconstruction surgery. In this procedure, a tissue graft may be taken from the patellar or hamstring tendons and inserted in place of the torn ligaments.

Visit OrthoTexas, Frisco for comprehensive treatment of knee sprain and other orthopedic conditions. To schedule an appointment with the knee surgeons in Frisco, you can call at (214) 618 – 5502.

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Knee Injury Prevention Tips

by Administrator 23. May 2016 17:42

The knee joint connects the thigh bone (femur) with the shin bone or tibia. The kneecap lies in the front and acts as a protective shield. The joint is further supported by muscles, ligaments, cartilage membranes and tendons. Weight bearing, direct trauma and faulty movement can damage one or more parts of the knee joint leading to injuries. Some of the common injuries related to knee are fractures, dislocations, ligament tears, meniscus tears, tendon stretch or tears etc.

Causes

  • Overweight
  • Sudden starts or stops while exercising or playing sports
  • Sudden increase in intensity of an activity
  • Wear and tear of bones, muscles and ligaments with age
  • Arthritis
  • Direct hit or fall on the knee joint
  • Vehicular accidents
  • Sports injuries
  • Deficiency of  calcium and phosphorous may make the joint weak
  • Lack of physical activity
  • Infection of the bursa (fluid sacs)

Symptoms

  • Pain in and around the knee joint
  • Tenderness
  • Swelling
  • Bruising or discoloration
  • Inability to move, stand or squat
  • Pain increases with movement
  • Instability
  • Popping sound in the joint
  • Change in gait

Prevention Tips

  • It is important to maintain a healthy body weight to avoid putting excessive pressure on the knee joint
  • Warming up before an activity or sport is essential to enhance the blood supply and prevent injuries
  • Avoid increasing the intensity of your work out suddenly
  • Use of shoes that fit well and provide adequate support may help to ease the pressure on the knees
  • It is important to learn the correct techniques and positions for an exercise or sport
  • Avoid bending too much while carrying or lifting heavy objects
  • A diet rich in calcium and phosphorus is important for bone health. Include milk, cheese, tofu, soy milk and yoghurt to improve your calcium intake
  • Avoid any movement or routine activities that cause pain or stress to the joint
  • Use good quality knee guards while playing
  • Replace your shoes as soon as the sole is worn out
  • Incorporate exercises such as hamstring stretch, calf stretch or leg raises in your daily routine to strengthen the muscles which support the knee joint
  • Avoid wearing high heels or ill-fitting shoes
  • Avoid running or jogging on hard surfaces
  • Smoking and alcohol should be avoided. These can increase the risk of developing
  • Osteoporosis which may eventually deteriorate bone health and disrupt blood supply.
  • Squats and lunges should be avoided in case a person has a medical history of knee injury and Osteoarthritis

The orthopedic surgeons at OrthoTexas, Frisco provide treatment for various injuries and medical conditions of the knee. To schedule an appointment with the knee specialists, call at (214) 618 – 5502 or visit 5757 Warren Pkwy, Suite 180, Frisco, TX 75034.

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Osteochondritis Dissecans: Orthopedic Frisco

by Administrator 25. April 2016 11:31

Osteochondritis Dissecans (OCD) is a rare disorder which leads to degeneration of the knee joint. The condition occurs when the surface between the bone and the cartilage is inflamed. Parts of the bone and the cartilage may break apart from their surface and either remain partially attached or float in between the joint spaces leading to pain and discomfort. In some cases, the blood supply to the bone may be hampered and lesions are formed. This leads to the degeneration and consequent death of the bone. Adolescents who are actively involved in sports activities are a greater risk of developing OCD.

Causes

  • Hereditary traits
  • Direct trauma or injury to the joint
  • Minor repeated injuries over a period of time can increase the risk of OCD
  • Ischemia- disruption or blockage of blood supply to the bone
  • Inherent bone deformities
  • Lack of calcium and phosphorous
  • Repeated stress to the joint caused by high impact activities/sports

Symptoms

  • Pain in the affected joint during activity
  • Swelling
  • Disruption of blood flow to the subchondral bone
  • Locking of the joint
  • Tenderness
  • A cracking sound or feeling when the joint is moved
  • A feeling of the joint giving away
  • Stiffness in the joint
  • Range of motion may be restricted
  • Inability to straighten the joint/limb

Diagnosis

  • Evaluation of the affected joint by the orthopedic doctor to check for swelling and loose fragments
  • Assessment of the symptoms and the medical history of the patient
  • Examination of changes in the patient’s gait
  • Wilson test may be helpful in diagnosis of OCD in the knee
  • MRI scan may help to diagnose soft tissue damage
  • X-ray imaging may reveal the abnormalities in bone structure
  • CT scans may be conducted to locate the loose pieces of bone or cartilage within the joint

Treatment

OCD is treated by surgical procedures in most cases as the propensity of the articular cartilage to heal is limited. Delayed treatment can lead to functional loss as well as degeneration of the affected joint in the future. The following non-surgical and surgical methods may be adopted depending on the severity:

  • Immobilization of the joint for some time
  • Prescription of anti-inflammatory drugs to ease pain and inflammation
  • Prevent weight bearing on the joint
  • Surgical removal of loose fragments within the joint
  • Joint replacement
  • The loose pieces of bone and cartilage may be held in place by screws and pins
  • Arthroscopic drilling of the subchondral bone to promote healing and blood supply
  • Physical therapy may be required which includes some low impact exercises

We, at OrthoTexas, Frisco, provide treatment for Osteochondritis Dissecans and other knee conditions. To schedule an appointment with the orthopedic surgeons, you can call at (214) 618 – 5502.

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Kneecap Instability: Orthopedic Treatment in Frisco, TX

by Administrator 26. March 2016 11:26

Kneecap Instability occurs when the kneecap or patella moves out of the trochlear groove which is located at the bottom of femur (thighbone). The kneecap connects the thigh to the shin muscles and allows straightening or bending of the joint. The condition can either lead to a partial or complete dislocation of the kneecap.

Causes:

  • Abnormal shape of trochlear groove- If the groove is uneven or shallow, the kneecap may misalign.
  • Previous kneecap injury- If a person has suffered from patellar dislocation injury in the past, there are chances of reoccurrence of the condition.
  • Trauma to the knee- A sudden blow to the knee due to a fall or an accident may cause the kneecap to move out of its place.
  • Other medical conditions- Knee Arthritis, Patellar Tendonitis, Plica Syndrome etc. are some medical conditions which may also cause Kneecap Instability.    

Symptoms:

  • Pain in the front of knee
  • Stiffness and swelling
  • Popping sound while moving the knee
  • Inability to bear weight
  • Buckling of the knee
  • Difficulty walking
  • Excessive weakness in the knee

Diagnosis:

The doctor may ask the patient to straighten or bend the knee to evaluate the symptoms. Certain imaging tests such as X-rays and MRI may be conducted to determine the severity of the condition.

Treatment:

Non- Surgical Treatment

  • Reduction- The doctor may apply pressure to place the kneecap in its trochlear groove. The procedure may be performed if the kneecap has been completely dislocated.  
  • Exercises- Physical therapy may be recommended to strengthen and improve flexibility of the thigh muscles. Cycling and other low impact exercises may also be beneficial in stabilizing the knee.
  • Immobilization- Braces or taping provides support to the knee and helps in the recovery process.
  • Rest: A doctor may suggest taking adequate rest to eliminate discomfort.
  • Ice Or Heat Therapy: Applying ice at frequent intervals may help to lessen inflammation. Heat therapy can also be beneficial in reducing swelling.  
  • Elevation: The doctor may recommend elevating the knee above the level of heart to improve circulation.  
  • Medication: Anti-inflammatory medications may be prescribed by the doctor to provide relief from pain and swelling.
  • Compression: Elastic bandages as suggested by the doctor can also relieve the symptoms.

Surgical Treatment

  • Arthroscopic surgery: In this procedure, the surgeon may realign the tendons so that the patella relocates into the trochlear groove.
  • It is advisable to enroll in a rehabilitation program after the surgery to boost the recovery process.

We, at OrthoTexas, Frisco, provide treatment for Kneecap Instability and various other orthopedic conditions. To schedule an appointment with our knee surgeons, you can call at (214) 618-5502 or visit 5757 Warren Pkwy, Suite 180, Frisco, TX 75034.

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Kneecap Dislocation: Causes, Symptoms And Treatment

by Administrator 19. February 2016 11:31

When the bone covering the knee (patella) gets out of place in the patellofemoral groove, it is referred to as Kneecap Dislocation. In certain cases, the kneecap may also partially move out of its original position, known as subluxation. Severe Kneecap Dislocation may even cause an injury to the ligaments.

Causes

  • Major trauma such as a fall, high-speed injury or car crash
  • A previous dislocation
  • Inherited tendency for the kneecap to slide
  • Sudden twisting or pivoting of the leg

Symptoms

  • Buckling of the knee
  • Inability to support body weight
  • Pain in the front part of the knee that worsens with activity
  • Stiffness and inflammation
  • Kneecap may slip off the side

Diagnosis

Imaging tests such as X-rays may be conducted by the knee doctor to ensure that there is no fracture. An arteriogram may also be ordered to look for arterial injuries. The doctor may also diagnose any associated nerve damage by checking for numbness in specific muscle groups.

Treatment

Since a knee dislocation mostly involves sprains and tears in the ligaments, reconstruction surgery is required to regain normal motion of the knee movement.

  • Ice packs: Application of ice packs to the injured area may help in controlling the pain and inflammation
  • Medications: Non-steroidal anti-inflammatory medications may be prescribed to provide relief from pain and discomfort.
  • Immobilization: The doctor may recommend wearing a knee brace or splint to restrict the movement of the affected joint.
  • Exercise: Performing light stretching and strengthening exercises, as recommended by the physical therapist, may help to regain the joint functionality.
  • Relocation: In this procedure, the doctor may move back the patella to its original position. This process, also known as reduction, may be conducted after administering pain medication or conscious sedation to the patient. Relocation may help to repair the damage to ligaments, blood vessels and tissues in the knee.
  • Surgery: Surgical intervention may be required in case there is any arterial damage. Repairing the injured vessels is necessary to maintain adequate blood flow in the leg.

After the surgery, the knee joint may be kept in a splint or an immobilizer to let it heal properly. This prevents the knee from bending and aids in repair of the tissues. Also, immobilization reduces the probability of injuring the kneecap again.

For comprehensive diagnosis and treatment of Kneecap Dislocation, visit OrthoTexas, Frisco. To schedule an appointment with our orthopedic surgeons, call at (214) 618 – 5502.

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PCL Injury: Orthopedic Treatment In Frisco, TX

by Administrator 17. September 2015 13:45

Posterior Cruciate Ligament (PCL) is one of the four main ligaments in the knee that helps to maintain the stability of the joint and prevents it from bending backwards. The ligament supports the body weight during sports and many other activities. It also prevents the tibia from twisting outwards. Any injury to the PCL can make the knee instable and the shin bone may sag backward when the knee is bent. Athletes who participate in football and other contact sports are at greater risk of suffering from PCL injury.

Causes

  • Direct blow to the front of the tibia
  • Sudden twisting
  • Hyperextension of the knee
  • Falling on a bent knee
  • Overuse
  • Sudden pivoting
  • Trauma due to motor vehicle accident
  • Contact sports
  • Incorrect landing from a jump

Symptoms

  • Sever pain in the knee
  • Swelling and tenderness
  • Reduced range of motion
  • Pop sound at the time of injury
  • Stiffness and bruising
  • Loss of functionality
  • Wobbling of knee while walking
  • Inability to bear weight
  • Feeling that the knee may give out

Diagnosis

The orthopedic doctor may conduct a physical examination by moving the knee in different directions. He may recommend an X-ray or MRI scan to rule out a broken bone or assess damage caused to other structures of the knee.

Treatment

PCL tear or injury can be treated surgically as well as non-surgically. The doctor may recommend discontinuing any strenuous activities that may cause further damage to the knee. To control swelling and pain, you must take proper rest, apply ice packs to the affected area and compress it using an elastic bandage. Keep the knee elevated to speed up the recovery.

The doctor may also recommend splints and braces to prevent further injury and offer relief to the knee. This will keep the knee safe and prevent any jerky movement. You may be suggested to use crutches to avoid putting weight on the injured knee. Your physician may also prescribe certain anti-inflammatory medications to offer relief from pain.

Surgery

In severe cases of PCL injury, you may require surgery to replace the torn ligament. Surgery becomes essential if the PCL is isolated or completely ruptured. During the procedure, the knee surgeon makes an incision in the joint and reconstructs the ligament using a tissue graft.

Rehabilitation and physiotherapy

A physiotherapist can help you strengthen the ligaments and muscles by suggesting some stretching exercises. A comprehensive rehabilitation program aims at helping you regain the range of motion and functionality of the knee joint.
For comprehensive treatment of PCL injury, visit OrthoTexas, Frisco. To schedule an appointment with our orthopedic surgeons, you can call at (214) 618 – 5502.

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