The decision to undergo a knee replacement is tough. Several factors need to be taken into consideration. If your doctor recommends a knee replacement procedure but you are still sitting on the fence, here are important facts things that may help you make an informed decision.
Indicators for a knee replacement
Knee replacement surgery is typically advised when –
- the pain makes it impossible for you to sleep or perform normal, everyday activities
- you suffer from arthritis of the knee
- your knee is significantly damaged (e.g., due to injury)
- other treatments have proven ineffective
Knee replacement procedure
During the procedure, you’ll be given a local (in the joint), regional (from the waist down) or general (that will make you sleep through the surgery) anesthesia. A small incision is then made in the knee. The knee is pumped with saline and a small camera or arthroscope is inserted inside the joint to make it easier for the surgeon to look inside the joint and carry out the procedure. Your orthopedic surgeon then investigates the source of the knee pain. Depending on the underlying condition, the doctor clean up or repair the joint tissues. Artificial implants are used to replace the damaged parts of the joint. The procedure presents minimal risk and has proven beneficial to a majority of the patients.
Recovery after the knee replacement
The post-surgery period is critical in terms of getting back on your feet. You have to do rehabilitation exercises at home to ensure your knee can completely recover.
The Osgood-Schlatter disease is a common cause of knee pain among adolescents. The pain is experienced in the front of the knee, just below the kneecap. The condition involves inflammation of a growth plate of the shin bone or tibia.
The bones of growing adolescents have growth plates. These are areas of cartilage located near the ends of bones. When full growth is achieved, the growth plates turn into solid bone. Some growth plates also serve as attachment sites for tendons, the tissues that connect muscles to bones.
At the end of the tibia, there is a bony bump called the tibial tubercle, which covers the growth plate. The quadriceps (muscles in the front of the thigh) attach to the tibial tubercle.
When the child is active, the quadriceps muscles pull on the patellar tendon, which in turn, pulls on the tibial tubercle. In some children, this leads to inflammation of the growth plate. The tibial tubercle may become very noticeable as a bump.
Causes and Symptoms
Osgood-Schlatter disease typically occurs during growth spurts. Since physical activity causes additional stress on bones and muscles, children who engage in strenuous activity are at an increased risk for this condition.
Symptoms for Osgood-Schlatter disease include –
- pain caused on jumping or running
- knee pain and tenderness
- tight thigh muscles
Osgood-Schlatter disease Treatment
In most cases the condition improves with –
- limiting activity
- over-the-counter medication
- stretching and strengthening exercises
- symptoms typically go away when the individual completes the adolescent growth spurt, around 14 years in case of girls and 16 years for boys.
Meniscus tears are the most common knee injuries. These injuries can affect either the medial or lateral meniscus. Tears may occur because of a sudden, twisting motion resulting in –
- ‘catching’ or ‘locking’ sensation
If the physical examination by the orthopedic surgeon shows a torn meniscus, an MRI can be advised for confirmation.
Initially, meniscus tears are treated conservatively with rest, ice and NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), such as ibuprofen, naproxen. It may be complemented with physical therapy for muscle strength and improved range of motion. Arthroscopic surgery may be recommended for severe cases.
However, now a highly effective, non-surgical intervention is available – PRP therapy. PRP or Platelet Rich Plasma therapy uses concentrated platelets from your own blood. With the help of ultrasound guidance, the injection is administered into the tear, allowing the tear to heal naturally. The injection is given under local anesthesia in an outpatient setting.
Other common knee injuries are –
- ACL or Anterior Cruciate Ligament tear
This tear occurs as the result of a sudden stopping, sudden change in direction or hyperextension. This could be accompanied with a ‘popping’ sensation followed by deep pain, swelling, and instability.
- PCL or Posterior Cruciate Ligament tear
The PCL can become inured due to a force to the anterior shin bone when the knee is flexed.
Both ACL and PCL tear can be treated with PRP therapy, stimulating the body’s natural healing mechanism.
The Knee Joint
The knee is the largest bone joint in the body that allows you to run, walk, stand, sit, bend your legs, pivot, swivel and more. The knee joint consists of bones, cartilage, muscles, ligaments, and tendons, all working together. Three bones – the tibia (shinbone), the femur (thighbone) and the patella (kneecap) come together at the knee joint.
Knee injuries are complicated because they can be the result of damage or injury to any of the several parts that make up the knee. It is also important to understand that the knee functions between two very mobile joints – the hip and the foot. Injury to the hip or foot can also affect the mobility of the knee.
With age, the strain on our knees increases and pain and discomfort become common complaints. However, the pain may also result from injury or an underlying condition, apart from aging. An experienced orthopedic doctor or surgeon can make an accurate diagnosis of the cause of knee pain and treat it.
Depending on its location, different problems can be responsible for knee pain.
- Front of the knee – related to kneecap injury or damage
- Inside or medial side of knee – related to medial meniscus tears, MCL injuries, and arthritis
- Outside or lateral side of knee – often caused by lateral meniscus tears, LCL injuries, IT band tendonitis, and arthritis
- Back of knee – due to the collection of fluid, also referred to as a Baker’s Cyst
Shoulder dislocation is a painful injury. It is common among athletes and may result from a fall or other trauma to the joint. Because the shoulder is a highly mobile joint, it is also at risk for easy dislocation.
Shoulder dislocation can be 2 different types –
- partial dislocation or subluxation – caused when the top of the humerus bone is partly out of the socket.
- complete dislocation – when the top of humerus comes completely out of the socket.
The shoulder can dislocate downward, backward or forward.
Symptoms of Shoulder Dislocation
- pain in and around the shoulder joint
- swelling around the shoulder
- shoulder joint stiffness
- weakness and/or numbness in the shoulder
- bruising in the shoulder region
- shoulder instability
Any combination of the above symptoms can mean a dislocated shoulder. It is best to have your shoulder examined by an orthopedic surgeon.
Whether your shoulder dislocation has happened for the first time or it is a repeat injury, it is important to have it diagnose and treated right away. The surgeon will be able to restore the joint into the correct place and provide immediate relief. This process is known as a closed reduction. Afterwards, your doctor may refer you to a physical therapist in order to help the joint become stronger and prevent future re-injury.
The rotator cuff is a group of muscles and tendons around the shoulder joint. They keep the head of the humerus (upper arm bone) secure in the shoulder socket. A shoulder injury can affect the rotator cuff, causing a dull ache in the shoulder, which may worsen when sleep on the affected side.
Rotator Cuff Tears
A rotator cuff tear is a common injury, in sports such as baseball, or in jobs such as cleaning windows. It can occur due to age-related wear and tear or overuse and repetitive motions. Your rotator cuff may also get injured if you fall on your arm or lift something heavy.
A rotator cuff tears can be partial (when the tendon is frayed) or complete (the tendon is pulled off the bone).
Rotator Cuff Tear Symptoms
A rotator cuff tear may present as –
- trouble raising your arm
- pain with certain arm movements
- pain when you lie on the affected side
- weakness in the shoulder
- inability to lift things
- clicking or popping sounds with arm movement
Left untreated, a torn rotator cuff can lead to a frozen shoulder or arthritis which is harder to treat.
Treatment for Rotator Cuff Tears
The orthopedic doctor would initially recommend –
- physical therapy to strengthen shoulder muscles stronger
- anti-inflammatory drugs to help with pain and swelling
Surgery may be required in some cases, especially if you have a complete tear. Surgery can be done to stitch together the torn area or reattach the tendon to the bone.
There are three types of rotator cuff surgery:
- Arthroscopic or minimally invasive surgery
- Open surgery
- Mini-Open surgery that uses both arthroscopic and open methods
If you were surprised at your Tennis elbow diagnosis or think that it happens only to Tennis players, this isn’t always the case. While Tennis elbow is certainly common among tennis players, it is essentially an overuse injury.
Tennis elbow is often the result of activities that use the same muscle group, such as gardening, painting, even using a screwdriver and of course, playing tennis.
Tennis elbow is characterized by soreness or pain on the outer side of the elbow. It occurs when the tendons connecting the muscles of the forearm to the elbow are injured or damaged. The pain may also radiate from the arm to the wrist. Left untreated, the injury may even cause pain when you are doing simple things like turning a key. Tennis elbow is formally referred to as ‘lateral epicondylitis’.
To diagnose tennis elbow, the doctor will examine your elbow and ask questions about the level of pain, any injuries and your daily activities. A diagnostic imaging test, such as MRI or X-ray, may be done. Once a diagnosis is made, your doctor would design a treatment plan for your condition or injury.
The first line of treatment is often anti-inflammatory medication and physical therapy. However, if your pain doesn’t ease with conservative treatment, the doctor may prescribe surgery followed by rehabilitation. You can return to activity gradually, as advised by your doctor.