A tear in the anterior cruciate ligament (ACL) is one of the most common knee injuries. An injury to this ligament causes the knee to become unstable and the joint to slide forward too much. ACL tears occur most often in athletes.
ACL reconstruction is usually not performed until several weeks after the injury, when swelling and inflammation have been reduced. The torn ligament is completely removed and replaced with a new ACL. Simply reconnecting the torn ends will not repair the ACL. Part of another ligament, usually from the knee or hamstring, is used to create a graft for the new ACL. Choosing the proper type of graft depends on each patient's individual condition.
ACL surgery requires a few months for full recovery and physical rehabilitation will be needed as well. Surgery is not required for all ACL injuries. Talk to Dr. Augustin to find out if ACL reconstruction is right for you.
The knee is a hinge joint where the thigh bone (femur) and the bone of the lower leg (tibia) meet. Arthritis (particularly osteoarthritis) and certain knee injuries and diseases can damage the cartilage that normally cushions the joint, leading to pain and stiffness. A knee replacement may be recommended when more conservative treatments -- such as anti-inflammatory medications and cortisone injections -- fail to relieve pain or improve movement.
During a total knee replacement, the entire joint is replaced with an artificial prosthesis. The end of the femur is replaced with a metal shell. Then the end of the tibia is fitted with a plastic cup and a metal stem that fits into the shell on the femur. This reduces friction in the joint, easing pain and allowing a greater range of movement. The main ligament of the knee (the posterior cruciate ligament) may be left in place, removed or replaced with an artificial post. The kneecap may also be replaced with, or supported by, a piece of plastic. The surgery itself lasts between one-and-a-half and three hours.
After the procedure, patients usually experience immediate relief from joint pain. Physical therapy starts right away to speed healing and to ensure that the patient enjoys full use of the joint.
Partial knee replacement may be possible for patients with damage to one part of the joint. Doctors refer to this limited damage as a Unicompartmental knee or "Uni" knee. In a partial knee replacement, only the diseased parts of the knee are removed and replaced; the healthy portions are left untouched. Successful partial knee replacements can delay or eliminate the need for a total knee replacement. They also allow a greater range of movement than standard (non-high-flex) total knee replacements.
Benefits of partial knee replacement surgery include a smaller incision (2-3 inches), shorter hospital stay (often 24 hours or less), and faster recovery and rehabilitation.
Cartilage is the smooth coating on the end of the bones that provides cushioning and support for comfortable, fluid movement. Cartilage damage occurs as a result of injury or degeneration and can lead to severe pain and arthritis. The cartilage eventually wears away and leaves the bone unprotected. Fortunately, there are now several techniques used to repair damaged cartilage and restore normal movement.
Cartilage repair is a relatively new field and long-term results are still not proven. These procedures aim to restore movement with the best possible tissue and to prevent further cartilage damage. Two common procedures used in cartilage repair include:
Autologous Chondrocyte Implantation - This procedure takes a sample of healthy cartilage and multiplies it in large quantities outside the body before being implanted back onto the bone. This newly grown cartilage coats the bone and provides regained support.
Osteochondral Autograft Transplant (OATS) - This procedure takes healthy cartilage from another area of the bone that does not bear weight and transplants it to the damaged, weight-bearing area. This is used for smaller defects and involves filling holes with small transplant materials.
A torn meniscus is a common injury often caused by forcefully twisting or rotating the knee. It can also be a result of degenerative changes in older adults. A meniscus tear can be repaired through arthroscopic surgery.
A torn meniscus causes pain and swelling, and may also be accompanied by a frequently locking joint and the inability to completely straighten the knee. Some people experience a popping or clicking sensation within the knee as well.
Treatment for a meniscus tear often begins with conservative methods such as rest, ice or over-the-counter medication. If these treatments are not effective and symptoms continue, you may benefit from meniscus repair surgery. Meniscus repair is an arthroscopic procedure in which the torn segment of the meniscus is removed and the torn edges are sutured together, which allows them to heal properly.