Think Spring, Think Injury Avoidance

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At this time of year, many individual can’t wait to leap into spring, getting back to the gym to drop some winter weight, or onto the golf course or other playing field. Proceed with caution! Sports injuries can be caused by poor training practices, improper gear and not warming up or stretching enough. People often get hurt because they are not in shape and take on too much, too soon.

The most common sports injuries are:

  • Achilles tendon injuries
  • ACL tears
  • Dislocations
  • Fractures
  • Knee injuries
  • Pain along the shin bone
  • Rotator cuff injuries
  • Sprains and strains
  • Stress fractures
  • Swollen muscles
  • Tennis elbow

If you do get injured, stop. Continuing to play or exercise can cause more harm. Treatment often begins with the RICE (Rest, Ice, Compression, and Elevation) method to relieve pain, reduce swelling, and speed healing. Other possible treatments include pain relievers, keeping the injured area from moving, rehabilitation, and sometimes surgery.

It’s important to know when to look further than your medicine cabinet to treat sports injuries. An orthopedic surgeon is a medical doctor or doctor of osteopathy with extensive training in keeping your bones, joints, ligaments, muscles, tendons, cartilage and spine in good working order. Together, all of these parts of our bodies make up our musculoskeletal system.

Orthopaedic surgeons have the greatest knowledge of and experience with the wide range of conditions and treatment options available in musculoskeletal care, many of which do not involve surgery. However, if surgery is the best option for recovery, an orthopedic surgeon is the best trained to provide that surgical treatment.

Orthopaedic surgeons use the most effective and efficient diagnostic tools and our experience in musculoskeletal treatment to determine the best care for our patients.

Initial treatment of an injury following the basic RICE formula may be all you need, but if your injury does not heal on its own and continues to be painful, swollen or stiff, you may need surgery.

Depending upon the type of injury, your age and other factors, your orthopedic surgeon may recommend minimally invasive surgery such as arthroscopy following by physical therapy to help you resume your normal activities. In other cases, more traditional surgical repair may be recommended by your orthopedic surgeon.

Sometimes preventing common sports injuries is beyond our control, but many times sports injuries are preventable. Working out regularly will help you to enjoy your sports activities safely and you’ll garner extra health benefits as well. If you feel your sports injury isn’t healing on its own, consult an experienced orthopedic surgeon to help you get well and back into the game as soon as possible.

Understanding ACL Reconstruction

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In ACL reconstruction or repair, an orthopedic surgeon restores the function of the normal anterior cruciate (KROO-she-ate) ligament of the knee. This ligament is important in stabilizing the knee in athletics and day-to-day activities. The term ACL is an acronym for the anterior cruciate ligament, and easier to pronounce.

In ACL reconstruction or repair, an orthopedic surgeon restores the function of the normal anterior cruciate (KROO-she-ate) ligament of the knee. This ligament is important in stabilizing the knee in athletics and day-to-day activities. The term ACL is an acronym for the anterior cruciate ligament, and easier to pronounce.

Anterior (front) view of arthritic adult knee from below hip to lower leg showing the bones of leg ghosted within the skin including the femur, patella, tibia and fibula. Osteophytes (bumps) and torn articular surfaces and indicative of osteoarthritis of the knee.

Ligaments are strong bands of tissue that connect one bone to another. The ACL, one of two ligaments that cross in the middle of the knee, connects the thighbone (femur) to the shinbone (tibia) and helps stabilize the knee joint.

ACL injury most commonly occurs during sports that involve sudden stops and changes in direction — such as basketball, soccer, football and volleyball. ACL injuries typically occur in non-contact events on the sporting field. They can also be the result of workplace injuries and traumas such as motor vehicle accidents.

In the past, a torn ACL would mean the end of high level athletic activity for a prolonged period of time and possibly permanently. Today’s minimally invasive arthroscopic reconstruction followed by aggressive rehabilitation can restore the knee’s stability and function.

Not everyone who tears an ACL requires reconstruction. Sedentary people who forgo sports that involve a lot of quick stops and changes in direction usually recover well with conservative treatments and physical therapy. Bracing is also an option.

An orthopedic surgeon may recommend ACL reconstruction if:

  • You are an athlete and want to continue in your sport, especially if the sport involves jumping, cutting or pivoting
  • More than one ligament or the cartilage in your knee is injured
  • You are young and active
  • The injury is causing instability in your knee during activities of daily life, such as stair climbing

What to Expect During ACL Surgery

ACL reconstruction is performed on an outpatient basis under anesthesia. The ACL is replaced with a piece of tendon from another part of the leg or from a tissue bank.

Orthopedic surgeons use an arthroscope, a small fiber-optic viewing instrument made up of a tiny lens, a light source and video camera, to perform ACL repair.

The orthopedic surgeon creates a tiny 5mm puncture in the joint space of the knee – about 1/4 of an inch – called a portal. Additional small punctures are made for the insertion of surgical instruments. These punctures result in tiny scars, which become unnoticeable, providing direct access to most areas of the knee joint.

The orthopedic surgeon views the procedure on a large screen monitor as the graft is positioned and then secured with screws or other fixation devices.

In an acute injury, surgery is usually delayed until muscle strength and knee mobility has been improved with physical therapy. People who go into surgery with a stiff, swollen knee often have problems regaining full range of motion after surgery.

What to Expect After ACL Repair

The patient returns home on the day of surgery and immediately begins the rehab process. Before going home, patients practice walking with crutches. To reduce swelling and pain in the days immediately following surgery, the R.I.C.E. model of self-care is followed at home:

  • Rest. Use crutches to avoid weight bearing on the knee.
  • Ice. Applying ice for 20 minutes every two hours when awake will help reduce swelling and ease pain.
  • Compression. An elastic bandage or compression wrap keeps the knee immobile and supported.
  • Elevate. Elevating the leg to heart level reduces swelling and pain.

The orthopedic surgeon will also prescribe medication to help manage pain. Physical therapy strengthens the muscles around the knee and improves flexibility. Most patients can expect a return to full function within 6 to 9 months. Athletes can often return to their sports after 6 to 12 months.

Choosing an Orthopedic Surgeon for ACL Repair

To ensure the best possible outcome, it is important to choose a surgeon experienced performing minimally invasive ACL repair.

Good communications between patient and surgeon is critical. You should be comfortable asking your doctor questions, sharing your concerns, and feel that your surgeon takes the time to respond fully and completely. Together, you and your orthopedic surgeon can create the best plan of care to help return you to normal activities as soon as possible following ACL repair.

Arthroscopy Revolutionizes the Treatment of Hip and Other Joint Injuries

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Arthroscopy is an outpatient procedure usually performed under regional or general anesthesia in a surgical center. The most common use of arthroscopy is for repair of tears of cartilage, ligaments, and defects in the surfaces of the knee, shoulder, ankle, wrist and hip. Arthroscopy is also used for diagnosis, reconstruction and restoration of damaged tissue in the joint, and in the treatment of arthritis.

Orthopedic surgeons use an arthroscope, a small fiber-optic viewing instrument made up of a tiny lens, a light source and video camera, to perform arthroscopy. An orthopedic surgeon inserts the arthroscope into the joint through a tiny 5mm puncture – about 1/4 of an inch – called a portal. Two or three very small punctures may be made for the insertion of surgical instruments. These punctures result in very small scars, which in most cases become unnoticeable, providing direct access to most areas of the joint, which the surgeon can view on a large screen monitor during the procedure.

As an orthopedic surgeon who has performed over 2,000 arthroscopic procedures, I have personally seen how arthroscopy has evolved and revolutionized the treatment of joint injuries. Arthroscopy enables skilled orthopedic surgeons to examine, diagnose and treat even complex joint injuries and conditions and quickly return patients to their normal routines.

In the past, treatment may have involved extensive surgery, including large incisions, a hospital stay, a prolonged recovery and risk of post-surgical infection and complications. With today’s high-technology arthroscopic surgery, patients experience less pain and quicker recovery, returning home on the same day as their procedure. Risk of infection and complications are minimal.

Hip Arthroscopy
Hip arthroscopy has emerged as a specialty in the last five or six years as an alternative to more invasive hip replacement surgeries. Hip arthroscopy is much less common than knee or shoulder arthroscopy and can help to relieve the pain that results from injury or chronic conditions of the soft tissue surrounding the hip joint.

While less invasive than conventional surgeries, outpatient hip arthroscopy is still technically challenging. As one of the few orthopedic surgeons in Monmouth County who regularly performs hip arthroscopy, this procedure offers pain relief to patients who would have required more extensive procedures in the past. Hip arthroscopy has been a part of my practice for the past five years.

All patients should choose an orthopedic surgeon who takes the time to get to know them and fully answers all questions. Initial patient contact should include an orthopedic evaluation consisting of a medical history; a physical examination to assess range of motion, stability, strength and alignment; X-rays to determine the extent of damage and occasionally blood tests, and an MRI or bone scan as needed.

After evaluation and diagnosis, treatment options are discussed. Your orthopedic surgeon should take the time to explain each treatment option so you can make an informed decision.

Arthroscopic Surgery – Solution for All Ages

As you go along the age spectrum, a younger active person may have a soft tissue or ligament injury repaired arthroscopically, and an older person may receive hip arthroscopy. Either way, both patients can be back to their normal routines very quickly. Thanks to arthroscopic procedures and a supportive care environment, most joint injuries and conditions are not the setbacks they once might have been.

It gives me personal and professional satisfaction to have returned thousands of patients to active lifestyles thanks to high quality, personalized care and innovative treatment.