ACL Archives - Orthopedic Surgeon Monmouth County NJ | Marshall P. Allegra, M.D.

Huddle Up About Back-To-School Sports Safety

Allegra — Fri, 25 Aug 2017 14:28:14 +0000

For many kids, back to school means back to sports. Youth sports are a valuable experience, filled with challenges, competition and fun. Being part of a team fosters feelings of belonging, inspires collaborative play and strategy, and can be an excellent form of exercise.

Still, parents often worry about the risk of injury their children face on playing fields. Even if your child returns to school in optimal condition after a summer spent building up body, flexibility and speed, too many kids still get stuck on the sidelines with injuries, some of which are preventable.

The Centers for Disease Control and Prevention says more than 2.6 million children are treated in the emergency department each year for sports- and recreation-related injuries.

Common injuries young athletes face are often related to the skeletal and muscular systems of the body. The American Academy of Orthopaedic Surgeons stresses that children’s bones, muscles, tendons, and ligaments are still growing, making them more susceptible to injury. Fortunately, many youth-sport injuries can be prevented.

Sprains And Strains
Sprains are injuries to ligaments, or the bands of tough, fibrous tissue that connect two or more bones at a joint. Strains impact a muscle or a tendon, which connects muscles to bones. Clinical research has linked acute strains and sprains to improper warm-up before sports, fatigue and previous injuries. Pre-participation conditioning and stretching can help reduce the risk of injury.

Periostitis, Or Shin Splints
Periostitis is an overuse injury that occurs in athletes engaged in activities that involve rapid deceleration. Periostitis causes inflammation of the band of tissue that surrounds bones known as the periosteum, and typically affects people who repetitively jump, run or lift heavy weights.

To head off potential pain in the shins, young athletes can gradually build up their tolerance for physical activity. Supportive shoes or orthotic inserts can help. Incorporating cross-training into a regimen also can work.

Repetitive Use Injuries
Swimmers, tennis players, pitchers, and quarterbacks may experience a repetitive use injury. This is pain in an area of the body that is used over and over again. Inflammation of muscles and tendons may appear, but repetitive use injuries also may result in stress fractures, which are hairline fractures in bones that are subjected to repeated stress.

Rest between exercises can help alleviate these types of injuries. Use ice, compression, elevation and immobilization if pain is persistent.

Growth Plate Injuries
Growth plates are the areas of growing tissue near the ends of the long bones in the legs and arms in children and adolescents. A growth plate produces new bone tissue. If the growth plate is injured, it cannot do its job properly. That may contribute to deformed bones, shorter limbs or arthritis. Growth plate injuries most often result from falling or twisting.

While there’s no surefire way to prevent growth plate injuries, getting proper and immediate care after an injury can help prevent future problems. An orthopedic surgeon has the expertise to diagnose and treat these injuries.

Concussion and TBI
Concussions and traumatic brain injuries (TBI) have received increasing national attention. To learn more about concussion and the adolescent athlete from the National Institutes of Health, click here.

Youth Sports Injuries Are Common But Often Preventable
Warming up, being in good physical shape and not overtaxing a growing body can help kids avoid pain and impairment.

Young players must feel that it’s OK to tell coaches and parents that they’ve been hurt and that it’s time to sit out. A Safe Kids Worldwide study reported that about 42 percent of student athletes surveyed reported that they’ve hidden or downplayed an injury during a game so they could keep playing. Kids need to know that “taking one for the team” can lead to a more severe and lasting injury.

Parents and coaches should work together to create an atmosphere where young athletes can compete, have fun and reach their full potential. Together, we can keep our kids active, strong and safe so they can enjoy the sports they love for a lifetime.

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Types of Orthopedic Surgery

Allegra — Wed, 21 May 2014 21:14:48 +0000

There are many types of joint reconstruction and replacement surgery. Some of the most common surgical procedures are explained here.

Total joint replacement
Total joint replacement is a surgical procedure in which certain parts of an arthritic or damaged joint, such as a knee joint, are removed and replaced with an artificial joint that moves like a healthy joint.

Total knee replacement
If you have very severe arthritis, for example, total knee replacement surgery may be an option. When knee replacement surgery is performed, the cartilage of the knee joint is replaced with an implant.

Total hip replacement
This procedure involves removing the ball and socket of a joint with arthritis and inserting a new ball and socket to allow movement at the new joint.

Total shoulder replacement
This procedure involves replacing damaged bone and cartilage with an implant to improve range of motion at the shoulder joint.

Rotator cuff repair
The rotator cuff helps keep your shoulder anchored and helps it to move. A tear in the cuff can limit your range of motion and cause pain. These tears can be repaired with surgery to relieve pain and improve strength and functioning of the shoulder.

Arthroscopic surgery
Arthroscopy is a method of viewing or performing surgery on a joint by use of an arthroscope, which consists of a very small tube, a lens, and a light source using fiber optics to visualize the surgical area. Orthopedic surgeons perform shoulder, knee and other repairs with arthroscopy. The incision made for inserting the arthroscope is very small, and fewer stitches may be required. The advantage to arthroscopy is a smaller incision heals more quickly and there is less trauma to tissue.

Spine surgery
A variety of problems may lead to spine surgery. There are a number of procedures that can be performed to improve function and remove back pain, and these procedures are done if more conservative treatment, such as medication or physical therapy, don’t work. These include such common procedures as laminectomy, diskectomy, fusion, and spinal decompressions. Kyphoplasty is a less-invasive technique for the pain of spinal fractures often caused by osteoporosis.

Ankle surgery
A variety of problems with the ankles and wrists require surgical treatment. Overuse injuries, rheumatoid arthritis, stress fractures and sprains can often be treated with surgery if more conservative treatment fails.

ACL reconstruction
The anterior cruciate ligament (ACL) is the major stabilizing ligament of the knee. When it ruptures, reconstruction can be performed in a number of ways, including state-of-the-art tendon grafts.

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Understanding ACL Reconstruction

Allegra — Thu, 30 Jan 2014 20:56:28 +0000

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.

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