Posterior cruciate ligament injuries (PCL) are one of the less commonly injured ligaments of the knee. Understanding this injury and developing new treatments for it have lagged behind the other cruciate ligament in the knee, the anterior cruciate ligament (ACL), probably because there are far fewer posterior cruciate ligament injuries than ACL injuries.
Ligaments are tough bands of tissue that connect the ends of bones together. The PCL is located near the back of the knee joint. It attaches to the back of the femur (thighbone) and the back of the tibia(shinbone) behind the ACL.
The PCL is the primary stabilizer of the knee and the main controller of how far backward the tibia moves under the
Relieving knee pain often requires experimenting with different approaches. It’s always best to start with the least invasive approach available. You’ll know it’s time for knee replacement when all of the other options fail to bring relief and your daily activities are severely curtailed by your knee pain. Here are a few approaches to try.
Exercise for relieving knee pain
It is natural to want to avoid movements and activities that make your pain worse. Yet health experts agree that people with knee osteoarthritis can benefit from certain types of exercise. People who stop activity because they feel pain are at risk of having more problems, because avoiding activity can cause muscles and bones to
Treatment of patellofemoral problems begins with decreasing the inflammation in the knee. This may be accomplished with rest and anti-inflammatory medicines like aspirin or ibuprofen. Physical therapy can help in the early stages of treatment. Your physical therapist may use ice, massage, and/or ultrasound to limit pain and swelling.
Your therapist may recommend bracing or taping your kneecap as part of the treatment for patellofemoral problems. The goal of bracing or taping is to correct the alignment of the kneecap. This may be all you need as you work with your physical therapist to improve your flexibility, strength and muscle balance in your knee.
If these measures fail to improve your condition,
Patellofemoral problems, such as alignment or overuse problems, can lead to wear and tear of the cartilage behind the patella (kneecap). This produces pain, weakness, and swelling of the knee joint. Several different problems can affect the patella and the groove it slides through in the knee joint. These problems can affect people of all ages.
Patellofemoral problems commonly develop when the kneecap suffers wear and tear. The underlying cartilage begins to degenerate. Wear and tear can develop for several reasons. Degeneration may develop as part of the aging process, like putting a lot of miles on a car. The patellofemoral joint is usually affected as part of osteoarthritis of the knee.
Glucosamine and chondroitin sulfate have been slowly gaining acceptance in the medical field as effective, non-surgical solutions to the inflammation and pain of knee osteoarthritis. Dietary supplements, they are usually taken in pill form. It is thought that they protect, and possibly help repair, cartilage cells. Degenerative, or “wear and tear,” arthritis affects the articular cartilage which covers the ends of the bones where they meet to form the knee joint. So, any measures that contribute to lubricating or otherwise protecting this cartilage is thought to be beneficial to the arthritis sufferer.
Glucosamine and chondroitin sulfate experiments
The data is not conclusive, but laboratory experiments
Prepatellar bursitis is often referred to in relation to its cause, such as “housemaid’s knee,” because most of those afflicted are people who are required to work on their knees, such as plumbers, roofers, carpet layers, and garden workers. Or they may be athletes who participate in a sport that commonly results in direct blows to the knee. Prepatellar bursitis can also result from a motor vehicle accident, a fall, or other trauma to the knee. It can be problematic for people who are obese, or who have rheumatoid arthritis and gout. If you have ever awakened to discover that the top of your knee is red, swollen, and warm to the touch you likely have prepatellar bursitis.
The knee is surrounded by
An X-ray does not signal the need for knee replacement. Frequently, an X-ray is one of the first tests chosen for joint pain because it is simple, painless and can be readily obtained in a physician’s office. There are literally hundreds of diagnoses that can cause knee pain. To sort through this considerable list of possible diagnoses, the surgeon has at his disposable dozens of tests that can be considered. In the course of your discussion with the surgeon, he will have considered when your pain started; what has been done to treat this pain; what other medical problems you have (such as hypertension, diabetes, kidney disease); and what level of activity you expect from your knee. Then he will consider
A second opinion for knee pain relief may be the first step that’s needed. Consider the following situation:
A doctor tells a patient they need a knee replacement, even though the knee just started hurting a few weeks ago and no other treatments have been attempted. Progressing to surgery without trying less invasive treatment first is generally not advisable.
Most of the time, the physician would try to determine if the patient had tried any of the over-the-counter arthritis medications such as Aleve, Ibuprofen or even Tylenol for a period. In addition, there are prescriptions for arthritis medications that cause fewer stomach problems, but cost a bit more. For many people these medications work
Revision knee replacement refers to the procedure to repair or replace a failed first knee replacement. All implants have a limited life expectancy depending on an individual’s age, weight, activity level and medical condition(s). We expect most knees to last more than 15-20 years. However, there is no guarantee that yours will last that long, and 5-10 percent will not last that long. A second replacement or a “revision” of the first joint replacement may be necessary. Although revision knee replacement can be done, it often doesn’t last as long as the first and carries a higher level of risk for a complicating event.
Why might I require revision knee replacement?
Post-operative questions about knee replacement vary, depending on the type of knee replacement surgery you have had. For instance total knee replacement on a same-day outpatient basis differs greatly from that conducted in a hospital setting. Still, many of the concerns are the same and we don't want you to be worried with post-operative questions about knee replacement, so we have addressed some of the common concerns in this article.
Will I need blood after my knee replacement surgery?
You may need blood after your knee replacement surgery. It has been shown that if you have a low blood count prior to knee arthroplasty, you will probably need donated blood after surgery. Pre-op donation only
After knee replacement surgery, your first thought will most likely be "When can I go home?" Some of the most important preparation for successful knee replacement surgery in Ft. Myers and in Naples relates to coming home from the hospital.
Prepare your home for your return from the hospital
Have your house ready for your arrival back home after knee replacement surgery. Clean your home beforehand, do the laundry and put it away. Put clean linens on the bed. Prepare meals and freeze them in single serving containers. Cut the grass, and tend to the garden and other yard work as it will be some time before you will be ready for this activity.
Pick up throw rugs and tack down loose carpeting. Remove
Medication issues for knee replacement surgery in Naples include which medicines or supplements to start and which to stop prior to surgery.
Important medication issues for knee replacement surgery
Start taking Iron supplement 325 mg per day prior to surgery. This is to build up your blood count. This can be obtained at your local pharmacy without a prescription.
Medication issues for knee replacement surgery also include which ones to stop. Discontinue the use of aspirin, aspirin-like products, non-steroidal anti-inflammatory medication, vitamins (except for Iron 325 mg), and herbal supplements one week prior to your knee replacement surgery in Naples.
If you are on a blood thinner such as
Preparing for knee replacement surgery involves establishing relationships - with a physical therapist, with your insurance company, and with the surgery facility you are using.
Get in shape before knee replacement surgery
It is well known by your surgeon that patients who are physically fit prior to surgery recover much faster. They also return to activity sooner than patients who are sedentary. If you want your recovery time to be shorter and have less pain then you need to get yourself in shape.
You will be directed to a physical therapist for instruction on which muscles to strengthen and which joints to stretch. Exercises should begin as soon as possible. Patients who enter surgery with good
Too old for knee replacement surgery? Nonsense! Each year, over 580,000 people in the U.S. undergo total knee replacement surgery. Typically, candidates for knee surgery are individuals with chronic joint pain from arthritis that severely diminishes their ability to perform normal daily activities. This often leads to a loss of independence and self-esteem. A replacement joint can make a big difference in your ability to return to work or other activities that you enjoy.
We have broken down the basic information on knee replacement surgery into four steps, which we will look at one at a time over the next few weeks.
STEP 1: Get Answers to Preliminary Questions
What is arthritis and why does my
A torn meniscus makes itself known in unusual ways. Has your knee “locked up”? Is your knee swollen and painful? Have you heard any “popping” or “clicking” when you bend your knee? If you have experienced any of these symptoms, then you could have a torn meniscus.
The menisci (there are two of them) are tissues in the knee joint between the thighbone (femur) and the shinbone (tibia). They act as shock absorbers, providing protection for the articular cartilage that keeps your joints moving fluidly.
Diagnosing a torn meniscus
The menisci are prone to injury. Your surgeon will diagnose meniscal injuries with a thorough physical examination and history. X-rays will not reveal a torn meniscus;
Meniscus tears are common injuries among athletes and aging adults. In your knee joint, between your shinbone (tibia) and your thighbone (femur), are two structures that act as shock absorbers. They are known collectively as menisci. The C-shaped medial meniscus lies on the inside part of your knee. The U-shaped lateral meniscus is found on the outer half. The two menisci form a gasket between the tibia and the femur. They help spread out the forces that are transmitted across the joint.
The ends of your tibia and femur are covered with articular cartilage – a smooth, slippery material that allows the bone surfaces to slide against each other without causing damage to either surface. The menisci protect
The ligamentum teres has a very important job. It helps hold the head of the femur (thigh bone) in the hip socket. If you pull a chicken leg out of its socket, you'll see a fibrous white ligament. That's the equivalent of the ligamentum teres in the human.
Traumatic or twisting injuries can cause this ligament to tear. Hip dislocation can stretch it to the tearing point, too.
Doctors don't have a test to help them find this type of tear in the ligamentum teres. It doesn’t show up in MRIs, X-rays or CT scans. The patient’s symptoms, such as deep groin pain and repetitive mechanical symptoms such as popping, catching, locking or “giving way” of the hip are the only signs that an injury to the
Hamstring injuries sideline many an athlete. The hamstrings are the big group of muscles and tendons in the back of the thigh. Injuries in this powerful muscle group are common. Though these injuries can be very painful, they will usually heal on their own. However, for an injured hamstring to return to full function, it needs special attention and a specially designed rehabilitation program.
When the hamstring is injured, the fibers of the muscles or tendon are actually torn. The body responds to the damage by producing enzymes and other body chemicals at the site of the injury. These chemicals produce the symptoms of swelling and pain.
Hamstring injuries happen when the muscles are stretched too far,
Partial knee replacement or total knee replacement? Which do you need? Not every patient suffering from knee osteoarthritis needs to have a total knee replacement. When only one side of the knee has worn down, you may be a candidate for partial knee replacement. Partial knee replacement is also known as unicompartmental knee replacement. Three major compartments make up your knee. The medial compartment is the inside part of the knee. The lateral compartment is the outside part. The patellofemoral compartment is the front of the knee between the kneecap and thighbone.
Advantages of partial knee replacement
In a partial knee replacement, we replace only the damaged compartment with metal and plastic. We
Articular cartilage covers the ends of the bones in your knee joint. Articular cartilage has a smooth, slippery surface that allows the bones to slide over each other without rubbing. Lesions can appear in the surface, damaging the articular cartilage. A grade IV, or full-thickness, lesion is a tear that goes all the way through the cartilage. Grade IV lesions usually require surgical repair.
You may have injured your articular cartilage and not even know it. This is because a lesion is not usually painful at first. There are no nerves in cartilage tissue, but any lesions can cause the knee joint to become inflamed and painful. If the lesion is large enough, the bone below the cartilage will be exposed.
Surgical treatment for knee osteoarthritis should be considered when other efforts to treat your pain fail to bring relief.
Using an arthroscope, your surgeon can check the condition of the articular cartilage. He can also clean the joint by removing loose fragments of cartilage. Some patients experience relief when the joint is simply flushed with saline solution. Your surgeon may use a burring tool to roughen badly worn spots on the cartilage. This procedure promotes growth of new cartilage called fibrocartilage, which is like scar tissue. The procedure is often helpful for temporary relief of symptoms for up to two years.
Proximal Tibial Osteotomy
Osteoarthritis usually affects the
Non-surgical treatment for knee osteoarthritis consists of several therapies. Osteoarthritis of the knee can't be cured, but these therapies may ease symptoms and slow down the degeneration.
Non-surgical treatment for knee osteoarthritis through medication
Your doctor may suggest acetaminophen (Tylenol) or a non-steroidal anti-inflammatory medication such as ibuprofen (Advil) or aspirin. Alternatively, he may prescribe one of the newer anti-inflammatory medicines called COX-2 inhibitors. They show promising results and do not cause as much stomach upset and other intestinal problems.
Glucosamine and chondroitin sulfate may also help people with knee osteoarthritis. These supplements seem to have nearly
Knee osteoarthritis is sometimes referred to as wear and tear arthritis. Osteoarthritis of the knee joint is a common problem for many people. It affects the articular cartilage, which is the smooth lining that covers the ends of the leg bones where they meet to form the knee joint. Articular cartilage decreases friction in the knee joint. Beneath the cartilage is a layer of bone. When the articular cartilage wears away, the bone below is uncovered and rubs against bone. Small outgrowths may form in the joint. These are commonly called bone spurs.
Knee osteoarthritis causes
Years of repeated strain on the knee can cause knee osteoarthritis. Abnormal movement and alignment of the knee caused by ligament
Surgical treatment for ACL injuries centers on keeping the tibia from moving too far forward under the femur bone and getting the knee functioning normally again. To reduce scarring inside the joint and to speed your recovery, most surgeons will prescribe several sessions of physical therapy before the surgery. This will also reduce swelling and ensure you can straighten the knee completely.
Surgical treatment for ACL injuries involve a substitute graft
ACL injuries are not generally repaired using sutures to sew the original ligament back into place because primary repair of the ACL has generally been shown to fail over time. Therefore, the torn ACL is replaced by a substitute graft made of a hamstring
Non-surgical treatment for ACL injuries focuses on decreasing the pain and swelling in your knee, beginning with rest and mild over-the-counter pain medications such as Tylenol. Your knee joint may need to be drained, in order to remove any blood in the joint.
You will most likely be instructed to put a normal amount of weight on the injured leg while walking, and may need to use crutches until you can walk without a limp.
Physical therapy as a non-surgical treatment for ACL injuries
The nonsurgical treatment of your ACL injury may continue with physical therapy. Therapists use ice, electrical stimulation, and rest periods with your leg supported in elevation to treat swelling and pain.
To help you
Osteoarthritis is the most common of the more than 100 different rheumatic diseases and conditions known as arthritis. Osteoarthritis affects more than 75% of people over the age of 55. "Osteoarthritis is a huge public health problem that's going to grow considerably in the next 20 years," predicts rheumatologist Patience White, a spokesperson for the Arthritis Foundation. Almost 54 million Americans say they have been diagnosed with arthritis. By 2030, the number is expected to grow to 67 million. Obesity, lack of physical activity, injuries, and the aging population are all factors contributing to this unprecedented growth.
Osteoarthritis is a chronic condition characterized by a breakdown of articular
As people live longer and more people receive joint replacements at younger ages, it is expected that an increasing number of those implants will wear out and / or fail for some reason. In these cases a second operation will be necessary to replace or revise the failed first replacement and this procedure is referred to as revision joint replacement. The increasing demands placed on these implants by patients in terms of longevity and durability; and expectations of patients to maintain their active lifestyles even with a joint replacement has presented a considerable reconstructive challenge to the surgeon, most of whom will not even attempt these complex revision surgeries.
Fortunately, despite the
In order to properly identify an ACL injury, it is imperative that you have an understanding of the ACL (anterior cruciate ligament) and its function as well as typical activities that tend to result in such injuries.
The anterior cruciate ligament (ACL) is a strong band of tissue that connects the femur (thighbone) to the tibia (shinbone). The ACL attaches to the backside of the femur, and goes under the femur, ultimately attaching to the front of the tibia. The femur has a special notch hollowed out at its bottom where the ACL runs across. This special notch is known as the intercondylar notch, and it keeps the ACL in place as it stretches and recoils.
The function of the ACL is to control how far forward
Injuries to the ACL (anterior cruciate ligament) are one of the most common sports injuries to the knee. They happen to professionals and amateurs alike. Injuries to the ACL affect the quality of life of all those who suffer such damage to the knee. They can restrict the range of activities for athletes as well as all others who are affected.
The ACL is a ligament. Ligaments are tough bands of tissue. Their function is to connect bones together. Specifically, the ACL connects the femur (thighbone) to the tibia (shinbone). It is a long ligament which connects the backside of the thighbone to the front portion of the shinbone. The ACL ligament restricts how far forward the shinbone can extend.
Advances in arthroscopy result in minimally invasive surgery. It used to be that when an orthopaedic surgeon “scoped a joint” all he or she could do was look inside the joint. But the development of tiny video cameras and instruments allow surgeons to do more than simply take a look. Now they can perform actual surgical procedures through the arthroscope.
Advances in arthroscopy benefits patients
Maximizing the use of the arthroscope in surgical procedures results in minimizing the size of the incision needed to perform the procedure. This minimally invasive arthroscopic surgery provides several benefits to the patient. It allows the joint to remain closed and reduces the risk of infection and drying out