Chondral injuries are common to the knee joint especially with ACL injuries or multi-ligament injuries. One study reported 23% of acute ACL injuries and 54% of chronic ACL knees had articular cartilage damage. In general, these lesions are not painful unless there is an elevated chondral flap (OCD) or a loose chondral piece.
There is much debate on the best way to treat a patient who has suffered an ACL tear regarding graft choice and when to do the surgery. However, the one opinion that most agree upon is doing a reconstruction on an isolated ACL injury to all school-age athletes and those individuals who want to return to high-risk activities is appropriate.
Common knee problems such as asymptomatic meniscus tears and most osteoarthritis will heal with non-operative treatment. Yet, patients with these problems are often told they need surgery based solely on an MRI or X-rays.
Following simultaneous anterior cruciate ligament (ACL) reconstruction and repair or removal of a locked bucket-handle meniscus tear, patients were having difficulty regaining full range of motion (ROM).
One of the most common problems that we have been seeing in our clinic are patients that have developed a stiff, arthritic knee; many seeing us for a second opinion. Often times, patients have seen another physician; either primary care, orthopedist, or orthopedic physician assistants and the patient may have been given a diagnosis of arthritis but did not fully understand the diagnosis.
A clear understanding of the anatomy and mechanics of the patellofemoral joint is critical when treating a patient that presents with a possible patellar dislocation. The alignment of the patellae should be evaluated to understand where the patellae sit in relation to the trochlea medially and laterally, as well as looking at the height of the patellae, proximal to distal. Physical exam should include assessing for a “J” sign, the patella height and patella tilt and comparing to the opposite knee.
At the Shelbourne Knee Center, our pioneering efforts to focus only on the specialty of knee pain and injuries have given us unmatched insight into the options available to patients. Our team has tracked the outcomes of thousands of patients from non-surgical treatments to ACL reconstructions. And from this experience, our fellowship trained surgeons know when therapeutic options are more successful than surgery and how to minimize recovery time when surgery is necessary.