Question 1

What Treatment Is Available for Rotator Cuff Injuries?

Accepted Answer

After a diagnosis is obtained following physical examination and image testing, the evaluating physician will have a better perspective of the extent of the rotator cuff injury.

If the damage is limited, surgery will not be required, and a conservative approach will be recommended to alleviate symptoms and regain proper joint use. Conservative treatment options include:

Rest and joint immobility
Anti-inflammatory medication
Physical therapy
Steroid injections

When symptoms fail to subside following non-invasive methods, surgical intervention may be the only option to repair an injured rotator cuff. This type of procedure is typically suggested if:

Patients still experience symptoms after 6 months
The injury is larger than 3 centimeters
The injury results from sudden trauma or a recent tear
Severe weakness or loss of function affects the shoulder

Surgical Treatment Options

Depending on the rotator cuff injury's severity, location, and size, the evaluating physician and surgeon will recommend the most appropriate surgical procedure to repair the damage. Patients will be under general anesthesia during the operation or will be administered a regional anesthetic and experience no discomfort or pain.

The most common surgical interventions for rotator cuff injuries are:

Arthroscopic Surgery – Using an arthroscope and specialized narrow instruments inserted through minor incisions in the shoulder, the surgeon can visualize the injury on a screen and repair damaged tendons in a minimally invasive manner. Recovery following arthroscopic surgery is usually faster than more invasive approaches.
Open Surgery – This procedure is recommended for larger and more complex tendon tears. The surgeon makes a sizeable incision to access the deltoid muscle and gently moves it out of the way to repair damaged tendons.
Mini-Open Surgery – In the first part of this procedure, the damaged bone and frayed tissue are repaired or removed using arthroscopic tools. During the second part of the operation, an incision is made to access the injured rotator cuff tendons and repair the injured area.

Anchors made out of a dissolvable material and stitches may be used to help attach the tendon to the bone. After the operation is done, the surgeon closes every incision and applies a dressing.

Since the surgery is performed on an outpatient basis, patients can return home on the same day and begin the road to recovery. The surgeon will provide pain relief medication to address post-op discomfort. However, it is recommended to have a designated driver following surgery and ensure that assistance can be provided for activities that will become challenging due to shoulder immobilization.

Question 2

Are Stem Cell Injections Efficient Knee Injury Treatments?

Accepted Answer

Due to aging and overuse, the knee's articular cartilage gradually wears down, leading to osteoarthritis, which exposes bones to friction and causes joint pain and inflammation. Since cartilage doesn't naturally regenerate, stem cell treatment is a novel and highly effective therapeutic approach that alleviates symptoms and promotes new cell growth.

Stem cells are some of the earliest occurring cells. They are commonly found in embryos, starting as a blank slate and differentiating into particular types of cells with distinct specializations. Adults also have stem cells, albeit not as many and at a lower concentration, making tissue regeneration increasingly challenging as we age.

Stem cells can be obtained from allogenic sources (donors) or harvested from a patient's (autogenic) tissues, like fat or bone marrow. Stem cells are injected into the injured area, which the body uses to slow down cartilage deterioration and promote cell renewal. Stem cell injections can also be used to treat other knee injuries, such as:

As a minimally-invasive procedure, stem cell injections have a low level of risk and demonstrate encouraging long-term potential. Professional athletes opt for cutting-edge stem cell treatment to avoid placing their careers on hold.

The positive effects of stem cell injections for knee osteoarthritis can last from 6 months to several years, with some patients never experiencing the same level of pain as they did before treatment.

Question 3

How Are Bankart Lesions Diagnosed?

Accepted Answer

Bankart lesions frequently occur in shoulder dislocations, with the most commonly cited symptoms including:

Painful sensations
Weakness/Instability
Affected mobility
Mechanical dysfunction

Since labrum damage shares many symptoms with different types of shoulder injuries like rotator cuff tears and SLAP lesions, a thorough examination conducted by a specialized physician is necessary to diagnose Bankart lesions properly.

MRI and CT scans are the preferred methods to identify Bankart lesions because of their ability to evaluate ligament displacement under the shoulder socket. Physicians obtain a better image of the sustained labrum damage by inserting a contrast medium between the socket and damaged ligaments. Bankart lesions that also include bone damage can also be identified using radiographs.

Depending on the injury's pathology and the extent of the damage, evaluating physicians may initially recommend conservative treatment methods, like:

Rest and joint immobilization
Light rehab exercises
Anti-inflammatory medication

If symptoms fail to subside following this approach and shoulder instability remains an issue, Bankart repair surgery may be needed to reattach a damaged labrum.

Question 4

How are Dislocations and Subluxations Diagnosed?

Accepted Answer

Comprised of the upper arm bone (humerus), shoulder socket (glenoid), and several ligaments that maintain its stability, the shoulder is perhaps the most important joint in the human body, playing a crucial role in mobility and allowing us to perform vital tasks. Due to its positioning and regular use in daily activities, shoulder injuries can frequently occur and range in severity.

The most common shoulder injuries include subluxations and dislocations. Although they share similarities, both injuries are distinct; while subluxations refer to a partial dislocation where the humerus is only partly shifted from the glenoid cavity, in complete dislocations, the humeral ball is entirely separated from the shoulder socket.

Subluxations can be more challenging to diagnose than dislocations, although they may be observed due to a protrusion under the skin indicating sustained damage. Individuals may report feeling increased shoulder instability accompanied by discomfort. The most common symptoms include:

Joint pain
Shoulder swelling
Visible deformity
Tingling or numbness along the arm
Limited shoulder mobility

Due to the shoulder joint's ability to rotate in multiple directions, subluxations and dislocations occur downward, forward, or backward, stretching or tearing the glenoid cavity and associated structures. Young individuals and those involved in intense physical activities face the highest risk of subluxations, which are often caused by:

Trauma – Includes motor vehicle accidents or falling improperly on an outstretched hand.
Sports Injuries – Contact sports like football or hockey, and sports that involve high velocities or falling, like gymnastics or skiing.
Stroke – 80% of individuals that experienced a stroke are at risk of subluxations due to muscle weakness that can lead to shoulder instability.

Considering that both injuries are related, it's no surprise that the symptoms of a complete dislocation are similar to those of subluxations but a lot more increased in severity. Additionally, bruising or redness, muscle spasms, and shoulder immobility may be distinguishing symptoms of a dislocation.

Just like subluxations, trauma and injuries that occur from sports are the most common causes of shoulder dislocations, including disciplines that require repetitive overhead arm movements, like baseball or tennis.

When such injuries occur, physicians will cover a patient's symptoms and medical history before performing a physical examination by palpating the affected area. X-rays, CT scans, or MRIs can also be ordered to obtain a better image of the internal shoulder damage and rule out other potential causes of pain or injuries, like:

AC joint injuries
Biceps tendonitis
Clavicular injuries
Glenoid labral tear
Rotator cuff injuries
Swimmer's shoulder

After determining the injury's extent and severity, physicians may be able to place the shoulder back in its socket on the spot or recommend a care plan consisting of either conservative treatment or surgical intervention.

Question 5

How Are Dislocations and Subluxations Treated?

Accepted Answer

After sustaining a dislocation or subluxation, the main priority is repositioning the shoulder back into place. The following step is a conservative treatment approach focused on healing, symptom reduction, and rehabilitation.

Closed reduction – During this procedure, the physician moves and rotates the arm so that the humerus slides back into the glenoid cavity. Though patients may experience discomfort, shoulder pain drastically subsides after the bones are correctly realigned.
Shoulder immobilization – Patients must wear a sling for a few weeks after closed reduction to keep the joint still and promote healing. Stretching and moving the shoulder during this period may lead to repeat injuries.
Pain relief medication – Physicians will prescribe pain relievers and anti-inflammatories to address discomfort, lingering symptoms, and swelling. Caution is advised with more potent medicine known to lead to chronic consumption. NSAIDs such as ibuprofen, aspirin, or naproxen can also be prescribed for pain relief over a more extended period.
Rehabilitation – If the shoulder is responsive to a limited course of treatment, physicians may recommend a series of light exercises to gradually restore the shoulder's range of motion and increase muscle strength.

Despite conservative treatment, some patients may continue experiencing shoulder instability or joint looseness. Activity modification may be recommended if instability results from specific activities. Surgical treatment is usually recommended for patients that require increased shoulder mobility like athletes or heavy laborers or if dislocations continue reoccurring.

Surgical Treatment Options

Subluxations don't usually require surgery, which is an option meant to address more severe injuries such as dislocations and damage to associated structures like bones, ligaments, tendons, and cartilage. Depending on the injury's severity, physicians may recommend open shoulder or arthroscopic surgery.

Open Shoulder Surgery is recommended if the shape of the bones is affected or if weakness and discomfort persist following less invasive interventions. It involves the operating physician accessing the joint through a sizeable incision above the shoulder to repair damaged ligaments, tendons, the labrum, or address bone damage. Surgeons may address bone loss due to repeated dislocations with grafts from the patient's bones (usually from the top of the hip), which gradually fuse with the shoulder socket providing stability.
Arthroscopic Surgery is a minimally intrusive procedure mostly recommended to tighten ligaments and tendons that have been torn or stretched, reattach the cartilaginous labrum to the shoulder socket, or clean out bone fragments. Physicians make small incisions around the shoulder, allowing access to a thin arthroscope to visualize the shoulder's interior and narrow surgical tools to carry out the operation. This procedure is preferred for its shorter time span, lower costs, and fewer complications or scarring.

Both types of interventions are performed under general anesthesia, with nerve blocking agents providing regional pain relief for up to 12-24 hours. After the incisions are closed and stitched, the operation is complete, and patients can begin focusing on healing. Arthroscopic surgery is performed on an outpatient basis allowing individuals to return home on the same day, but open shoulder surgery may require a stay in the hospital overnight.

Question 6

How Are Knee Ligament Injuries Diagnosed?

Accepted Answer

As the body's most complex joints, knees comprise several bones and cartilaginous structures, which are held together tightly by ligaments and tendons. Ligaments are durable strands of fibrous tissue that connect the joint's bones and provide stability.

The knee has 4 primary ligaments that connect the thighbone (femur), shinbone (tibia), and fibula (calf bone):

Cruciate Ligaments – The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) cross one another inside the knee in an "X" shape, with the ACL crossing forward and the PCL backward.
Collateral Ligaments – The lateral collateral ligament (LCL) is located on the knee's exterior, and the medial collateral ligament (MCL) is situated on the inside, both controlling side-to-side movement and limiting the joint's range of motion.

Damage to the ligaments can occur as a result of vehicle accidents, sports injuries, or falling and landing improperly, with the most common symptoms including:

Sudden and severe pain
Excessive swelling in the first 24 hours
Popping/snapping sound
Joint looseness and instability
Inability to place weight on the knee

When diagnosing injured ligaments, physicians will ask patients about any prior joint issues and analyze the ligament damage in a thorough physical examination. They may order X-rays to see if any bones have sustained damage, and MRI imaging is used to observe damage to softer tissues internally. Arthroscopic diagnosis may be performed to confirm imaging test results.

Knee ligament injuries differ for every individual and are classified based on their extent and severity:

Grade 1 – The damage is minimal and treatable non-operatively
Grade 2 – Ligaments may be partially torn or stretched but remain intact overall
Grade 3 – One or more ligaments are entirely torn

Grade 1 injuries usually respond to conservative treatment and don't require surgery. In contrast, grade 2 and 3 knee ligament injuries are more extensive and need surgery to repair or replace the damaged structures.

Question 7

How Are Meniscus Injuries Diagnosed?

Accepted Answer

The meniscus is a cartilaginous structure in a C or wedge shape, whose purpose is to act like a shock absorber between the thighbone and shinbone. Both knees have two menisci, one on the knee's interior (medial) and one on the outer (lateral) side.

The menisci's primary function is absorbing pressure and distributing body weight. At the same time, they protect the bones from grinding against each other and causing osteoarthritis. Given that the knee joint can gradually deteriorate due to strenuous activity or aging, meniscal injuries can occur, requiring reparative treatment.

Meniscal tears are most commonly caused by traumatic or sporting injuries involving an abnormal overextension or leg rotation that partially or fully ruptures the cartilage. Individuals that suffer a torn meniscus usually report the following symptoms:

Pain near the torn area
Sudden pain after the injury
Slow symptoms onset
Pain when moving
Pain after resting
Swelling from fluid accumulation
Joint locking

These symptoms can vary for every individual depending on the tear's location, severity, patient health, and time that passed since the injury. Additional damage to surrounding structures like the ACL can also co-occur.

Diagnostic physicians first establish if a meniscal tear is present or the symptoms have a different cause. If a tear is evident, they will determine which meniscus was affected and the extent of the damage. The diagnostic process focuses on:

Patient history – Physicians usually ask if any other meniscal issues have occurred before, which can affect the nature of the subsequent treatment.
Physical examination – Physicians determine which meniscus has been damaged and if joint locking is present and caused by torn pieces of cartilage inside the knee. They may employ either the McMurray or Apley's Compression test.
Imaging tests – X-rays, CT, and MRI scans enable a deeper view of the knee joint, helping physicians determine the location and extent of the tear and if any soft or hard tissue particulate is lodged in the joint.

The diagnosis also determines the type of meniscal tear, which include flap, degenerative, bucket handle, and radial tears. These factors allow physicians to determine which type of treatment is required. Light injuries may respond to conservative treatment methods, but more complex injuries may require surgical interventions to repair, remove or replace a torn meniscus.

Question 8

How Are Meniscus Transplants Performed?

Accepted Answer

When meniscus tears occur, physicians will assess the damage to determine if the cartilage can be repaired, trying to maintain as much of the original tissue as possible. However, if the meniscus is damaged beyond repair or its condition is highly deteriorated, physicians may recommend removing it altogether and substituting it with a transplant.

Meniscus transplant is a safe and commonly performed procedure that is recommended for patients meeting the following standards:

Are younger than 40
Are motivated to undergo a lengthy rehabilitation program
Have had previous interventions to remove damaged meniscal tissue
Have ongoing pain that limits activities
Have a proper or correctable limb alignment
Have a body mass index lower than 30 (not obese)

The intervention is also known as meniscal allograft transplantation, meaning that the transplanted cartilage tissue is acquired from a donor that passed away. Notably, transplant rejection doesn't occur in this type of intervention, and patients won't require immunity suppressant medication.

At the start of the intervention, patients are administered general, regional, or local anesthetics to prevent them from feeling discomfort. Operating physicians typically employ the minimally invasive arthroscopic method to perform meniscus transplants, making several tiny incisions around the knee. A small camera with a light source known as an arthroscope is inserted through one of the incisions to guide the surgery.

After clearing the knee joint of any cartilaginous particulate, small tools are introduced through the other incisions to remove the remaining damaged meniscus. The donor tissue is then positioned and anchored in the shinbone using screws or plugs and connected to the knee joint capsule with the help of sutures. After the transplant is effectuated, the surgeon removes the instruments and closes the incisions, dresses the wound, and the operation is done.

Meniscus transplant surgery usually takes about 2 hours to complete but can last longer if additional interventions like ACL reconstructions are performed simultaneously. As an outpatient procedure, patients may be able to return home on the same day as their operation. However, because the original tissue has been replaced with donor cartilage, patients may be required to spend 1 - 2 nights in the hospital before returning home and focusing on recovery and rehabilitation.

Question 9

How Are Patellofemoral Disorders Diagnosed?

Accepted Answer

The knee is the body's most complex joint with a crucial role in mobility, formed by the thighbone (femur), shinbone (tibia), and kneecap (patella), which are held together by strong ligaments and tendons. The kneecap connects to the muscle in front of the femur via the quadriceps tendon and the tibia via the patellar tendon.

The kneecap moves within a groove located in the femur known as the trochlea, with articular cartilage and synovium allowing the bones to move against each other without friction. Due to the knee's frequent use, the soft tissues and bones around the patella can gradually be affected, leading to patellofemoral disorders.

Patellofemoral disorders most commonly result from strenuous physical activities and sports that repeatedly stress the knee, like climbing, squatting, or jogging. An increase in the frequency and intensity of such activities can also affect the kneecap. Additionally, a misaligned patella can lead to increased pressure on the trochlear groove, leading to the irritation of soft tissues or subluxations and dislocations.

The typical symptoms of patellofemoral disorders include:

Pain surrounding the patella
Lasting dull and aching pain in the joint
Pain when running, going up/down the stairs, sitting, or squatting
Pain when flexing the knee completely
Unusual noise from the kneecap when moving
Reduced kneecap mobility
Swelling

Since patellofemoral disorders share similar symptoms with other lesions to nearby structures, a thorough diagnosis is required to rule out other injuries. Patellofemoral disorders are often mistaken for ACL injuries, and locking of the knee may be more indicative of meniscal issues.

The diagnostic process for patellofemoral disorders includes reviewing the patient's history of knee injuries and a physical examination of the affected area, usually through palpation. If internal damage is more extensive, X-ray, CT scans, and MRI imaging may be required to determine the extent of the damage to bones and tissues.

Question 10

How Are Rotator Cuff Injuries Diagnosed?

Accepted Answer

The rotator cuff is the shoulder joint mechanism comprised of muscles and tendons connecting the upper arm bone (humerus), shoulder blades (scapula), and collar bone (clavicle), providing stability and a wide range of motion. When tears occur, the resulting pain and weakness can affect everyday life by limiting joint movement and producing discomfort.

Nearly 2 million individuals experience rotator cuff injuries every year in the US. Gradual wear and tear, advancing in age, and improper posture are general risk factors. Repetitive overhead motions typical in certain sports (tennis, baseball, football) and occupations (carpentry, construction, painting) can also lead to tendon injuries. Rotator cuff tears can also be sustained during sudden trauma, such as falling on an outstretched hand.

When damage occurs, the most common symptoms include:

Weakness and pain in the shoulder
Joint instability accompanied by a grinding sensation
Inability to sleep on the injured area
Limited range of motion

Diagnosing Injuries

The evaluating physician will first review the patient's medical history to determine if they're predisposed to rotator cuff injuries and if other underlying issues could be relevant. A physical examination will be used to identify the precise cause of the pain.

The following step involves imaging tests to better visualize the nature and extent of the damage, with the most common methods used being:

X-Rays – usually employed to identify bone spurs and exclude other potential causes like arthritis.
Ultrasound – sound waves allow the imaging of muscles and tendons, helping physicians better assess their structure during movement.
MRI – this method using radio waves and a powerful magnet is preferred because it provides a more detailed image of the shoulder joint's internal structure.

Rotator cuff injuries can involve either partial or complete tears of the tendons. If the damage is minimal, the physician may recommend a conservative course of treatment focused on symptom relief and progressive rehabilitation. Surgical intervention is imperative to regain proper function if the damage is extensive or patients don't respond to conservative treatment.

Question 11

How Are SLAP Tears Diagnosed?

Accepted Answer

Identifying and adequately diagnosing a SLAP tear can be a challenging endeavor. The symptoms are similar to other shoulder lesions that can be sustained in addition to the SLAP tear.

Several diagnostic methods are available, although shoulder arthroscopy seems to be the most effective. This is because an arthroscope (a small tube fitted with a camera and light source) can provide a more detailed internal image of the sustained damage. Other methods may be helpful but lack the accuracy of shoulder arthroscopic diagnosis.

The diagnostic process follows a three-step clinical approach and can indicate the treatment that will be required.

Patient Medical History

Several details need to be established while evaluating a patient's medical history, ranging from potential previous treatments to present-day symptoms and their evolution. Such information may include:

Activities involving overhead motions – Athletic activities such as baseball, football, or swimming require repeated throwing-like actions that can wear down the shoulder joint and lead to a SLAP tear. Lifting heavy objects overhead in non-athletic activities can also lead to labral lesions.
Initial source – Because the damage is sustained over prolonged periods through repetitive overhead movements, it may be challenging to establish where the pain originally began.
Discomfort location – Patients usually cite an acute and deep pain that is difficult to locate, at times accompanied by uncommon popping or clicking sounds and sensations of stiffness and grinding within the shoulder joint.

Physical Exam

As the most hands-on approach, doctors perform physical exams to evaluate joint strength, stability, and the shoulder's range of motion. The neck and head may also be inspected to ensure that a pinched nerve isn’t causing the pain. While there are particular tests that doctors may employ to diagnose a SLAP injury, opinions on the reliability and accuracy of these methods vary among specialists.

Physical exams present several challenges because they are not always precise, and some labrum lesions may not be accurately identified. Because of this ambiguity in outcomes, image scanning is usually recommended to obtain a clearer diagnosis.

Imaging Scans

X-rays aren't regarded as the most effective diagnostic tool because cartilage damage isn't usually imaged when using this method. On the other hand, X-rays are useful in ruling out other bone-related injuries affecting the shoulder.

MRI scans are considered the most efficient noninvasive method for SLAP tear diagnosis. Because of the shoulder's complex structure, MRI scans can also identify additional problems stemming from ligament, tendon, and muscle issues. Conversely, MRI scans may encounter difficulties in pinpointing minute tears or produce a false positive. In such cases, minimally invasive methods such as shoulder arthroscopy could be employed for a more detailed analysis.

Question 12

How Are Wrist Injuries Diagnosed?

Accepted Answer

The wrist is structurally one of the most complex joints, consisting of tendons, ligaments, and small bones. Because it doesn't bear bodyweight the same way that knees do, wrists are more susceptible to injuries.

Wrist injuries result from physical trauma such as falling on an outstretched hand, sudden twisting, bending backward, overuse, or heavy impact and are common in several sports, including:

Basketball
Baseball
Football
Martial Arts
Gymnastics
Skateboarding

Physicians will cover a patient's symptoms and wrist injury history before performing a physical examination to determine the cause of pain and swelling. If the damage is extensive or difficult to determine, X-rays, CT scans, and MRI imaging may be ordered to pinpoint which bones and soft tissues have been affected.

Additionally, some physicians may choose to diagnose internal wrist injuries using an arthroscope. They insert a thin camera through a small incision that displays the joint's interior on a screen, allowing a clearer view of the damaged structures and a definitive diagnosis.

If damage to the wrist is minimal, the first approach to recovery is conservative treatment, which may require joint immobilization, icing, elevation, rest, and medication to reduce pain and swelling. If wrist injuries fail to heal after this period, patients may require surgery to repair the damaged bones or tissues.

Question 13

How Does Platelet-Rich Plasma Work?

Accepted Answer

Knees are often affected by gradual cartilage deterioration, which results in osteoarthritis, with the bones grinding against each other and leading to pain, inflammation, and joint swelling. Additionally, strenuous activities like high-impact sports can lead to knee ligament injuries that typically require extensive recovery.

Platelet-Rich Plasma (PRP) injections represent a novel alternative treatment aiming to promote cell growth and improve healing using the body's resources. Although the FDA hasn't extensively approved PRP treatment, athletes and other patients have used this method to heal injuries faster.

Platelets are the smallest blood cells with a vital role in clotting and tissue regrowth. Plasma is the liquid component of blood that contains multiple proteins or "factors" with regenerative qualities. Medical specialists consider that PRP injections in injured tissues can stimulate new cell development and alleviate pain, and due to the concentrated growth factors may speed up the healing process.

A sample of the patient's blood is taken and placed in a centrifuge that rapidly spins around, separating the blood into its constituent components. The plasma is collected separately and concentrated for treating arthritic conditions or soft tissue injuries, such as ACL tears. Ultrasounds may be used to identify the exact area for injection.

PRP injections' positive effects can last up to 12-18 months. Certain risks that are common for all injections include infection and flaring pain; however, they are considered rare. To increase the efficiency of PRP injections, patients should:

Drink 1-1.5 liters of water (or around 6 glasses) to ensure proper hydration before receiving the injection
Avoid NSAIDs like ibuprofen and aspirin which affect platelets for 10 days before treatment and a few weeks after.
Avoid exercising or using the knee for a week after PRP injections; rest time may vary depending on the injury.

Question 14

How Is a UCL Injury Diagnosed?

Accepted Answer

After the initial review of the medical history of the patient and a physical exam, multiple tests and exams will be ordered to determine how severe the ulnar collateral ligament injury is. Often, diagnosing this kind of injury is more difficult and challenging than the treatment per se. They are usually diagnosed by a sports medicine expert or orthopedic surgeon. These tests and exams include the following:

valgus stress test: during it, the physician tests the elbow for instability
MRI scan: using large magnets and radio waves, this imaging test provides the surgeon and physician with clear, detailed images from the inside of the elbow
X-rays: they are used to see the changes in the ulnar collateral ligament stemming from the injury, although they are less accurate than MRI scans

While MRI scans typically show a UCL tear, they may not be 100% accurate. For this reason, injecting a special dye into the elbow joint before the MRI will increase the accuracy of the test.

Question 15

How Is Arthroscopic Knee Surgery Performed?

Accepted Answer

When pain resulting from knee injuries isn't responsive to conservative treatment, physicians may recommend surgery to alleviate the symptoms. Knee arthroscopy is usually recommended for its minimally invasive approach and faster healing time.

Arthroscopic knee surgery is used for several reparative operations, including:

Repairing or removing torn menisci
Ligament reconstruction
Removing frayed articular cartilage
Bone debridement
Removing inflamed synovial membranes
Kneecap (patellar) realignment

Leading up to the procedure, patients will be instructed to limit certain medications like blood thinners and other aspects that may interfere with the surgery. The operation is carried out using local, regional or general anesthesia, so the patient doesn't encounter discomfort.

After stabilizing the joint, the operating physician will make several small incisions around the knee. Next, he inserts a narrow and long tube with a camera and light source known as an arthroscope to inspect the area internally. For a better view, a saline solution may be injected to provide more room for the arthroscope to maneuver.

When good imaging of the damage is achieved, the operating physician will insert small specialized tools through the incisions that will allow him to perform the required repairs. After carefully examining the repaired area for damage or bleeding, the tools are removed, and the saline solution is drained from the knee. After the incisions are closed with sutures, the procedure is complete, and the wounds are covered with a clean dressing.

Knee arthroscopy is a safe procedure with generally good outcomes and usually takes around 1 hour to complete. Since it's performed on an outpatient basis, individuals typically return home on the same day and begin focusing on their recovery.

Question 16

How Is Arthroscopic Shoulder Surgery Performed?

Accepted Answer

Patients who choose arthroscopic shoulder surgery must undergo a comprehensive evaluation to address any medical issue that can intervene and complicate the procedure. Similarly, patients should notify their physician about any health conditions they're experiencing and the medicine used to treat them, as they may negatively influence the intervention's outcome.

In the period leading up to the operation, patients will be provided with detailed instructions about what the procedure involves, when to arrive, and when to stop eating or drinking before the intervention.

Before the intervention, patients are administered a general or regional anesthetic to prevent pain, and nerve blocking agents may be used to provide extended pain relief for 12 to 24 hours after the procedure. After securing the patient in a reclining position or on their side, arthroscopic surgery can commence.

Small incisions are made around the shoulder, enabling surgeons to introduce a narrow tube-like camera fitted with a light source known as an arthroscope to visualize the shoulder's interior on a screen.
Specialized small surgical instruments are inserted through the tiny incisions to perform the required repairs, including cutting, shaving, tying knots, passing sutures, drilling holes, and fitting anchors into the bone.
After the repairs have been effectuated and all damage has been addressed, the surgeon closes the incisions with steri-strips or stitches and covers the wound with a bandage. The procedure is thus complete, and the patient is moved to the recovery area until the effects of anesthesia subside.

Arthroscopic surgery takes between 1-2 hours to perform depending on the extent of the injury, and patients return home on the same day. It is, however, recommended to have a designated driver following arthroscopic shoulder surgery, as the arm and joint will be immobilized in a sling.

Question 17

How Is Birmingham Hip Resurfacing Different from Total Hip Replacement?

Accepted Answer

When the hip joint suffers damage from an injury or by the progressive wear down of the cartilage, a physician may recommend surgical intervention if conservative treatment options fail to alleviate symptoms.

Birmingham Hip Resurfacing (BHR) is an alternative to Total Hip Replacement, mostly recommended to young and active individuals. While the hip joint requires replacement components in both procedures, there are distinct differences that set them apart.

How Do They Differ?

In a standard Total Hip Replacement operation, the symptoms are addressed by replacing the femur ball and the pelvic socket. The femoral head is replaced with a stemmed component and fitted in the proximal femur (thing bone). The stemmed implant has a ball on the tip that articulates with the replaced socket in the pelvis.

Total Hip Replacement has a few drawbacks for individuals that want to maintain an active lifestyle and whose age would allow them to outlast the expected durability of a conventional hip replacement, estimated at 10 to 20 years. A failed hip replacement caused by joint loosening and thinning articulation may require a revisionary procedure, which is riskier due to less available bone matter to fix the new replacements.

Conversely, Birmingham Hip Resurfacing is a radically different procedure in how the femoral neck is addressed. Rather than removing the femoral head, surgeons shave it down to allow a replacement ball to be fitted around it, thus preserving more bone. The metal socket replacement is fitted into the pelvis similarly and allows the replaced femoral head to fit in perfectly.

What Are The Advantages?

The BHR procedure preserves more bone on the femur and makes potential revision surgery less complicated.
Due to the increased femoral head size compared to hip replacements, dislocations are less likely to occur.
Stress is more evenly distributed to the femoral head due to a smaller metal implant in the femur's neck.
Since the BHR procedure removes less bone, the likelihood of post-op unequal limbs is highly reduced.
BHR provides more resiliency for higher intensity activities like jogging or sports.
BHR implants are more durable and last longer in young patients than total hip replacements.

Question 18

How Is Birmingham Hip Resurfacing Performed?

Accepted Answer

The Birmingham Hip Resurfacing (BHR) procedure was first introduced in 1997 in the UK by Derek McMinn and Ronan Tracy, and it was the first FDA-authorized hip resurfacing procedure available for US citizens, receiving approval in May 2006.

BHR is a less invasive option compared to Total Hip Replacement and it was designed to preserve more native bone in the femur's head and neck. With more bone available younger patients will have more options for future interventions if they're required, including a conventional hip replacement.

Hip Resurfacing Process

Birmingham Hip Resurfacing begins by administering a general or spinal anesthetic to sedate the patient during the procedure. The surgical intervention can last between 1 ½ and 3 hours, usually averaging 2 hours.

The patient is positioned on his side, allowing the surgeon to make a 6-8 inches incision in the thigh and gain access to the hip joint.
Damaged bone and cartilage are shaved off the femoral head's peripheries using special equipment.
The metal replacement for the femoral head is inserted into the femur's neck and attached using surgical cement.
Afflicted bone and cartilage are cleared from the pelvic socket.
The metal socket replacement is fixed into position, attaching itself to the pelvis due to the roughened texture on its back.
The new femoral head is moved in place into the reconstructed joint socket.
After the intervention is completed, the surgeon closes the incision using stitches.

What to Expect After Surgery

After the anesthetic wears off, the patient will usually spend 1 or 2 days in admission or longer, depending on the degree of the injury and other conditions. An X-ray may be required to ensure that the intervention was successful.

Patients will likely experience some degree of pain and require mobility aids to alleviate the pressure on the reconstructed hip. Painkillers like nonsteroidal anti-inflammation drugs are usually prescribed to ease post-operative pain. Physical therapy will begin soon to help regain mobility and strength.

Rehabilitation from BHR surgery usually involves three stages:

Immediate Post-Op Stage – 3 to 4 weeks
Intermediate Stage – 4 to 12 weeks
Return to Prior Activity Levels – varies depending on the intended level of effort

Generally, patients can expect to resume regular activities 6 weeks after their intervention. Patients can expect a full return to unrestricted activities and sports after 12 months of adequate rehabilitation.

Question 19

How Is Cubital Tunnel Release Surgery Performed?

Accepted Answer

Surgery for cubital tunnel release is the last resort when it comes to treating nerve compression. If the condition fails to improve with non-surgical treatments or if it causes persistent pain and numbness, the patient is most likely a good candidate for cubital tunnel release surgery. The most notable benefit of surgery is that if the ulnar nerve is compressed, the procedure will relieve the pressure. If the patient experiences some of these symptoms, they may be recommended surgery:

a persistent and intermittent tingling and numbness in the fingers
a grip in the affected hand
a sense of “falling asleep” of the fingers
muscle weakness and impaired muscle function in the fingers
difficulty controlling fingers for various tasks
tenderness and pain in the elbow joint
sensitivity to cold temperatures

After the patient receives anesthesia, the orthopedic surgeon makes a small incision behind the elbow to access the ulnar nerve passing through the bony pathway known as the cubital tunnel. Subsequently, medical instruments known as retractors are used to draw back superficial nerves from the ulnar nerve. The surgeon then inserts the endoscope to assess the condition of the ulnar nerve. The camera of the endoscope permanently offers clear, detailed images from the inside of the elbow joint on a monitor so that the surgeon and the medical team can see what is going on and what they need to repair.

Finally, the surgeon inserts miniature surgical instruments through the endoscope and divides the roof of the cubital tunnel to relieve pressure on the nerve. After decompression, they manipulate the elbow in various directions to evaluate the stability of the ulnar nerve. Once the procedure is finalized, the soft tissue and skin are closed with sutures, and a sterile dressing is applied over the incision.

Question 20

How Is Cubital Tunnel Syndrome Diagnosed?

Accepted Answer

Following a full medical history and physical exam, the physician will order some of the following tests and exams to determine whether the patient has cubital tunnel syndrome, which occurs when the ulnar nerve on the inside of the elbow becomes inflamed, swollen, or irritated:

nerve conduction test: it measures how fast signals travel down the nerve to find a compression or constriction of the nerve
electromyogram: it is used to observe nerve and muscle function and may also be used to test the forearm muscles controlled by the ulnar nerve – if the muscles do not work properly, this may be a sign that there is a problem with the ulnar nerve
X-ray: it is recommended for patients who might have arthritis or bone spurs in their elbow, as it allows the physician and surgeon to look at these growths if they are present

Only after the patient undergoes all the ordered tests and exams will the orthopedic surgeon be able to make a decision regarding which procedure is the best to cure their cubital tunnel syndrome. Additional tests and exams may be necessary, depending on the complexity of the case.

Question 21

How Is Elbow Cartilage Damage Diagnosed?

Accepted Answer

Cartilage damage follows a significant injury to the elbow, such as a dislocation or fracture. However, it can also be the result of osteoarthritis or normal wear and tear from age and activity. To diagnose elbow cartilage damage, the physician will ask the patient about the symptoms they experience, which usually include swelling, joint pain, stiffens, and a clicking or grinding sensation.

If they suspect cartilage damage, they will refer the patient to several medical specialists to determine how severe the damage is. The patient will undergo one or both of the following:

MRI scan: using a magnetic field and radio waves to create detailed, complex images of the inside of the body, this exam allows the orthopedic surgeon to see what is wrong with the elbow cartilage
Arthroscopy: this is a minimally invasive procedure that entails one or several tiny incisions in the elbow area, through which the arthroscope – a tube with a camera – is inserted to examine the elbow joint and cartilage, and the surgeon can also perform cartilage repair while the patient undergoes this procedure if their problem is not extremely complex

Question 22

How Is Knee Cartilage Damage Diagnosed?

Accepted Answer

Cartilage is the strong and flexible tissue blanketing the joints preventing friction between the bones, and serves as a cushion during intense activities like jumping or running. Knee cartilage can wear down and sustain damage over time, producing discomfort while walking or during sports.

Patients will undergo a clinical examination to assess the extent of the damage. The physician inspects the affected area for swelling and will ask the patient about the pain he experiences and related symptoms.

If patients experience pain on the knee's interior or exterior, it's usually indicative of the injury occurring in the bottom of the femur, with the discomfort intensifying during strenuous activities that involve weight bearing on the joint. When pain occurs after sitting for a prolonged period or during activities like kneeling or climbing stairs, the cartilage damage is usually behind the knee cap.

Physicians will typically order X-ray imaging to detect severely deteriorated cartilage or rule out other potential causes leading to painful symptoms. While x-rays can detect acute tissue damage, they do not help pinpoint localized injuries or cartilage fraying and may require MRI scanning for a more precise diagnosis.

If the symptoms and diagnostic results don't indicate advanced damage, treatment will be limited to a conservative approach. Conversely, if the damage is apparent or symptoms don't respond to conservative treatment, physicians may recommend surgical intervention to repair the injured cartilage.

Who Qualifies for Surgery?

Knee cartilage repair surgery is recommended for acute cases when mobility is affected; however, not everybody is eligible for this type of intervention. Due to the knee cartilage's anatomy and patient particularities, surgery is primarily recommended for individuals who:

Are younger than 40
Experience pain while at rest
Have experienced pain for weeks or months, not years
Encounter no issues with the knee's stability or alignment
Have isolated cartilage injuries
Have an active lifestyle

The procedure is elective, and not everyone eligible for surgery will opt for it.

Question 23

How Is Meniscectomy Performed?

Accepted Answer

When the meniscus suffers a severe tear that cannot be repaired, causing knee locking and ongoing pain, partial or total meniscectomy is recommended to regain proper joint use. The intervention can be performed simultaneously with other procedures, such as an ACL reconstruction that actually improve its chance of success.

Although open surgery used to be performed in the past, now operating physicians prefer the minimally invasive arthroscopic method to carry out meniscectomies, which favors faster recovery.

Before the operation, patients are sedated using local, regional or general anesthesia to dull their senses and prevent discomfort.
Several incisions are made around the knee, which allows a thin camera (arthroscope) to be inserted, projecting the image on a screen and guiding the operation.
A sterile saline solution is pumped into the joint to provide more space and better access.
Specialized small surgical instruments are inserted through the other incisions to remove torn pieces of cartilage (partial meniscectomy) or remove a heavily damaged meniscus altogether (total meniscectomy).
After the affected cartilage has been successfully removed, the saline solution is drained, the instruments are removed, and the incisions are closed and dressed, finalizing the procedure.

Meniscectomy usually takes about 1 hour to complete if the intervention doesn't include other additional procedures. After their operation, patients are moved to the recovery room and can return home after the effects of the anesthetic wear off.

Patients should have a designated driver on the way back; likewise, it's recommended that patients ensure someone helps out with menial tasks in the first 24-48 hours of their recovery.

Question 24

How Is Tennis Elbow Diagnosed?

Accepted Answer

Because tennis elbow (lateral epicondylitis) is a condition resulting from overuse, it develops over time, with symptoms appearing gradually. It's not uncommon for these symptoms to fluctuate, mainly manifesting during periods of increased effort. Even if the buildup of stiffness and pain in the elbow is progressive, some of the symptoms may be non-specific to the condition, with the patient only noticing a reduction in the ability to perform athletic or occupational activities.

Common Symptoms

Pain/stiffness in the dominant arm
Pain/stiffness that gradually intensifies
Pain that increases with effort and decreases with rest
Pain in the elbow’s exterior
Pain/stiffness during mornings
Complications with gripping or maneuvering items
Tenderness in the elbow and/or wrist

Diagnosis

If these symptoms are experienced, it's recommended to consult with a physician. The condition is diagnosed through a physical exam and may involve imaging to rule out other elbow injuries that manifest similar symptoms to tennis elbow. If the condition is more severe, the physician may make a referral to an experienced physical therapist or surgeon specializing in sports medicine.

The physician will go over the patient's history to assess potential risk factors, including sports and occupations, when the symptoms began manifesting, what area is most affected, how the pain is spread and radiates, and checking for numbness or tingling in the digits.

During the exam, the physician will visually and manually inspect the affected elbow and arm, testing nerve reflexes, bone and joint alignment, and range of motion to dismiss joint damage or potentially trapped nerves.

Even though diagnostic imaging isn't usually required, its use may be necessary to exclude other factors that might influence a patient's symptoms:

X-rays – can detect bone fractures/chips, a misaligned joint, or arthritis affecting the elbow.
MRI – magnetic resonance imaging may be conducted to rule out symptoms resulting from other afflictions and identify tears in the tendon, thus excluding other possible causes like damaged cartilage or ligaments.
EMG – An electromyography may be required to test nerve conduction and rule out nerve entrapment or compression.

Question 25

How Long Does It Take to Recover After Surgery for Elbow Nerve Injury?

Accepted Answer

After surgery for elbow nerve injury, it is recommended to keep the arm elevated for 24 to 48 hours to prevent swelling. Usually, it will be necessary to wear a splint on the elbow for several weeks to promote healing, and the patient should move their fingers and apply ice packs, which will help prevent stiffness.

The majority of patients can resume most of their daily activities shortly after the procedure. Their physician will tell them which movements and activities to avoid and may suggest physical therapy exercises to build strength and mobility in the elbow. Depending on the nature of their job, the patient may be able to return to work within one to two weeks following surgery, but they will have to limit their workload and avoid physically demanding tasks.

Full recovery is typically achieved 6 weeks following the procedure, but the time may vary depending on how severe the elbow nerve injury was. In the long run, mild symptoms will disappear completely, while severe symptoms may take longer to alleviate or may never fully disappear.

Question 26

How Long Does Recovery For Patellofemoral Injuries Take?

Accepted Answer

Patients who experience patellofemoral disorders have overall good outcomes when following physicians' recommendations. Conservative treatment includes resting, pain relief medication, icing, and progressive rehabilitation to regain muscle strength and the knee's range of motion.

Patients can expect to return to non-strenuous and sedentary occupations a few days after their surgery and, with proper care and rehabilitation, can return to physical activities at pre-op levels after 6-8 weeks.

Recovery following arthroscopic surgery for patellofemoral injuries usually takes longer than non-surgical treatments. Patients can expect to use crutches for the first 1-3 weeks, followed by 2-3 months of recovery and rehabilitation. A progressive return to more strenuous activities typically takes between 3-6 months.

Recovery following open surgery for knee realignment and stabilization usually involves activity modification and extensive physical rehabilitation. Depending on the procedure, patients may have to use crutches for the first 2-4 weeks and return to sedentary work and driving after 1-2 months. Physical rehabilitation after open surgery takes longer than arthroscopic surgery, and a full return to sports and activities at prior levels can last between 6-9 months.

As with any other surgery, there is an inherent risk of complications. Even if less than 5% of procedures for patellofemoral disorders result in complications, some of the risks that patients should be mindful of include:

Joint stiffness resulting from improper rehab
Excessive joint swelling
Ongoing pain, unresponsive to treatment
Bleeding, hematomas, and blood clots
Infections and wound discharge

Question 27

How Long Does Recovery for Scaphoid Surgery Last?

Accepted Answer

Since it's a non-weight-bearing joint, the wrist is more susceptible to injuries and can result in scaphoid fractures that require surgery. Most wrist surgeries are performed using the minimally-invasive arthroscopic method, which allows patients to return home on the same day as their intervention.

During the first phase of recovery, patients will be required to wear a cast or splint to immobilize the wrist. Doctors will prescribe strong medication to alleviate pain for up to 2 weeks, although caution is advised to avoid developing a habit.

The sutures are usually removed after 10-14 days, and doctors perform a follow-up examination to ensure that the scaphoid is healing correctly. On average, it takes about 6 weeks before the cast/splint can be removed and replaced with an easily removable brace.

Joint stiffness and weakness are not uncommon after removing the cast, and surgeons will recommend physical therapy to gradually improve muscle strength and the wrist's range of motion. Patients should follow recommendations to prevent re-injury and avoid:

Lifting, pulling, pushing, or carrying heavy objects
Using heavy or vibrating machinery (like jackhammers)
Using the injured arm to throw
Taking part in contact sports
Taking part in activities that can lead to falling on the wrist (like skating or skiing)
Climbing trees or ladders

Because the wrist isn't sufficiently vascularized, scaphoid fractures typically heal slower, and a full recovery can last as long as 6-9 months. However, most patients can return to routine non-strenuous activities as soon as 3 months. Not all fractures heal at the same rate, and some fractures may remain unresponsive after the first intervention requiring a second surgery to address failed bone unions.

Question 28

How Long Does Recovery from Ankle Instability Surgery Last?

Accepted Answer

Shortly after the procedure, the patient's foot will be in a plaster cast below the knee, and they will be sent home once they are comfortable. They will have to go to follow-up appointments and may be prescribed medication to manage the pain and discomfort. The patient will usually be referred to a physiotherapist who will develop a personalized rehabilitation program.

During the first several weeks, the patient will have to:

elevate their foot as much as possible to reduce swelling
move around only when they need to, such as to use the toilet without putting weight on the operated leg
take anti-inflammatory medication for approximately 6 weeks after the surgery

After 2 to 4 weeks, they will be given a boot to immobilize their foot and start partially bearing weight using crutches. Subsequently, after roughly 6 weeks from the procedure, the patient may still have to use the boot, but they will generally be able to fully bear weight and wear their usual shoes.

As for returning to work, this will highly depend on the nature of their work and how fast they recover. Usually, if the patient's job involves sitting down most of the time, they should be able to return after 2 weeks. However, if their job entails manual work, they may need to take between 8 and 10 weeks off.

Question 29

How Long Does Recovery from Knee Ligament Repair Take?

Accepted Answer

Knee ligament injuries with minimal damage may respond better to conservative treatment and not require surgery to improve. Patients will experience pain and swelling during the first days after their operation and will have their knee immobilized in a brace or a cast.

Resting, icing, compressing and keeping the knee elevated (RICE) help reduce pain and inflammation.
Pain relief medication will be prescribed to manage discomfort and should be taken according to the physician's instructions.
Patients should engage in light exercise to increase flexibility and avoid strenuous activity for 4-6 weeks.

Since every procedure and individual is different, recovery will depend on the number and extent of repairs, the patient's overall health, and his adherence to physical therapy. While MCL and LCL surgeries require an average of 6-9 months for a full recovery, ACL, PCL, and multi-ligament surgeries could take 9-12 months of recovery and rehabilitation.

Physical therapy and rehab are crucial for a faster recovery and are performed gradually to avoid reinjury. Likewise, after returning to the prior level of activities, doctors recommend wearing a supportive brace to reduce pressure on the operated knee.

Most knee ligament recoveries have good outcomes, although certain risks are present even if their occurrence is rare. Patients should seek medical attention if they experience:

Excessive bleeding or clotting
Infection and purulent wounds
Deep vein thrombosis
Nerve and blood vessel damage
Joint stiffness and instability
Graft or repair failure

Question 30

How Long Does Recovery Take After Bankart Repair?

Accepted Answer

After Bankart repair surgery, patients are required to spend a night in the hospital and are discharged the following day if no complications occur. Patients are provided pain relief medicine to alleviate discomfort and antibiotics to prevent infections.

Several key factors are analyzed to determine the proper course for post-operative rehabilitation, including:

The cause of the injury
Activity level before injury
Degree of shoulder instability
Dislocation frequency
Direction of dislocation
Associated injuries

After being discharged, patients will have to keep their shoulder immobilized in a sling between 3 to 6 weeks, and the stitches will be removed 10 to 14 days following the operation. To prevent the shoulder from locking, physicians will prescribe light and passive exercises to improve the joint's mobility.

After 4 to 6 weeks, physicians will focus on exercises that increase the shoulder's flexibility and range of motion. At this stage, patients may begin performing daily activities like driving which would've not been possible with an immobilized shoulder.

During the last phase of rehab lasting between 6 to 12 weeks, patients will be instructed to carry out exercises meant to stabilize the joint and strengthen the shoulder muscles. Though athletes can commence sport-specific routines after 12 weeks, full recovery usually lasts up to 6 months after the operation.

Question 31

How Long Does Recovery Take After Dislocation and Subluxation Repairs?

Accepted Answer

After surgery to repair a dislocated shoulder, most patients will be required to follow steps similar to conservative pre-op treatment. Following their discharge from the hospital, patients will have their shoulder immobilized in a sling between 2-6 weeks, allowing the joint to heal without lifting heavy weights.

Pain relief drugs, applying ice, and therapeutic massage may be recommended to alleviate painful symptoms. Patience and limiting arm movements prevent repeated dislocations that would require further interventions.

8-10 days after surgery, the operating physician will usually schedule a follow-up check to ensure that the shoulder is healing properly. At this point, he may also determine when physical therapy should begin and include exercises designed to improve the joint's mobility and strength like:

Shoulder flexors
Shoulder extensors
Shoulder abductors
Pendulum exercises

Individuals with an office job or similar sedentary occupations may return to work after 1-2 weeks following surgery. Occupations requiring light manual labor may be resumed after 3-4 weeks, and patients can begin driving again after 4-6 weeks.

Athletes should consult their surgeon to receive clearance to return to their sport. While activities like swimming or golf can be resumed after about 6 weeks, high-impact sports like football, volley, or hockey may require a more extended recovery period of several months.

A full recovery and return to sport at pre-injury activity levels may take up to a year; however, the outlook for recovery after surgery is generally positive, with a low rate of reinjures.

Question 32

How Long Does Recovery Take After Knee Cartilage Repair?

Accepted Answer

Following surgery to repair damaged knee cartilage, patients are moved to the recovery room until the effects of the anesthetic wear off. Minimally-invasive surgeries like knee arthroscopy typically allow individuals to return home on the same day as their operation, but more extensive repairs involving open surgery could require a few days of clinical care and observation.

After being discharged, patients will need crutches in the first 2-6 weeks of their recovery to reduce weight bearing on their operated knee. Symptom management is similar to conservative treatment and includes:

Using ice to reduce joint inflammation
Pain relief medication as prescribed by surgeons
Resting the knee and keeping it elevated

Some patients may require a cast or brace to keep the knee immobile, and maintaining an adequate weight is vital for relieving stress on the joint. Novel regenerative treatments such as platelet-rich plasma, exosome, or stem cell injections can help patients recover faster by stimulating new cell growth.

Patients can typically return to non-strenuous activities and sedentary occupations after about 6 weeks. Physical therapy and rehabilitation are essential to healing and regaining proper knee function, but the recovery time will vary for every person, according to the type of repair.

Patients that undergo osteochondral allograft or autograft procedures are usually cleared after about 6 months, while autologous chondrocyte implantation and microfractures could require 12-16 months to recuperate. Professional athletes and active individuals should use supportive braces for a few months after being cleared to avoid reinjures and future repairs.

Question 33

How Long Does Recovery Take for Meniscus Repairs and Transplants?

Accepted Answer

Although meniscal repairs and transplants address injuries in the same structure, they are different procedures involving separate types of restorations. Consequently, recovery and rehabilitation for both interventions will not be the same.

During the initial recovery phase, patients undergoing either procedure will have their knee immobilized in a brace and require mobility aids like walkers or crutches to reduce weight bearing on the operated joint. NSAIDs will be prescribed to reduce pain and swelling, and patients will be instructed to care for their wounds properly.

Since every individual is different, recovery following either intervention will depend on variable factors such as age, weight, lifestyle, overall health, and adherence to rehabilitation. Patients recovering from meniscus repairs may remove their brace and stop using mobility aids after a few days or a few weeks, while patients recovering from meniscus transplants typically have to utilize them for up to 6 weeks.

Rehabilitation will focus on progressively regaining muscle strength and joint mobility, steadily advancing to more intensive exercises. Meniscus repairs usually involve a shorter recovery and rehabilitation period of 4-6 months, while meniscus transplants may require 8-10 months before returning to pre-op activity levels.

Both procedures' outcomes are overall favorable as long as patients follow recommendations and adhere to their rehabilitation schedule. Some complications may arise even though it's rare, and patients should seek medical attention if they report any of the following:

Joint stiffness
Severe swelling
Excessive bleeding
Pain that doesn't go away with medication
Wound discharge indicative of infections (including fever)

Question 34

How Long Is the Recovery Period After Tennis Elbow Surgery?

Accepted Answer

Tennis elbow surgery is usually performed when there are large tears in the elbow tendon from a sudden injury or if there is severe damage to the elbow. Following the procedure, which, in most cases, is carried out arthroscopically, the patient will be able to return to their everyday activities within approximately 2 to 6 weeks.

They can go back to work in 3 to 12 weeks, depending on the nature of their job, and they should be able to play sports again in 4 to 6 months. During recovery, the patient may need to wear a brace at work and when they play sports that stress the elbow and forearm, such as tennis. Lastly, they will be able to drive when they can comfortably extend the elbow within 1 to 2 weeks after surgery.

Question 35

How Long Is the Recovery Period After the Tommy John Procedure?

Accepted Answer

Recovery can take 9 months to one year if the patient undergoes the Tommy John procedure, as it is a complex surgery. Patients with extremely serious injuries may have to wait even longer to achieve complete recovery. Their elbow will be placed in a hinged brace to gradually increase the range of motion until they can fully extend it.

If the patient plans to return to throwing and compete, they will need more rigorous physical therapy to strengthen their elbow enough to handle the stress. It is essential to remember that everyone recovers at their own pace, and the return to sports should not be rushed. Too much stress before the patient heals can increase the risk of surgery failure.

Question 36

What Are Exosomes and How Do They Function?

Accepted Answer

As we age, our knee joints gradually deteriorate, and the articular cartilage at the ends of bones is worn down, causing pain and inflammation. In regenerative medicine, exosome therapy is a novel non-invasive treatment for degenerative conditions like osteoarthritis by stimulating new cell growth.

Exosomes are extracellular vesicles that enable cell-to-cell communication, carrying information and instructions from one cell to another in the form of chemical messaging molecules or mRNA snippets.

Exosomes derived from stem cells contribute to cartilage regeneration by regulating the immune response, reducing cell death, and increasing cell proliferation. They're most commonly produced by separating lab-cultured stem cells from the exosomes and the surrounding liquid. The liquid is subsequently ultra-centrifuged to increase the small number of exosomes through concentration.

Exosome treatment is administered through injections in the affected joint, and early clinical results show that cartilage and bone damage can be significantly reversed and almost completely restored after 12 weeks. Athletes opt for this type of treatment to increase their recovery rate following injuries that would sideline them for a long time.

Although further research is required to optimize exosome therapy, they provide a novel treatment approach to close the gap between conservative and surgical procedures and have been shown to:

Help with wound recovery
Increase immunity and reduce infection
Mitigate inflammation
Repair injured tissue
Stimulate cellular renewal and specialization

Question 37

What Are SLAP Tears and How Do They Occur?

Accepted Answer

SLAP is an acronym that stands for Superior Labrum – Anterior to Posterior and describes a type of shoulder injury involving the labrum.

The labrum is the rim of cartilage surrounding the shoulder socket that keeps the shoulder joint's ball in its proper position. It also serves a cushioning role for the bones in the joint, a connective part for tendon and ligaments, and provides a full range of motion in the shoulder.

SLAP tears are common injuries for athletes that participate in sports involving overhead movements. Repeated throwing motions can gradually wear down the labrum and lead to a tear in the upper part where the biceps tendon connects. The tear takes place in the front and back of this attachment, and it's not uncommon for the biceps tendon to also be affected.

Causes and Risks

The biggest concern regarding SLAP tears for athletes is their potential to sideline a player for a prolonged period. It should be noted that non-athletes can also experience this sort of injury.

The most common causes and risk factors that lead to a SLAP tears are:

Repetitive overhead movements – The labrum can suffer wear and tear from activities involving this type of motion and lead to damage over time.
Multiple dislocations – Repeat shoulder dislocations can wear out the joint over time and lead to labral fraying or lesions.
Traumatic injury – Sudden or intense trauma, such as falling on an outstretched arm, rapid arm movement above shoulder level, a powerful tug on the arm, or a motor vehicle accident.
Normal aging – Labrum damage in individuals over 40 can be attributed to the general aging process.

Sports that see the most SLAP tears or lesions include:

Baseball/Softball
Football
Weightlifting
Swimming

Question 38

What Are the Benefits of Ankle Ligament Repair Surgery?

Accepted Answer

If someone has ankle instability or a serious sprain, they will most likely have to undergo ligament repair surgery, which can be performed arthroscopically in the majority of cases. The symptoms of a sprain are bruising, pain, and swelling, even if the person may still be able to put some weight on their foot, a feeling that their ankle is "catching" or "locking", and a lack of stability in the ankle, which causes it to give way frequently.

The benefits of undergoing arthroscopic surgery for ankle ligament repair include the following:

restoring full stability and functionality to the ankle
a faster recovery since it is a minimally invasive procedure
being able to return to playing sports within a much shorter time in the case of athletes
significantly lower risk of postoperative complications
reduced rehabilitation time

Not all people with ankle instability or a sprain will be good candidates for arthroscopic surgery, as complex cases may require traditional, open surgery. While this surgical approach entails a longer recovery time, if it is performed by a very experienced, reputable orthopedic surgeon, it will be successful and restore the patient's ankle stability.

Question 39

What Are the Benefits of Arthroscopic Shoulder Surgery?

Accepted Answer

When shoulder injuries occur due to trauma, overuse, or aging, conservative treatment may not be sufficient to address sustained damage, requiring surgical intervention. Traditionally, such operations used to be performed using an open surgery approach where physicians would make a sizeable incision to access the shoulder joint and repair the damaged structures; today, most surgeons opt for the more effective arthroscopic surgery method.

Shoulder arthroscopy is a minimally-invasive diagnostic and operative procedure that provides multiple advantages compared to open surgery, including:

Higher diagnostic accuracy
Shorter surgery time
Decreased risk of complications
Faster recovery
Less scarring

To determine the appropriate course of treatment, doctors will perform a physical examination that may include blood tests and EKGs and order X-rays, MRI, or CT scans to have a complete image of the internal damage to the shoulder socket, humerus, and associated structures. Arthroscopic shoulder surgery is recommended as a treatment option for several shoulder injuries, including:

Though less common, arthroscopy can also be employed to release or fix tangled nerves, repair fractures, or remove cysts. On the other hand, it's not a viable treatment method for more complex interventions like shoulder replacement, which can only be performed with an open shoulder procedure.

Question 40

What Are the Benefits of Foot and Ankle Arthroscopy?

Accepted Answer

Because it is a minimally invasive, technologically advanced surgery, arthroscopy yields numerous benefits for patients who undergo it for foot or ankle problems. The following are only some of the most notable benefits of this procedure:

getting a more accurate diagnosis: joint injuries are quite challenging to diagnose even for the most experienced orthopedic surgeons, but arthroscopy is a very precise diagnostic tool, as it offers the surgeon clear images from the inside of the joint, which allows them to both diagnose and treat the problem within the foot or ankle
a faster recovery: because it uses tiny incisions, arthroscopic surgery is easier on the body and entails less stress, which promotes quicker recovery, with the incisions usually healing within a week and the patient being able to return to their daily activities within a few weeks
lower risk of complications: since it is minimally invasive, arthroscopy for the foot and ankle implies a substantially lower risk of infection, catching a virus or disease from being inside of the hospital (because the procedure is outpatient), and damage to the joints following surgery
surgical precision: because the arthroscope is equipped with a fiber-optic camera, the orthopedic surgeon is always in control, as they permanently observe what is going on inside the joint and how they are performing the procedure, which means there is a lower risk of them making a major, irreversible error

Question 41

What Are the Necessary Steps for Rehabilitation after ACL Reconstruction?

Accepted Answer

After undergoing anterior cruciate ligament (ACL) reconstruction surgery, a recovery period is required to ensure that the healing process is underway.

Rehabilitation from this type of intervention begins once the patient wakes up in the recovery room.

This process aims to protect the reconstructed ligament and gradually progress towards and achieve a pre-operation level of activity and motion in the knee.

It should be noted that patients that have undergone additional surgical repairs in their knees (i.e., MCL or PCL surgery or repairs) will progress differently in their rehabilitation.

In the first week following ACL reconstruction, patients are encouraged to lift their legs by themselves while lying on their backs. These leg raises address post-operatory stiffness issues and help manage pain.
During the first weeks following the intervention, crutches are usually needed to alleviate the stress on the knee while moving. After this period, the patient can generally walk without the help of mobility aids.
Rehab sessions typically begin 1 to 2 weeks after surgery under the supervision of a physical therapist. During this period, weight-bearing may be allowed so long as the patient's meniscus wasn't also operated on during the ACL reconstruction procedure.
During the first couple of months of rehabilitation, a 0 to 140 degrees range of motion is an appropriate goal to strive for.
Strenuous activity in the lower body that requires effort from muscles such as the quadriceps isn't recommended given the stress placed on the new ACL graft. Bike riding and leg presses using light weights are acceptable activities in the first 3 months after the intervention. These exercises allow the quadriceps to develop while using the hamstrings to alleviate the pressure on the reconstructed graft.
Running and swimming isn't recommended for up to 5 months, although swimming motions with the hands while not paddling is permissible around 2 to 3 months after ACL reconstruction.

As the patient advances through the months of rehabilitation, strength and mobility exercises will gradually increase, adapting the reconstructed ACL to the efforts of active gameplay. Return to sports is aimed for at least 6 months after the surgery. However, due to the varying nature of every injury and procedure, a full recovery can take up to 9 or 12 months in some cases.

Question 42

What Are the Risks of Arthroscopic Surgery for the Foot and Ankle?

Accepted Answer

Like any other surgical procedure, arthroscopy comes with several risks, although considerably fewer than open surgery, regardless of which joint it is performed. Arthroscopy has a 90% success rate, and the risk of infection from this procedure is very small, ranging from 0.009% to 0.4%. Nevertheless, patients who undergo arthroscopic surgery for foot and ankle issues can also experience these postoperative complications:

blood clots in a vein
artery damage
excessive bleeding
numbness at the incision sites
allergic reaction to the anesthesia
nerve damage
persistent pain in the calf and foot
heart attack
stroke
kidney failure
recurring swelling, pain, and stiffness

Despite the potential risks, arthroscopic surgery is generally a very safe procedure, and complications are uncommon. To ensure arthroscopy for the foot and ankle will be safe and carried out correctly, the patient must look for a very experienced orthopedic surgeon with at least several years of practice. Having foot or ankle arthroscopy performed by a reputable surgeon further reduces the risk of complications. Lastly, the overall health of every patient who is scheduled to undergo arthroscopic surgery will be thoroughly evaluated to make sure they are a good candidate for the procedure.

Question 43

What Are the Risks of Complete Hip Replacement?

Accepted Answer

Every surgical intervention carries an inherent risk, and several complications may arise following complete hip replacement. Since general or regional anesthesia are used to sedate patients for the procedure, the usual risks involve the possibility of a stroke, heart arrhythmias, pneumonia, and liver toxicity.

It should be noted that hip replacements are some of the most successful surgeries performed with high rates of success, and while complications are uncommon, they can invariably occur. Individuals that suffer from severe rheumatoid arthritis, diabetes, hemophilia, systemic lupus, obesity, or anemia and those with previous prosthetic infections face a greater risk of complications.

Common complications that may occur over the short and long-term include:

Blood Clots – Approximately 1% of patients may develop deep vein thrombosis or pulmonary embolism.
Infections – Though antibiotics are administered during and immediately after surgery, infections can rarely occur. Some infections may arise years after the procedure and lead to the artificial joint failing requiring revisionary surgery.
Injured Nerves and Blood Vessels – In rare instances, nerves and blood vessels may sustain damage during the operation leading to regional discoloration, varying leg temperature, and sensations of weakness and numbness.
Loosening – Regular wear and tear is a common long-term issue and leads to the replaced hip loosening; however, this occurs far less thanks to advances in prosthetics engineering and better materials.
Breakdown – Old implants can gradually deteriorate and break, though less than 0.5% of patients report such cases
Dislocations – Around 2-4% of hip replacements suffer dislocations where the prosthetic ball is displaced from the artificial socket.
Different Leg Lengths – After surgery, most legs will measure the same length, though differences can be noticed at times, requiring orthopedic footwear solutions to address it
Joint Instability and Stiffness – Commonly occurs when soft tissues solidify into bone, in what is known as heterotopic ossification.
Residual Pain – While most patients report less pain following a hip replacement, residual symptoms may linger and become apparent after performing activities.

Question 44

What Are the Usual SLAP Tear Symptoms?

Accepted Answer

SLAP tears or labrum lesions are shoulder injuries where the labral cartilage is damaged in the upper part where the biceps tendon connects. Due to its positioning, a SLAP tear can be mistaken for other shoulder injuries and require a more thorough examination to determine the precise nature of the trauma.

Individuals that sustain a SLAP tear usually notice a reduction in their athletic performance, discomfort when they move their shoulder, and an acute, deep pain emanating from the joint.

Common symptoms

Shoulder pain (moving or static) – Strenuous activities such as lifting heavy objects over shoulder level or sports involving overhead motions can generate discomfort. Certain fixed positions of the joint can also lead to painful sensations, including arms extended outward or stretching behind the head.
Reduction of athletic abilities – Athletes are the most prone demographic for SLAP tears; when labral damage occurs, their shoulder power is diminished, accompanied by stiffness in the upper side of the arm.
Affected range of motion – Individuals that suffer a SLAP tear notice that they have difficulties when they try to extend their arm or attempt overhead activities.
Difficulty when lifting objects – Weightlifters generally notice acute discomfort when trying to perform overhead lifts, and non-athletes lifting heavy objects above shoulder level likewise experience pain.
Imprecise source of pain – Acute internal discomfort is one of the most cited symptoms of a SLAP tear, even though it may be difficult for patients to identify where the source of the pain is accurately located. The back of the shoulder is most commonly affected; however, pain can be felt in the front of the joint if the biceps tendon is also injured.
Unusual joint sounds and sensations – Although these symptoms may be shared with other types of shoulder injuries, popping and clicking sounds and joint stiffness and grinding sensations are regularly associated with SLAP tears.
Shoulder instability – Patients affected by SLAP tears may feel that their joint is unsteady and experience a loosening sensation indicative of a possible dislocation.

Question 45

What Arthroscopic Procedures Are Available for Elbow Cartilage Repair?

Accepted Answer

As a procedure used to diagnose and treat joint problems, arthroscopy is a minimally invasive procedure that allows the orthopedic surgeon to take a close look inside the elbow joint. To repair the damaged cartilage, there are multiple types of arthroscopic surgeries, depending on the specific problem the patient has concerning their elbow:

debridement: it involves smoothing the cartilage and removing loose edges to prevent it from rubbing and irritating other parts of the body
bone marrow stimulation: during this procedure, the surgeon drills tiny holes, known as microfractures, under the cartilage and exposes the blood vessels inside the bone, which is meant to cause a blood clot to form inside the cartilage that will trigger the creation of new cartilage
mosaicplasty: the surgeon takes healthy, undamaged cartilage from one area and moves it to the damaged site and the procedure is only suitable for isolated areas of cartilage damage, typically limited to 10-20 millimeters
autologous chondrocyte implantation: a tiny portion of cartilage is removed and subsequently taken to a laboratory, where it is grown to produce more cartilage cells, and after 1 to 3 months, the new cartilage cells are placed into the elbow to develop into healthy cartilage

The procedure the patient will undergo will highly depend on the particularities of their elbow cartilage damage and the severity of their case. Only a reputable, experienced orthopedic surgeon can guide the patient and help them make the wisest decision when it comes to elbow cartilage repair.

Question 46

What Causes AC Joint Injuries?

Accepted Answer

The acromioclavicular (AC) joint unites the shoulder's cap (acromion), which is part of the shoulder blade and the collar bone (clavicle), holding them together with the help of the strong AC and coracoclavicular (CC) ligaments. Even though the joint is durable, its location leaves it vulnerable to injuries that can result in sprains or separations.

AC joint injuries are most frequent in individuals under 35, with males being 5 times more prone. Injuries can result from overuse and trauma, especially in the case of sports requiring repeated overhead motions or high-impact collisions:

Football
Lacrosse
Hockey
Baseball
Tennis
Swimming

AC joint injuries can also occur due to falling improperly on an outstretched arm during sports involving high velocities like skiing, ice skating, and cycling, or non-athletic causes like falling off a ladder. AC joint injuries can also be sustained due to overuse in non-athletic occupations such as construction work or from the gradual deterioration caused by aging.

AC Joint Injury Diagnosis

When AC injuries occur and the symptoms are evident, some individuals may dismiss them as discomfort common with contact sports or a normal part of the aging process. Ignoring symptoms and leaving them untreated may worsen the injury and produce long-term consequences like arthritis, collarbone fracture or displacement, severe shoulder separation, and damage to adjacent structures like the rotator cuff.

Regardless of the injury's cause, AC joint injuries share similar symptoms:

Pain in the shoulder or arm
Tightness and loss of mobility
Weakness in the shoulder or arm
Visible bruising or swelling
Popping sound during shoulder movement

Differential diagnosis is required to assess the damage and rule out other potential injuries like rotator cuff tears, arthritis, biceps tendonitis, or scapulothoracic bursitis. X-ray imaging and physical examination are usually sufficient to determine the extent of AC joint injuries, ranging from I to VI depending on severity.

Types I, II, and III involve low to medium damage to the AC and CC ligaments, which can be treated non-surgically with healing times ranging from a few weeks to months.
Types IV, V, and VI involve a higher level of joint and ligament damage that requires invasive surgery.

Question 47

What Causes Bankart Lesions?

Accepted Answer

The shoulder is one of the most significant joints in our bodies, providing a broad range of motion and functionality. In a healthy joint, the ball (humeral head) is firmly positioned in the socket (glenoid). Its stability is reinforced by ligaments and the connective ring of fibrocartilaginous tissue surrounding the socket known as the labrum.

Shoulder trauma caused by injuries or overuse can produce dislocation or subluxation that separates the ligaments and tears the labrum. Left untreated, labrum tears may lead to chronic shoulder instability, easily causing repeated dislocations.

Bankart lesions occur during anterior shoulder dislocation when the humeral head is forced either forward or downward and pushes against the anterior labrum covering the socket. When the tear also involves a bone fracture in the shoulder socket, the injury is referred to as an osseous Bankart lesion.

Leading Causes

Bankart lesions are most frequent in young individuals in their 20s, although they can affect anybody. They commonly occur due to high-energy trauma and injuries resulting from sports or occupational activities. Leading causes include:

Automobile Accidents – A forceful blow resulting from cars colliding can knock the humeral head out of the socket tearing the labrum in the process.
Athletic Collisions – Most common in sports that involve athletes crashing into competitors at high speeds with massive force, as in football, hockey, rugby, or lacrosse.
Athletic Falls – Losing balance and landing improperly on the shoulder can lead to dislocations, especially in disciplines that involve speed and height like basketball, gymnastics, and skiing.
Non-Athletic Falls – Similar to athletic injuries, landing on the shoulder after falling off a ladder, losing balance, or tripping may deliver sufficient force to cause dislocation and damage the labrum.
Overuse – Athletes involved in disciplines such as weight lifting, swimming, tennis, volleyball, or baseball are the most susceptible. Non-athletes whose occupations require similar repetitive shoulder movements can also experience Bankart lesions, as is the case in construction jobs, carpentry, and painting.
Ligament Issues – Some people are genetically predisposed to having loose ligaments, as is the case of double-jointed individuals who may find that their shoulders suffer frequent misalignments. In such cases, treatment is more complex than in the case of regular Bankart lesions.

Ignoring Bankart lesions can lead to chronic shoulder instability that requires operative treatment to reattach the torn labrum, using either arthroscopic surgery or open Bankart repair.

Question 48

What Causes Biceps Injuries?

Accepted Answer

The biceps muscle plays a significant role in mobility enabling elbow bending and arm rotation. Tendons attach the biceps to the shoulder and elbow, with the two superior tendons attaching to the shoulder being susceptible to inflammation and pain due to their connection mechanics.

Overuse and repetitive movements common in sports like tennis, baseball, golf, or swimming can gradually wear down the tendons leading to muscle strain or tear. Biceps injuries can also occur following acute trauma such as falling on an outstretched hand, twisting the arm in an unfamiliar way, sports collisions, or auto accidents.

When biceps injuries occur, the most common symptoms are a sudden surge of pain accompanied by a popping sound, and can also include:

Shoulder weakness
Bruising
Limited mobility
Muscle spasms
Muscle deformities

Doctors will evaluate a patient's symptoms and medical history before performing a physical examination. In cases such as complete tears, the diagnosis is evident due to the appearance of a sizeable bump indicating the biceps' irregular positioning and lack of support.

Since biceps injuries are often accompanied by associated conditions like shoulder tendonitis, shoulder impingement, or rotator cuff damage, doctors may order X-ray or MRI imaging to assess its severity and fully rule out other potential causes.

If damage is minimal, conservative treatments are usually sufficient to alleviate painful symptoms using rest, ice, and anti-inflammatory medications. Other non-surgical treatment options include platelet-rich plasma therapy and physical therapy.

Question 49

What Complications Can Arise Following Jones Fracture Surgery?

Accepted Answer

While the rate of complications of arthroscopy for treating a Jones fracture is very low, some patients may experience postoperative complications, depending on their overall health and the complexity of the procedure they underwent. Some of the most common risks after a Jones fracture surgery are:

blood clots
damage to blood vessels or nerves
excessive bleeding
infection
muscle atrophy
nonunion or malunion
delays in bone healing
persistent pain

Unfortunately, Jones fractures have some of the highest risks of nonunion when it comes to broken bones. Still, if the procedure is performed by a very experienced, reputable orthopedic surgeon who had carried out this surgery many times before, the risk of nonunion drops substantially.

Question 50

What Does Complete Hip Replacement Surgery Involve?

Accepted Answer

A few weeks before the complete hip replacement procedure, patients will undergo a series of evaluations to assess their health and receive clearance for the operation. These evaluations include:

Laboratory testing
Urine analysis
Electrocardiogram (EKG)
X-ray imaging

The surgeon will review the patient's medical history and ask about any medication they're taking that could potentially interfere with the procedure. The hip is inspected to assess its range of motion and surrounding muscle strength. Patients may be advised to perform specific physical exercises to build up strength.

Some patients will be asked to lose weight before the operation and limit or quit smoking to reduce the risk of complications. During this time, patients will also receive advice on requirements for the post-operatory period, including social planning and home preparations.

Surgical Procedure

Complete hip replacement surgery can take between 2 to 4 hours to complete and follows a series of basic steps.

Patients are administered regional or general anesthesia before the operation.
The surgeon makes an incision to access the damaged joint and uses precise tools to remove bone and cartilage.
The acetabulum or pelvic socket replacement shaped like a cup is implanted.
The surgeon drills through the top of the femur and inserts a stem to which the artificial femoral head is attached. The artificial femoral head is placed in the newly implanted pelvic socket cup.
The surgeon closes the incision to finalize the operation, and the patient is moved to recovery, where measures will be taken to manage pain and reduce swelling.

The replacement prosthetics are made from durable materials like cobalt-chromium, stainless steel, titanium, polyethylene, or ceramic. Patients' outlook following surgery is more than favorable, with 85% of cases reporting good results after 20 years.

After patients are discharged, they will be advised how to tend to their healing wounds properly and will be prescribed medication to control pain. A few weeks after the operation, patients will begin rehabilitation to regain hip function.

Question 51

What Does Meniscus Repair Involve?

Accepted Answer

When a meniscus tear occurs, physicians may recommend a non-surgical approach of conservative treatment based on the RICE (rest, ice, compress, elevate) protocol, non-steroidal anti-inflammatory drugs, physical therapy, and cortisone injections. If symptoms fail to subside after this initial approach, patients may consider meniscus repair surgery if their diagnosis allows it.

Not every meniscus tear can be repaired, and sometimes a partial or total removal of an injured meniscus may be required; however, physicians typically choose to perform repairs whenever possible since it leads to fewer complications and prevents arthritis from setting in.

Meniscus repair performed through the minimally invasive arthroscopic method may be recommended in the following cases:

Healthy patients who want to remain active
The quality of meniscal tissue is good (not including the injury)
The tear runs vertically across the meniscus
The tear is situated in the vascularized outer "red zone" of the meniscus that favors healing
The patient understands the necessity of undergoing a lengthy rehab

Arthroscopic meniscal repairs are performed with patients being administered a general, spinal, or local anesthetic, so they don't experience any pain. After the knee is secured in a proper position, the operating physician makes several small incisions around the knee, through which a narrow tube with a camera and light (arthroscope) is introduced to visualize the knee internally. A sterile saline solution can be injected into the joint to increase instrument maneuverability.

After determining the tissue quality, stability, size, pattern, and location of the meniscus tear, specialized small tools are passed through the incisions to perform the required repair. If blood flow to the operated area is insufficient, several methods may be employed to promote faster healing, including:

Placing a blood clot within the tear
Creating access channels for increased vascularization in the meniscal peripheral rim
Allowing the joint lining to bleed

After the meniscus is repaired and secured with sutures or absorbable stitches, the saline solution is drained, the incisions are closed, and the intervention is done. The length of meniscus repair surgery is usually 1 – 1 ½ hours; however, if patients require additional repairs such as an ACL reconstruction, the length of the operation may increase.

Meniscus repairs have a 90% success rate, and since they're performed on an outpatient basis, individuals can return home the same day as their intervention. Since the knee will be immobilized to ensure proper healing, it's recommended to have a designated driver on the way back and have someone help out in the first days with menial tasks.

Question 52

What Does Recovery after ACL Reconstruction Surgery Involve?

Accepted Answer

Anterior cruciate ligament (ACL) injuries are typical among athletes who practice sports that involve jumping, running, cutting, and pivoting motions, such as football, basketball, lacrosse, skiing, and many others.

Whether it results from non-contact mechanisms or direct impact, the ACL may be completely ruptured, leading to a painful injury that will require reconstructive surgery to regain the full functionality of the knee.

For the reconstructed ligament to successfully heal, it's imperative to undergo a period of recovery and rehabilitation.

It should be noted that ACL reconstruction surgery isn't the only available treatment route. However, due to the ligament's limited capacity for healing, a severe tear of the ACL typically requires such an intervention, especially if the patient's sport or occupation demands strenuous effort.

After completing the ACL reconstruction intervention, the patient is allowed to go home on the same day. Before being discharged, the surgeon will offer advice on reducing aches, stiffness, and swelling, using mobility aids, what medication is recommended to alleviate pain, and applying bandages to the operated area.

Recovery from ACL Reconstruction Is a Lengthy Process Taking Several Months to Complete

The use of a brace to maintain knee stability is recommended, as well as progressive physical therapy. During this recuperation period, patients can gradually return to athletic activities that don't overexert the repaired knee. Such activities include:

Biking and linear motion activities – 3 to 6 weeks
Running on a treadmill – 10 to 12 weeks
Running outdoors – 3 to 4 months
Pivoting sports – 6 to 8 months

This timeline is merely a median average and is highly dependent on the patient's particular condition. To ensure a successful recovery, it is imperative to consult with your physician on the best time to reintroduce such activities into your routine.

While it may feel like recovery from ACL reconstruction takes a long time, it's essential to understand why this is. As the body's largest joint, the knee works together with all the muscles and bones on the side of the lower body and throughout the back, supporting strenuous activities. When the knee is damaged, it disrupts the entire mechanism. Blood circulation in the knee is limited and hinders fast healing, thus resulting in a longer recovery time.

ACL reconstruction rehab cultivates strength and functionality – the latter ensures the ability to perform an activity while the former enables said activity to be performed with force. As a rule of thumb, strength takes longer to develop compared to functionality.

Question 53

What Does Recovery and Rehab After Complete Hip Replacement Entail?

Accepted Answer

The rate of success and longevity of a hip replacement is highly dependent on proper rehabilitation following the surgical intervention. The first few months of recovery are vital, and most of the progress is achieved in this period, but rehabilitation will take longer.

Pain control medication will be prescribed to alleviate discomfort, and some patients may receive blood-thinning medicines to prevent blood clots. Patients will receive instructions on adequate wound care and how to approach personal hygiene to avoid infections.

If medication isn't effective or signs of blood clots and infections are evident, recovering patients should notify their healthcare provider immediately.

Physical activities will begin once a therapist clears the patient. He will work with the patient to help him:

Regain normal gait
Maintain artificial hip motion
Strengthen the lower limbs

During the first weeks of recovery, mobility aids like canes, crutches, or walkers may be needed to ensure stability. Swelling of the ankles and calves is not uncommon and will gradually subside.

Rehabilitation usually involves exercises focused on stretching and strengthening the muscles that surround the new hip for about 20-30 minutes daily. Patients will progressively return to regular activities like walking, bending, and going upstairs to increase muscle strength and regain motion. Tangible progress is apparent after several weeks to a few months with commitment to rehab, but caring for the newly implanted joint will take longer to ensure its durability.

Long-Term Care

Complete hip replacements aren't permanent, and regular wear and tear or other complications may lead to deterioration that requires revisionary surgery. Fortunately, experts in the field indicate that modern prosthetics last longer than previous models.

As painful symptoms subside and moving becomes increasingly more manageable, patients should take mindful steps to protect their repaired hip and reduce injury risks.

Establish a program of light physical activities to maintain strength and mobility
Avoid high-impact activities, including running or jumping that may overexert the hip.
Take precautionary measures to prevent tripping or falling outside and at home.
Follow-up examinations to track progress and assess any potential damage.

Question 54

What Does Recovery Following Wrist Arthroscopy Involve?

Accepted Answer

After the procedure has concluded, the surgeon closes the two minor incisions with stitches and applies a bandage to the operated area. Because arthroscopic surgery is minimally invasive, most patients are discharged on the same day as their intervention, except for cases of uncommon complications.

The patient will likewise be prescribed painkillers for any discomfort he might experience during the healing, and in some cases, the use of a splint or sling may be required to keep the hand immobile.

Recovery time is usually fast at around 6 weeks; however, this is dependent on the extent and type of injury. Tissue damage usually requires a longer healing time.

Steps to a Full Recovery

During the first days of recovery, patients will experience swelling around the operated area and may notice a skin discoloration. These are common symptoms and will go away on their own in a few days.

To reduce swelling and pain, it's recommended to follow the RICE protocol (rest, ice, compression, elevation), with particular emphasis on maintaining the hand higher than the heart level. If the prescribed pain medication causes the patient discomfort, he should ask his physician for a more effective substitute.

The surgical incisions need to be covered, and the bandages kept clean, dry, and intact. Surgical dressings are usually removed 48–72 hours after the procedure and replaced with a waterproof covering. Bathing or soaking should be avoided until the incisions are fully healed.

The rehabilitation process involves exercises recommended by a therapist to regain:

wrist strength
range of motion
gripping
pinching

During this period, patients should refrain from activities that involve pushing, lifting, twisting, or pulling movements. By closely and patiently following the therapist’s advice and rehab regimen athletes can expect to return to the game quicker than in the case of open hand surgery.

Question 55

What Does Recovery from Arthroscopic Shoulder Surgery Involve?

Accepted Answer

Due to its minimally-invasive operative approach, arthroscopic shoulder repair is performed faster than traditional open shoulder surgery and involves fewer traumas. After the operation, patients spend 1-2 hours in the recovery room and are provided medication to address discomfort if needed, after which they are discharged and return home to focus on healing.

During the first 4-6 weeks of recovery, patients will be required to keep their shoulder immobilized in a sling; while this can make daily activities challenging, it's a key part of ensuring adequate healing and preventing future pain and stiffness.

Pain and swelling are common during recovery and can be alleviated with ice and pain relief medication like opioids, NSAIDs, or local anesthetics. Although pain killers help prevent discomfort, patients must be cautious of the stronger varieties known to cause dependency issues with chronic use.

Rehabilitation is essential to ensuring a faster recovery time and returning to daily activities. Depending on the nature of the repairs, the surgeon will recommend a rehab plan designed to help patients gradually regain the joint's strength and range of motion. They will likewise recommend avoiding specific movements that can strain the shoulder and cause reinjury, such as reaching behind, raising the arm above the head, or lifting heavy objects.

Arthroscopic surgery is performed with a high success rate and overall good outcomes. While rare, certain complications can arise, and patients should seek medical attention if they experience any of the following:

Excessive or continuous bleeding
Pain that isn't responding to medication
Increased swelling of the shoulder or arm
Tingling or numbness in the lower hand
Discolored discharge or redness around the wounds
Body temperature higher than 38°C/101°F

Since every procedure addresses different types of injuries in separate individuals, recovery time varies depending on each case's particularities. Minor repairs may not require sling immobilization, and patients can return to regular activities after a shorter recovery period.

More complicated procedures that involve extensive repairs require a more extended recovery period of up to 6 months, with a full recovery to previous activity levels lasting up to 12 months. Even if it's a slow process, committing to rehabilitation and following the surgeon's recommendations are crucial to ensure a successful outcome.

Question 56

What Does Recovery From Knee Arthroscopy Involve?

Accepted Answer

Following arthroscopic knee surgery, recovery will highly depend on the specific type of repair that was performed. After the procedure, patients usually return home on the same day, although it will be required to have a designated driver on the way back.

Pain and swelling are expected symptoms for the first days after surgery. During this initial recovery period, patients are instructed to follow a few recommendations:

Minimal movement – In the first few days, the knee shouldn't bear any weight, and mobility aids like a walker or crutches may be required.
Keeping the knee high – Maintaining the joint above heart level when resting helps reduce swelling and alleviate pain.
Ice – Similarly, regularly applying ice to the operated knee helps reduce swelling and reduces pain.
Medication – Physicians will prescribe NSAIDs and anti-inflammatory medication to manage discomfort. Anti-coagulants may also be recommended to prevent blood clots from forming.
Wound care – Patients should keep their incisions clean and ask their physician when the bandages should be removed or when to bathe unconcerned.

A follow-up examination with the operating physician will usually take place a week after the procedure. If the recovery looks promising, he may recommend physical therapy to gradually regain muscle strength and improve the knee's range of motion.

Full recovery time differs for each individual based on the extent and type of repairs performed. Injuries that don't require complex interventions could allow patients to return to sedentary office jobs in a few days and return to non-strenuous activities in 6 to 8 weeks.

In contrast, more complicated operations like ligament reconstruction, restoring cartilage, and meniscus repair can require several months of recovery. Besides physical therapy, some individuals may have to make lifestyle changes to accommodate their recovery, such as avoiding activities involving jumping or running.

With 700,000 arthroscopic knee surgeries performed yearly in the US, the outlook following this procedure is generally good with proper care and rehab, especially for young individuals.

Question 57

What Does Recovery from Meniscectomy Involve?

Accepted Answer

After returning from meniscectomy and the lingering effects of anesthetics wear off, patients will experience pain and swelling in the operated knee. Physicians will prescribe strong pain medication for the first 48 hours to alleviate discomfort, followed by safer over-the-counter options. Keeping the knee elevated and regularly applying ice are recommended to reduce swelling.

Walking with crutches may be required for the first week after surgery, although some weight bearing on the knee may be allowed by physicians. As the symptoms subside and the knee recovers, patients can return to sedentary office or school work a few days after their operation and resume driving in about a week, depending on the knee that was operated on.

To improve recovery time, physicians recommend a course of rehabilitation to rebuild muscle strength and improve the knee's mobility:

1 – 10 days: Restore range of motion, reduce swelling, and increase quadriceps strength.
10 days – 4 weeks: Regain full range of motion without pain, restore muscle strength, increase endurance, and progressive return to regular activities.
4 – 6 weeks: Maintain full range of motion, maximize muscle strength and endurance, and complete return to prior activities (including sports).

The rehabilitation process following meniscectomy may seem aggressive because gradual weight-bearing and stress on the knee are required to improve the joint's functionality. Physicians indicate progress to more intensive exercises according to patient tolerance.

It should be noted that arthritic conditions in the knee (more common in individuals over 40) may prevent seeing the full benefits of arthroscopic meniscectomy for up to 6 months. Although increasingly rare, complications from meniscectomy can arise, and patients should seek medical attention if they experience:

Fever higher than 101°F
Pain that doesn't improve with painkillers or ice
Redness around the wounds
Wound discharge
Breathing issues
Calf pain when moving
Ankle, foot, or leg swelling

Question 58

What Does Recovery from Rotator Cuff Surgery Involve?

Accepted Answer

After rotator cuff surgery, patients will experience pain in and surrounding the operated area. They will be prescribed pain relief medication to address discomfort and will be provided further instructions for proper post-operatory care.

During this period, patients will likely require assistance with daily activities. It's recommended to refrain from sleeping on the operated area for 6 weeks and avoid lifting any objects for up to 12 weeks.

Stages of Recovery

1 to 6 weeks – During the first phase, the operated shoulder will require a sling to keep it immobilized, promoting tendon healing. Activity isn't usually allowed except for prescribed therapeutic exercises, and advancing to the next recovery step will depend on the physician's expert opinion.
6 to 12 weeks – The second phase of recovery will primarily focus on physical therapy. Light activities may be resumed, and physicians will recommend exercises to regain muscle control and movement.
+12 weeks – At this stage, most patients can increase activity level and include exercises to regain shoulder strength and range of motion gradually. It's best to closely follow the physician's recommendations and not overexert the recovering shoulder.

Periodic checkups will ensure that the healing process is unaffected, and patients can generally expect steady progress to pre-injury activities after 6 months.

The long-term outlook is generally favorable; however, factors such as age, smoking, and more significant injuries may affect recovery requiring additional time to heal.

Question 59

What Injuries Qualify for Meniscectomy?

Accepted Answer

Situated in the knee joint between the thighbone and shinbone, the meniscus is a durable piece of cartilage that functions as a shock absorber and provides cushioning while distributing body weight. Each knee has two menisci:

Lateral – located on the outer edge
Medial – located closer to the inside

Meniscus damage in the form of a tear can develop due to injuries (sports-related or otherwise) or degenerative conditions such as osteoarthritis. As we age, the meniscus is gradually worn down, and injuries can happen more frequently.

Notably, symptoms from degenerative tears that are more common with aging can improve and subside with time. Similarly, before considering surgical options, physicians recommend a conservative treatment approach that includes:

Rest, Ice, Compression, and Elevation (RICE)
Non-Steroidal Anti-Inflammatory medication like aspirin or ibuprofen
Immobilizing the knee in a brace
Physical therapy and activity modification
Steroid injections

Meniscus tears on the outer edge where the blood flow is higher (red zone) are more responsive to conservative treatment and have a better chance of healing on their own. Conversely, if a tear occurs closer to the meniscus interior where blood supply is decreased (white zone), meniscectomy is usually recommended to alleviate pain and improve mechanical symptoms like joint locking.

To establish the necessary course of treatment, physicians review a patient's symptoms, medical history and perform a physical examination. They may also order MRI imaging or arthroscopically probe the joint to establish the type, shape, location, and extent of the damage.

Diagnosing physicians always consider if meniscal tears can be repaired, as this usually has a better long-term outcome. If repairing the tear is not feasible, possible treatment options include:

Partial meniscectomy – removing torn cartilage tissue
Total meniscectomy – completely removing the damaged meniscus

Question 60

What Is a Scaphoid Fracture And How Is It Diagnosed?

Accepted Answer

The wrist is made up of eight small bones known as "carpal bones," and the scaphoid is one of them. Situated beneath the thumb in the shape of a kidney bean, the scaphoid (or navicular) bone is involved in wrist movement and stability.

Because of its relatively large size and positioning on the side of the wrist, the scaphoid is prone to injuries and fractures, making up the majority of carpal bone fractures in athletes (85%) and non-athletes (70%).

Injuries that result in such fractures usually occur by falling onto an outstretched hand. When falling, the instinctive reaction is to cock the wrist in order to break the fall with the hand. The wrist ends up taking on the brunt of the force and depending on its angle during impact it can hyperextend, leading to a fractured scaphoid. Other causes include a traumatic direct blow to the hand or road traffic accidents.

Common symptoms that indicate a possible scaphoid fracture are:

Localized swelling and bruising of the wrist
Acute pain during gripping or pinching
Tenderness of the anatomical snuffbox
A flat, internal ache in the radial side of the wrist

Scaphoid Fracture Diagnosis

Scaphoid fractures are not easy to diagnose because they are not as obvious and can be mistaken for sprains. It's not uncommon for patients that have sustained such an injury to try and treat it at home only to refer to a physician when the pain increases.

When the fracture isn't immediately immobilized, it may fail to heal leading to a nonunion of the bone that can cause complications in the long run.

X-rays are the primary diagnostic tool; however, fresh fractures may not be visible, resulting in inconclusive results. If a physician suspects a fracture, he will recommend immobilizing the wrist for two weeks. This will allow the potential fracture to heal and show up on X-rays, especially if it's non-displaced.

Athletes and individuals that cannot afford to wait for two weeks to repeat X-rays can opt for an MRI scan to diagnose the fracture. A CT scan is likewise useful in determining if a fracture has occurred and can also identify bone displacement.

Depending on the diagnosis results, the physician will recommend the appropriate treatment plan according to the severity of the incurred fracture.

Question 61

What Is ACL Reconstruction Surgery?

Accepted Answer

The ACL, or anterior cruciate ligament in medical terms, is one of the four ligaments that support the knee, connecting the femur and tibia bones – it's a small band of fibrous tissue that plays a major role in knee functionality.

The ACL mainly ensures the knee joint's stability during activities that involve turning, cutting, twisting, and pivoting. Unfortunately, such brusque motions can hyperextend and damage the ligament leading to a painful injury that athletes are all too familiar with.

When the body moves in a way that the ACL can't support, it can lead to a sprain, partial tear, or a complete rupture of the ligament. They commonly occur during jumps, turns, or sudden motions while running or playing sports. The most indicated solution is reconstructive surgery when an ACL suffers a total tear.

Before the procedure, patients usually undergo a few weeks of physical therapy to mitigate swelling and pain, reinforce muscles and restore the joint's full range of motion. Not doing so can result in further knee mobility issues after the intervention.

The Procedure Itself

Prior to starting the operation, the patient receives general anesthesia. The surgeon makes 2-3 minor incisions in the knee to allow access for the surgical instruments. After flushing the knee's interior with a sterile saline solution, the surgeon inserts the operating tools, cutting and removing the damaged ACL.

After drilling a hole or tunnel in the femur and tibia bones, the next step is to place the replacement tendon (graft) in both openings and anchor the new ligament using sutures or screws.

Grafts come in two varieties:

Autograft – When the graft is harvested from the patient's patellar, quadriceps or hamstring tendons
Allograft – When the graft is harvested from a donor that passed away

Since additional ligaments and tendons in the knee may be damaged from the initial injury, surgeons may also clean out the joint and repair them to ensure no further complications arise after the intervention.

Depending on the extent of the damage, ACL reconstructive surgery can last up to two hours. Given that ACL reconstruction is an outpatient intervention, patients are able to go home the same day as the surgery once the anesthesia wears off. Even so, it is advisable that patients have a designated driver to take them home.

After completing the procedure, patients may have to practice walking using crutches. It may be recommended to wear a knee brace or splint to ensure that the newly inserted graft is protected. The doctor will also provide instructions on reducing swelling and pain during the days of rest before the required physical therapy to ensure a safe recovery.

Question 62

What Is Birmingham Hip Resurfacing?

Accepted Answer

Athletes who begin training and practicing sports at young ages when their bodies are still developing subject their hips to physical stress that can gradually wear down the joint.

Several conditions can likewise debilitate the hip joint, causing pain, encumbered mobility, and difficulties sleeping, including:

Tumors
Osteoarthritis
Injuries
Osteonecrosis

When this occurs, the damaged hip may require surgical intervention known as arthroplasty to alleviate the symptoms and help individuals recover their mobility.

What Does It Involve?

The femur bone connects to the pelvis through a ball and socket joint, with the ball (known as the femoral head) situated at the tip of the femur. In a normal hip, the femur ball fits right in the pelvic socket (known as the acetabulum).

The socket and ball are lined with cartilage to prevent bone friction while moving. When the cartilage is worn down through progressive use, the femoral head and pelvic socket begin to grind against each other and require an intervention to address the pain and mobility difficulties.

Birmingham Hip Resurfacing (BHR) is a less invasive option than Total Hip Replacement. It involves two implants made from a durable chromium-cobalt alloy. The femoral head is resurfaced before the metal replacement is fitted over it. The acetabulum is likewise replaced with a metal component that allows the reconstructed femur ball to fit adequately.

With more than 100,000 interventions performed, Birmingham Hip Resurfacing is considered the gold standard and is especially recommended for young, active individuals. Athletes can expect to fully return to high-impact sports as soon as 12 months, and the durability of the implants is reported to last for 10 to 15 years.

The primary advantages of a Birmingham Hip Resurfacing are:

Reduced risk of post-op dislocations
Reduced risk of revisionary surgery
Reduced bone removal favoring regrowth
It is usually performed as an outpatient operation

Question 63

What Is Complete Hip Replacement?

Accepted Answer

The hip is one of the largest joints in the body with a significant role in stability and mobility. It's formed by the ball of the femur's head that fits into the pelvic socket known as the acetabulum. In a healthy hip, the femoral head and pelvic socket are lined with articular cartilage that acts as a cushion allowing easy movement and preventing bones from grinding against each other.

When chronic hip pain develops due to medical conditions or severe unaddressed injuries, complete hip replacement may be recommended to alleviate symptoms and restore proper mobility and function. Hip replacements are some of the most successful procedures in all of medicine, with more than 450,000 operations being performed every year in the US.

This type of procedure is mainly recommended for older individuals whose level of intense activity is reduced but can also be successfully performed in younger patients. Common causes that lead to chronic and debilitating hip pain include:

Osteoarthritis
Rheumatoid arthritis
Posttraumatic arthritis
Osteonecrosis
Childhood hip disease
Severe bone fractures

Who Is a Good Candidate for Complete Hip Replacement?

Complete hip replacement surgery highly depends on the pain a patient experiences and its debilitating effects in daily life. There are no absolute restrictions based on age or weight; however, surgeons do account for these factors and evaluate each case individually.

While this procedure is most common for patients in the 50-80 age range, complete hip replacements have been performed successfully even in younger individuals with juvenile arthritis.

As an elective procedure, the decision to undergo complete hip replacement should be taken in cooperation with a patient's family, primary physician, and surgeon. This surgery is usually recommended when painful symptoms:

Persist even when taking pain medication
Become worse while walking – even with the help of mobility aids
Interfere with rest and sleep
Affect the capacity to move up or down the stairs
Prevent easily standing up from a seated position

Complete hip replacement isn't recommended for everyone, and several factors may exclude individuals from qualifying for surgery. Such conditions include:

Severe medical issues (heart failure, recent heart attack, anemia, unstable angina, etc.)
Active infection
Underdeveloped skeleton
Muscle weakness or irreversible muscle damage
Para- or quadriplegia
Morbid obesity

Question 64

What Is Involved in Recovery After a Jones Fracture Surgery?

Accepted Answer

The majority of patients need 3 to 4 months to recover from a Jones fracture surgery. If complications such as nonunion or refracture occur, the recovery time will be even longer. If the patient had a bone graft placed in their foot to repair a Jones fracture, they will also need more time to heal after this procedure, even if it was performed arthroscopically. Some useful tips for recovery are:

elevating the foot while seated
applying ice to the surgical site for 20 minutes a day to alleviate pain
keeping weight off the operated foot for the time recommended by the surgeon
quitting smoking at least temporarily to experience a faster recovery
taking anti-inflammatory medication such as ibuprofen to manage pain

If the patient develops a fever or experiences unbearable pain, increased swelling, numbness or tingling, or skin turning purple, they should immediately contact their orthopedic surgeon or physician. Patients who underwent surgery for a Jones fracture must be willing to wait for their foot to fully heal before making any physical effort that may interfere with the healing process. A Jones fracture takes so much time to heal because the blood supply to that area of the bone is reduced, and less blood flow will increase the recovery period.

Frequently Asked Questions

AC Joint & Bicep Injuries

ACL Reconstruction

Bankart Repairs

Birmingham Hip Resurfacing

Dislocation / Subluxation Repairs

Elbow Cartilage Repair

Elbow Nerve injury

Foot Instability/Ligament Repairs

Foot/Ankle Arthroscopy

Hip Replacement

Jones/5th Metatarsal Fractures

Knee Arthroscopy

Knee Cartilage Repair

Knee Ligament Injuries

Meniscectomy

Meniscus Repair/Meniscus Transplant

Patellofemoral Disorders

PrP, Exosomes, Stem Cell Injections

Rotator Cuff Repairs

Scaphoid Fracture

Shoulder Arthroscopy

SLAP Repair

Tennis Elbow

UCL Injuries (Tommy John Procedure)

Wrist Arthroscopy