Knee Arthroscopy
What is a Knee Arthroscopy
Knee Arthroscopy is a minimally invasive procedure that is done by making small incisions on your knee and looking inside with a tiny camera.
Uses
- Repair or remove meniscus
- Repair torn ACL or PCL
- Swollen or damaged lining of the joint
- Patella misalignment
- Removal of cysts
Perform the following to help recover from Knee Arthroscopy.
Download a PDF of the exercises.
Recommended Exercises
Prone Knee Hangs
While lying down on your stomach, allow your leg to hang off the end of a table/bed. Position yourself so that your knee cap is just over the end of the table/bed. Hold for 5 minutes.
Propped Knee Hangs
While lying comfortably on a firm surface, straighten the involved leg out allowing the heel to rest on a firm object. The back of the knee and calf should not touch the chair or bed. relax the thigh and leg muscles to allow the knee to straighten fully. Hold for 5 minutes.
Quad Sets
While lying or sitting with a small towel roll under your ankle, tighten your top thigh muscle to press the back of your knee downward towards the ground. Do 3 sets of 10 reps.
Heel Slides (Towel)
While in a sitting position, hook a towel around your foot and pull your knee into a bend position and towards your buttock. Do 3 sets of 10 reps.
Terminal Knee Extension
Place a rolled up towel or object under your knee and slowly straighten your knee as you raise up your foot. Do 3 sets of 10 reps.
Single Leg Raise (VMO)
While lying or sitting, raise up your leg with a straight knee and your toes pointed outward. Do 3 sets of 10 reps.
Hip Extension
While lying face down with your knee straight, slowly raise up leg off ground. Do 3 sets of 10 reps.
Hip Abduction
While lying on your side and upper most leg on pillows, slowly raise up the top leg to the side. Keep your k nee straight the entire time. Do 3 sets of 10 reps.
Hip Adduction
While lying on your side, slowly raise up the bottom leg towards the ceiling. Keep your knee straight the entire time. The top leg should be bent at the knee and your foot planted on the ground supporting your body. Do 3 sets of 10 reps.
Hip Adduction Squeeze
Place a rolled up towel, ball or pillow between your knees and press your knees together so that you squeeze the object firmly. Do 3 sets of 10 reps.
Clam Shells
While lying on your side with your knees bent, draw up the top knee while keeping contact of your feet together. Do 3 sets of 10 reps.
Wall Squats
Leaning up against a wall on your back, slide your body downward and then return back to upright position. Do 3 sets of 10 reps.
ACL Injuries
Your anterior cruciate ligament, or ACL, is one of the most important ligaments in your knee. The ACL runs through the center of the knee joint and provides rotational stability. In certain high-intensity activities, however, the ACL may become sprained or torn.
ACL Injury Causes
ACL injuries are common during physical activities involving sudden, explosive force on the knee. This includes popular sports like football, basketball and soccer. Participants in other high-intensity activities, such as weightlifting and crossfit, may also be at risk for ACL injuries.
- Common ACL injury causes include:
- Sudden pivot while running or sprinting
- Sudden stops while running or sprinting
- Awkward landing after jumping
ACL Injury Symptoms
An ACL injury is usually accompanied with a audible “pop” sound. The patient may lose feeling in the knee, or feel like their knee is unable to bear weight. Swelling, severe pain and loss of motion around the knee are also common symptoms of an ACL injury. Patients may see the swelling go down and attempt physical activity, only for the knee pain to return.
ACL Injury Treatment
We begin all ACL injury treatments with a diagnosis Dr. Melander will review your medical history, X-rays and perform a physical examination. If necessary, an MRI will be used to determine if the ACL is torn. Although some turn out to be tears, the majority of ACL injuries result in a torn ACL.
In order to restore the ACL and return the patient to full mobility, Dr. Melander will typically perform an ACL reconstruction by grafting ligaments from other parts of the body. Dr. Melander will often recommend an autograft procedure, as it provides greater stability to the knee and lowers the risk of re-rupture.
Dr. Melander may also recommend an allograft procedure, especially in patients with previous ACL injuries. This is a minimally invasive procedure in which three small incisions are made in the knee. However, an allograft procedure may increase the risk of re-rupture.
Watch the video below for a detailed look at how Dr. Melander repairs a torn ACL using an allograft procedure.
ACL Injury Recovery
The recovery time for ACL injuries depends on the patient and the severity of the injury. Following surgery, a patient can expect to be in a hinged knee brace for 6-8 weeks. From there, physical therapy will be prescribed in order to rehabilitate the knee and restore full mobility. For athletes, Dr. Melander develops a “return to play” protocol, which is an extension of physical therapy designed to put them through activities similar to their sport. Depending on their progress in physical therapy, it may take 8-10 months for athletes to return to their sport.
ACL Injury Prevention
ACL injuries can happen to any athlete, although they are slightly more common in females, due to the anatomy of their hips and knees. All athletes should be aware of the risk factors of ACL injuries and practice ways to prevent them.
This includes:
- Understanding proper landing techniques while jumping
- Strengthening hamstring and quadricep muscles
- Bending the knees and hips while pivoting
Schedule a Consultation
If you’re experiencing knee pain that you believe may be due to an ACL injury, schedule a consultation with Dr. Melander as soon as possible. The team at Melander Sports Medicine will evaluate your injury and provide a comprehensive treatment plan that restores you to full strength.
Patellofemoral Syndrome (Chondromalacia)
The Stages of Patellofemoral Syndrome (Chondromalacia) Treatment
Stage 1
When you have Runner’s Knee, the knee will be swollen and in pain and you must rest it. Avoid stair climbing and squatting. Make sure to also keep the leg straight when seated. Ice the knee for 30 minutes two or three times a day after any activity and take any anti-inflammatory/analgesic medication prescribed to you by your doctor.
Stage 2
Begin range of motion and strengthening exercises. The exercises below are used to stretch, strengthen and balance the thigh muscles that control the patella in the grove allowing the patella to move through the femoral grove more accurately and with less pressure.
Download a PDF of the exercises.
Recommended Exercises
Quad Sets
While lying or sitting with a small towel roll under your ankle, tighten your top thigh muscle to press the back of your knee downward towards the ground. Do 3 sets of 10 reps.
Heel Slides (Towel)
While in a sitting position, hook a towel around your foot and pull your knee into a bend position and towards your buttock. Do 3 sets of 10 reps.
Short Arc Quad Sets
Place a rolled up towel or object under your knee and slowly straighten your knee as you raise your foot. Focus on contracting the quad muscles. Hold for 3 seconds. Do 3 sets of 10 reps.
Hip Adduction Squeeze
Place a rolled up towel, ball or pillow between your knees and press your knees together so that you squeeze the object firmly. Do 3 sets of 10 reps.
Single Leg Raise (VMO)
While lying or sitting, raise up your leg with a straight knee and your toes pointed outward. Do 3 sets of 10 reps.
Hip Extension
While lying face down with your knee straight, slowly raise up leg off ground. Do 3 sets of 10 reps.
Hip Abduction
While lying on your side and upper most leg on pillows, slowly raise up the top leg to the side. Keep your k nee straight the entire time. Do 3 sets of 10 reps.
Hip Adduction
While lying on your side, slowly raise up the bottom leg towards the ceiling. Keep your knee straight the entire time. The top leg should be bent at the knee and your foot planted on the ground supporting your body. Do 3 sets of 10 reps.
Clam Shells
While lying on your side with your knees bent, draw up the top knee while keeping contact of your feet together. Do 3 sets of 10 reps.
Meniscectomy HEP
What is a Meniscectomy
A meniscectomy is the surgical removal of all or part of a torn meniscus. Often the pattern of the tear as well as the individuals age and activity level determine if it should be repaired or removed.
A partial meniscectomy, is the removal of unstable meniscal fragments; and the surface that remains is a meniscus with smoothed ends. Surgical intervention is determined on the tear pattern, stability of the tear as well as the location of the tear. Often when a tear of the meniscus causes pain or swelling a decision for surgery is made.
Following surgery the patient’s symptoms should reduce, but the loss of a portion of the meniscus reduces cushioning and stability in the knee and the patient may experience slight discomfort with certain activities. Learn more about this procedure with our Patient Education video.
Recommended Exercises
Prone Knee Hangs
While lying down on your stomach, allow your leg to hang off the end of a table/bed. Position yourself so that your knee cap is just over the end of the table/bed. Hold for 5 minutes.
Quad Sets
While lying or sitting with a small towel roll under your ankle, tighten your top thigh muscle to press the back of your knee downward towards the ground. Do 3 sets of 10 reps.
Propped Knee Hangs
While lying comfortably on a firm surface, straighten the involved leg out allowing the heel to rest on a firm object. The back of the knee and calf should not touch the chair or bed. relax the thigh and leg muscles to allow the knee to straighten fully. Hold for 5 minutes.
Heel Slides (Towel)
While in a sitting position, hook a towel around your foot and pull your knee into a bend position and towards your buttock. Do 3 sets of 10 reps.
Terminal Knee Extension
Place a rolled up towel or object under your knee and slowly straighten your knee as you raise up your foot. Do 3 sets of 10 reps.
Single Leg Raise (VMO)
While lying or sitting, raise up your leg with a straight knee and your toes pointed outward. Do 3 sets of 10 reps.
Hip Extension
While lying face down with your knee straight, slowly raise up leg off ground. Do 3 sets of 10 reps.
Hip Abduction
While lying on your side and upper most leg on pillows, slowly raise up the top leg to the side. Keep your k nee straight the entire time. Do 3 sets of 10 reps.
Hip Adduction Squeeze
Place a rolled up towel, ball or pillow between your knees and press your knees together so that you squeeze the object firmly. Do 3 sets of 10 reps.
Clam Shells
While lying on your side with your knees bent, draw up the top knee while keeping contact of your feet together. Do 3 sets of 10 reps.
Wall Squats
Leaning up against a wall on your back, slide your body downward and then return back to upright position. Do 3 sets of 10 reps.
Meniscus Tears
Your meniscus is a group of two pieces of cartilage wedged between your thighbone and shinbone. Combined, they provide shock absorption and stability to your knee, a necessity for athletes of any skill level. During times of intense physical activity, however, your meniscus may tear.
Meniscus Tear Causes
Meniscus tears happen most frequently in sports involving sprints and quick pivots, such as soccer and field hockey. The meniscus may tear as a result of physical contact, or from explosive force around the knee. In older athletes, the meniscus may also degenerate over time, making it more prone to tearing even in low-stress activities.
Meniscus Tear Symptoms
Unlike more severe injuries, such as an ACL tear, meniscus tears are generally more subtle and may not be immediately detected by athletes. The patient may feel some swelling in their knee, along with soreness or tightness. They may feel like something happened to their knees, but can’t quite explain it.
Meniscus Tear Treatment
Dr. Melaner begins meniscus tear treatments with a complete physical exam. Various tests, such as the McMurray’s test or Apley’s compression test, may be used to detect tears in the meniscus. If those exams are inconclusive, an MRI may be recommended to obtain a full image of the knee.
Depending on the type of tear, Dr. Melander may recommend a variety of treatment options to repair the meniscus. The most common treatment is a partial meniscectomy, in which Dr. Melander removes the torn meniscus with small tool and smooths the remaining edges to ensure comfort. He may also perform a meniscal repair, in which he stitches the torn meniscus back together.
All of Dr. Melander’s meniscus treatment options are performed via arthroscopic surgery, which are considered outpatient, minimally invasive procedures. Watch the video below for a detailed look at how Dr. Melander performs an arthroscopy.
Meniscus Tear Recovery
Recovery time for a meniscus tear depends entirely on the severity of the injury. For patients undergoing a standard meniscectomy, we typically advise 4-6 weeks before returning to physical activity. Patients going through a full meniscal repair may require 10-12 weeks before resuming their sport.
Meniscus Tear Prevention
Unlike other sports injuries, meniscus tears are common in athletes and non-athletes alike. Most injuries occur as a result as a result of slip-and-fall accidents, but some are directly tied to overexertion. Dr. Melander recommends thoroughly stretching before physical activity and performing strengthening exercises to build muscle around your knee.
Schedule a Consultation
If you’ve experienced a dull pain around your knee for more than a week, schedule an appointment with Dr. Melander’s sports medicine team. We’ll perform a thorough exam and determine if your knee pain is the result of a torn meniscus, and if so, develop a customized treatment plan to restore your knee to full strength.
Knee Arthritis
Knee arthritis is a condition that causes pain around the knee during everyday activities. For both athletes and non-athletes, knee arthritis may create health complications that could worsen over time if not examined by an orthopaedic professional.
Knee Arthritis Causes
There are several factors that could contribute to the formation of arthritis in the knee. Arthritis typically sets in shortly after the cartilage in the knee is broken from some type of trauma, such as a collision or fall. This is especially common in soccer players.
Non-athletes may also develop arthritis due to a number of factors. These include:
- Trauma from an injury, such as a car accident or slipping on ice
- Congenital conditions
- Lifestyle factors, such as obesity
- Age-related factors
Knee Arthritis Symptoms
Patients experiencing knee arthritis will feel pain or stiffness with prolonged walking or weight bearing. The knee joint may have recurrent swelling, meaning it comes and goes. The patient may feel pain when bending the knee, such as when rising from a seated position. Finally, the patient may experience mechanical symptoms when moving the knee, such as a feeling of clicking or catching.
Knee Arthritis Treatment
Diagnosis of knee arthritis generally begins with a thorough physical exam and x-ray imaging, which should reveal the narrowing of the joint that is causing the pain. Dr. Melander will begin knee arthritis treatment with oral or injective anti-inflammatory medications. This will reduce the pain and swelling around the joint. From there, he may recommend a physical therapy regimen that could call for some lifestyle changes, such as weight loss or activity alterations.
Depending on the severity of the condition, Dr. Melander may recommend a viscosupplementation procedure in which synthetic joint fluid is injected into the knee to reduce friction and provide temporary relief. In the most serious cases, Dr. Melander will perform a knee arthroscopy in order to repair the affected joint and provide long-term relief.
Knee Arthritis Prevention
Unfortunately, arthritis is not completely preventable, as age, family history and gender all contribute to its formation. Dr. Melander instead recommends that all patients stay aware of the condition and follow simple lifestyle changes that could reduce your risk of developing it. This includes eating a healthy diet and getting plenty of exercise. Since arthritis typically begins with a traumatic injury, consider taking precautions to avoid injury, such as wearing protective gear and following a thorough stretching routine.
Schedule a Consultation
If your knee pain isn’t getting any better, you may be suffering from arthritis. Schedule an appointment with Dr. Melander’s sports medicine team and we’ll take a closer look. If intervention is necessary, rest assured that Dr. Melander will develop a custom treatment plan to help you make a full recovery.
Orthobiologics
One of the fastest-growing areas of orthopaedic treatment is orthobiologics. For certain, minor injuries, orthobiologics have proven to be a safe, effective solution that accelerate the body’s natural healing process. Let’s take a closer look.
Orthobiologics Definition
Orthobiologics refers to the application of biologic treatment for musculoskeletal injuries. The orthobiologic substances are derived from the body’s own cells, proteins and growth factors. When injected into the site of an injury, orthobiologics have a good chance of reducing inflammation and creating an environment more conducive to healing.
When Are Orthobiologics Used?
Dr. Melander typically recommends orthobiologic treatment for tendon, ligament and cartilage injuries. It is considered a hybrid between conservative and surgical treatment. Dr. Melander may recommend it as an intermediate step before surgery, or as a temporary relief for chronic conditions, such as arthritis. In some cases, orthobiologics may delay major treatments, such as a joint replacement.
Where Do Orthobiologics Come From?
Orthobiologics are usually created from two sources: platelet-rich plasma (PRP) and pluripotent stem cells, and occasionally stromal fat cells. PRP cells are drawn from your own blood and contain the critical growth factors necessary to enhance healing. Stem cells, on the other hand, are usually harvested from the bone marrow or pelvis or from a donor. In theory, these cells assist with the rebuilding of the damaged tissue.
Outlook on Orthobiologics
Although orthobiologics have provided relief for several patients experiencing joint pain, science has yet to completely validate them as a reliable treatment option, however, there is growing evidence that orthobiologics can work exactly as intended. That said, the treatment is quite promising and may be right for some patients experiencing specific types of pain. Dr. Melander will be able to evaluate your injury and recommend the best course of action.
Schedule a Consultation
If you are experiencing joint pain and are interested in orthobiologic treatment, schedule an appointment with Dr. Melander and the sports medicine team. If he determines you are a good candidate for orthobiologics, he will develop a treatment plan that restores you to full health as quickly as possible.
