28. November 2016 11:25
The knee is the largest and most complex joint that regulates most of the body movement. It comprises of three major bones- femur, tibia and the patella. These bones are joined and held in their normal anatomical positions by the ligaments. These ligaments are categorized into two groups:
- Collateral Ligaments- These lay on either side of the knee joint and prevent any abnormal knee movements. These are the Medial Collateral Ligament (MCL) and Lateral Collateral Ligament (LCL)
- Cruciate Ligaments- There are two ligaments viz. Posterior and Anterior Cruciate Ligaments (PCL and ACL) that cross each other as well as control the back and forth movement of the joint
The stability of the knee joint depends on these ligaments and any stress or tear can affect the working of the joint. Tearing or stretching of the ligaments is medically termed as sprain. It may vary from a slight stretch or loosening of the ligament to a complete tear. When more than one ligament is affected, the condition is referred to as Combined Knee Ligament Injury.
- Sudden change in intensity of physical activity or workout
- Not following a proper warm up and cool down regime before as well as after a sport
- Direct injury or trauma to the joint
- Vehicular accident
- Fall from a height
- Debilitating pain may be felt immediately after the injury
- Difficulty in weight bearing and movement
- Swelling and inflammation of the joint
- Redness and tenderness
- The knee may feel cold when touched
- The joint is likely to get dislocated as multiple ligaments are damaged at the same time which results in loss of stability
- Detailed clinical evaluation of the injured joint to check for visible symptoms, whether there is an open wound, loss of sensation and motion as well as muscular strength
- Neurological or nerve tests may be conducted by an orthopedic doctor
- Blood flow to the lower extremities may be checked
- X-ray imaging may be required to diagnose changes in bone position or any other structural damage
- MRI and CT scan may give clear pictures of the ligaments and location as well as severity of the tear/strain. It may also help the doctor decide the mode of treatment that needs to be adopted
Combined Knee Ligament Injury is a serious medical condition that needs immediate medical attention. It may be treated both surgically and non-surgically depending on the severity of injury. Following methods may be recommended by the doctor:
- Bracing- This may be recommended to patients with low grade injuries, have a moderate level of physical activity or if he is not in a position to undergo surgery. It helps to promote healing of the soft tissues and restoring stability of the joint
- Antibiotics may be prescribed to prevent infection in case of open wounds
- Arthroscopy- A small camera guided instrument is used to reconstruct the damaged ligaments. The dislocated knee bones may be repositioned and held together by inserting screws and pins
- Surgical grafting to re- construct completely torn ligaments
- Surgical removal of debris and scar tissue
- In case of damage to the blood vessels or nerves, nerve reconstruction and grafting may be done to restore the sensory functions within the joint
- Physical therapy may be required to restore mobility, muscular strength and prevent joint stiffness
- Activity modification and avoidance of weight bearing may be recommended post-surgery
For treatment of Combined Knee Ligament Injury and other orthopedic conditions, visit OrthoTexas. To schedule an appointment with the knee surgeons in Flower Mound, TX, call at (972) 899 – 4679.
22. February 2016 12:16
De Quervain’s Tendinosis is a condition that causes irritation and constraint in the tendons around the base of the thumb. Inflammation in the tendons and the tendon sheath can lead to pain and tenderness along the whole thumb. The pain increases while performing simple activities such as forming a fist or grasping something.
- Overuse of the thumb
- Direct blow to the thumb
- Repetitive grasping
- Inflammatory conditions such as Rheumatoid Arthritis
- Racquet sports
- Activities such as gardening
- Pain and swelling at the back of the thumb
- Pain that travels into the thumb or upwards to the forearm
- Pain increases when pinching or grasping things
- Swelling and pain on the side of the wrist at the base of the thumb
- Pain gets worse while moving thumb or wrist
- A catching or snapping sensation can be felt during thumb movement
The orthopedic doctor may perform the Finkelstein test to diagnose the condition. The patient may be asked to make a fist with the thumb placed in the palm. The wrist may be bent towards the outside causing the swollen tendons to stretch. If this movement is painful, the patient may be suffering from De Quervain's Tendinosis.
- Medication: Non-steroidal anti-inflammatory medication may be recommended by the doctor to provide relief from inflammation and pain. The medication may be injected directly into the thumb to provide immediate relief.
- Corticosteroids: Corticosteroid injections may be administered into the tendon sheath to reduce pain and inflammation.
- Splints: Splints may be used to provide support to the thumb and wrist. It is important to completely stop all activities that worsen the pain.
- Ice packs: Application of ice packs may also be useful in reducing the swelling and discomfort.
- Exercise: The doctor can suggest certain strengthening exercises to regain the normal range of thumb movement.
Surgical intervention may be required in case conservative treatment methods fail to provide any relief. The procedure involves opening the thumb covering to make space for the swollen tendons. The patient may resume his routine work once the thumb regains full range of movement.
The orthopedic surgeons at OrthoTexas provide effective treatment for De Quervain's Tendinosis. For appointment, you can call at (972) 899 – 4679 or visit 4951 Long Prairie Rd, Suite 100, Flower Mound, TX 75028.
3. April 2014 11:36
Shin Splint is a painful condition that is often faced by athletes while jumping or running. In this condition, the inside or the front of the shin bone (tibia) starts paining due to a quick or sudden motion. The shin splint that involves the front muscles, tissues of shin is called anterolateral shin splint, while, the pain in the back and inner part of the muscles of shin is called a posteromedial shin splint.
- Shin Splints occur due to vigorous exercise, repetitive activities such as dance, running, or sports, etc.
- Overuse or stretching of muscles
- Running on hard surfaces
- Changing the intensity and duration of workouts
- Having rigid arches or flat feet
- Exercising without warming up
- Muscle imbalance
- Running on slanted surface
- Wearing inappropriate footwear
The most common symptom of shin splints is excessive pain on the inner or outer part of the lower leg that worsens with exercise or running. The muscles tighten and become stiff. Often the pain worsens and causes inflammation and swelling. Different people may have different symptoms, so it is crucial to consult a physician for proper diagnosis. The physician will confirm the condition after reviewing complete medical history of the patient and physical examination.
Depending upon the age, medical history, and extent of pain, and type of shin splint, an orthopedic doctor determines the course of treatment. The patient is recommended to discontinue any physical activity that is responsible for the condition. They are advised to wear running shoes with rigid heels and arch supports that are specially designed to offer relief to the patient. Wearing an elastic compression bandage can also help. The orthopedic surgeon may suggest rest, strengthening and stretching exercises, cold packs and some anti-inflammatory medicines. Physicians may recommend MRI or X-rays to determine the extent of damage and in case of a rare severe shin splint and stress fracture, the surgeon may recommend surgery. The patients may be required to change their daily routine and decrease their exercise time.
A patient may take up to 3-4 months to recover from shin splint. To ensure that the patient has fully recovered, it is important that the patient should be able to use leg, exercise, jump, and run without any pain. The affected leg should be as flexible as the other leg, and there should not be any weakness and follow ups can make sure of that.