Knee pain

Osteoarthritis Pain Treatment – Using your own Stem Cells?

April 12th, 2013 By Emory Sports Medicine

hip resurfacing procedureIt is reality now! Physicians at Emory Orthopaedics & Spine are among a select group of physicians around the country to offer a unique procedure using stem cell injections to relieve osteoarthritis (OA) pain. During the procedure, the physician extracts stem cell blood from the bone marrow in a patient’s hip and then injects the stem cells directly into the patient’s damaged joint. The stem cells are from the patient’s own body so the risk of rejection is very low.

Hear first hand from Dr. Mautner and one of our patients how this new treatment option is helping relieve pain from Osteoarthritis:

About Ken Mautner, MD

Ken Mautner, MD is an assistant professor in the Department of Physical Medicine and Rehabilitation and the Department of Orthopedic Surgery. Dr. Mautner started practicing at Emory in 2004 after completing a fellowship in Primary Care Sports Medicine at the American Sports Medicine Institute in Birmingham, Alabama. He is board certified in PM&R with a subspecialty certification in Sports Medicine. Dr. Mautner currently serves as head team physician for Agnes Scott College and St. Pius High School and a team physician for Emory University Athletics. He is also a consulting physician for Georgia Tech Athletics, Neuro Tour, and several local high schools. He has focused his clinical interest on sports concussions, where he is regarded as a local and regional expert in the field. In 2005, he became one of the first doctors in Georgia to use office based neuropsychological testing to help determine return to play recommendations for athletes. He also is an expert in diagnostic and interventional musculoskeletal ultrasound and teaches both regional and national courses on how to perform office based ultrasound. He regularly performs Platelet Rich Plasma (PRP) injections for patients with chronic tendinopathy. Dr. Mautner also specializes in the care of athletes with spine problems as well as hip and groin injuries.

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Cartilage Replacement Surgery – A Patient’s Succes Story

March 25th, 2013 By Emory Orthopaedics & Spine Center


cartilage repairMarcus Hutchinson knows all too well about surgery and physical therapy – he has had 6 surgeries on his left knee. He has also been a physical therapist for 22 years. As a teenager, Marcus was diagnosed with osteochondritis dissecans, also known as OCD, a joint condition in which a piece of cartilage, along with a layer of the bone beneath it, comes loose from the end of a bone due to trauma or lack of blood flow to this area. Osteochondritis dissecans is most commonly found in the knee and often occurs in young men.

By the time Marcus arrived at Emory Orthopaedics & Spine in Dr. Sam Labib’s clinic in 2006, his left knee had been operated on 4 different times. Dr. Labib examined Marcus and determined he had a massive osteochondral defect in his left knee that involved his entire lateral femoral condyle, a portion of the top bone of the knee joint.

Previous doctors had told Marcus that the only option he had left was total knee replacement. Dr. Labib did not recommend knee replacement because Marcus was too young to have this procedure. Typically, a joint replacement will only last about 15-20 years so if Marcus were to have the knee replaced in his 30’s, he would probably need to have another knee replacement by his 50s.-

Dr. Labib was able to offer Marcus a unique procedure called cartilage replacement surgery. Marcus had a massive fresh allograft implantation taken from a cadaver in February 2010 to treat his osteochondral defect.

There are several surgical techniques available to treat patients with OCD.

Below are three that Dr. Labib regularly performs.

• Microfracture Surgery – In microfracture surgery, small holes are drilled into the underlying bone, creating blood clots. As the blood clots heal, new repair cartilage or fibrocartilage forms.

• Autologus Osteochondral Plug Transfer – In this procedure, the patient’s own cartilage and bone are harvested from a low-stress area of the knee and implanted into the patient’s knee in the damaged area to fill the holes and defects with healthy cartilage and bone.

• Fresh Allograft Implantation – In this surgery, the cartilage and bone are taken from a fresh cadaver that has been donated for medical use. The donated tissue, also called an allograft, is thoroughly screened and matched to the patient defect to give it the best possible chance of successful healing. The surgeon prepares the patient’s knee by removing the damaged area. The allograft is then implanted and anchored to the surrounding bone.

Marcus’ surgery was performed at Emory University Orthopaedics & Spine Hospital. When asked about his experience he states, “I had such a positive experience at the hospital. Great care! Very attentive staff. Clean, professional and efficient.”

Marcus had one major goal following surgery and that was to walk and stand without pain. “I stand all day at work when seeing my patients for physical therapy. Before surgery with Dr. Labib, I had so much pain in my knee that it was affecting my job and day to day life. I feel so much more stable and pain-free now after having cartilage replacement surgery.” Marcus says he has a new perspective on what patients are experiencing after surgery and during physical therapy which has made him better at his job as a physical therapist. He is back to enjoying life with no pain and participating in low-impact activities such as swimming, cycling, and yoga.

About Dr. Sameh (Sam) A. Labib

Sam Labib, MD, is a sports medicine fellowship-trained surgeon and director of the foot and ankle service at Emory. Dr. Labib started practicing at Emory in 1999. He is an Associate Professor of Orthopedic Surgery.

Dr. Labib has a particular interest in problems and procedures of the knee, ankle, and foot. He is the head team physician for the athletic programs at Oglethorpe University, Spelman College, and Georgia Perimeter College. He is also an orthopaedic consultant to the Atlanta Falcons, Georgia Tech and Emory University.

He has lectured both nationally and internationally at many orthopedic meetings. His research has been published in several journals, including the JBJS, Arthroscopy, Foot and Ankle International and the American Journal of Orthopedics as well as numerous video presentations and book chapters. Dr. Labib is Board Certified in orthopedic surgery with additional subspecialty certification in Sports Medicine Surgery. For the past 5 years, Dr. Labib has been nominated by his peers as one of “America’s Top Doctors” as tracked by CastleConnelly.com.

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Back to Life After an ACL Injury!

January 31st, 2013 By Emory Sports Medicine

Prevent Joint PainACL, anterior cruciate ligament, injuries are one of the most common knee injuries among athletes. The American Orthpedic Society for Sports Medicine estimates there are over 150,000 ACL injuries each year in the US. ACL injuries can happen to everyone – from the professional athletes to the weekend warriors. The good news is that with proper treatment with an ACL specialist and adequate recovery, you can get back to the sport you love! Watch this short video of Neil, an Emory Sports Medicine patient, who has recovered from ACL surgery and is back to playing tennis and doing the things he loves to do.

About Dr. John Xerogeanes
Dr. Xerogeanes is Chief of Sports Medicine at the Emory Orthopaedic & Spine Center. Known as Dr. “X” by his staff and patients, he is an Associate Professor of Orthopaedic Surgery at Emory University as well as an Adjunct Professor at Georgia State and Mercer University. Dr. X is entering his 12th year as Head Orthopaedist and Team Physician for Georgia Tech, Emory University, Agnes Scott College and the Atlanta Dream of the WNBA. He specializes in ACL and ACL revision surgery performing over 200 of these operations each year. He is board certified in orthopaedic surgery and has his sub-specialty certification in orthopaedic sports medicine.

Dr. Xerogeanes has been recognized as one of US News & World Report’s Top Doctors with a special distinction listing him among the top 1% in the nation in his specialty. 

About Dr. Spero Karas
Dr. Karas is the Director of the Orthopaedic Sports Medicine Fellowship Program and an Associate Professor of Orthopaedic Surgery at Emory University. His specialties include sports medicine, surgery of the shoulder and knee, and arthroscopic surgery. He came to Emory in 2005, after serving as Chief of the Shoulder Service and team physician at the University of North Carolina in Chapel Hill. He is Board Certified in Orthopaedic Surgery, with a subspecialty certification in Orthopaedic Sports Medicine. He currently serves as head team physician for the Atlanta Falcons and is a consulting team physician for Emory University and Georgia Tech athletics. He cares for patients and athletes of all levels: professional, collegiate, scholastic, and recreational.

Dr. Karas was recognized as one of America’s “Top Orthopaedic Doctors” in Men’s Health Magazine April 2007 and “Top Sports Medicine Specialists for Women” in Women’s Health Magazine. Atlanta Magazine has named him “Atlanta’s Most Trusted Sports Medicine Specialist” for the past three years. Dr. Karas is an internationally recognized expert in the field of shoulder, knee, and sports medicine.

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Understanding the Potential Benefits of Physical Therapy

October 24th, 2012 By Emory Orthopaedics & Spine Center

National Physical Therapy MonthThe American Physical Therapy Association (APTA)’s National Physical Therapy Month (NPTM) is celebrated each October as a way to bring awareness around the potential health benefits to be sustained via physical therapy. Over 90% of back and neck problems, for example, will resolve themselves without surgery, and for some patients, there are unique benefits achieved from treatment by a physical therapist.

Physical therapy is a form of treatment—practiced by a licensed physical therapist under the referral of a physician. The purpose of physical therapy is to improve and/or restore mobility in patients for whom it is limited due to a medical condition, surgical procedure, accident or fall, neurological disease or other medical condition that has limited a patient’s functional mobility.  Often the injury limits the performance of everyday tasks.

Physical therapy programs at Emory Healthcare are available to support every type of mobility and functionality issue patients may experience. Whether a patient’s functional mobility issues relate to a neurological occurrence like a stroke, or an athletic injury like a torn ACL, our physical therapists available on both an inpatient and outpatient basis are here to help.

For more information on our physical therapy programs, including information on our department of Rehabilitation Medicine, please visit the links below.

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Did you know that July is Juvenile Arthritis Awareness Month?

July 20th, 2012 By Emory Orthopaedics & Spine Center

We are all painfully aware that arthritis affects many older adults, but did you know that kids can develop juvenile arthritis?

Approximately 294,000 children age 16 or younger are affected by pediatric arthritis and rheumatologic conditions.
In adults, arthritis typically affects the joints. While juvenile arthritis can cause bone and joint growth problems, it also can affect the eyes, skin, and gastrointestinal tract.

The most common symptoms of juvenile arthritis are joint swelling, pain, and stiffness that won’t go away, particularly in the knees, hands, and feet. Symptoms are generally worse in the morning and after naps. Other signs of juvenile arthritis include:

•    Limping due to a stiff knee

•    Excessive clumsiness

•    High fever and skin rash

•    Swelling in the lymph nodes

The most common type of juvenile arthritis is juvenile idiopathic arthritis. (Idiopathic means “from unknown causes.”) You may have heard this referred to as juvenile rheumatoid arthritis. This type of arthritis is diagnosed when a child has swelling in one or more joints for at least six weeks.

There are several different types of juvenile idiopathic arthritis. The type is usually determined by the number of joints affected as well as by the results of a rheumatoid factor blood test. While children may have a genetic predisposition that makes them more likely to develop the disease, at this point, researchers have not determined a direct cause, and there’s no evidence that toxins, foods, or allergies can cause it. Most children with juvenile arthritis experience remission, when the symptoms get better or go away, and times when symptoms flare, or get worse.

If your child has juvenile arthritis symptoms, the first thing to do is get an accurate diagnosis. Your child’s pediatrician can run tests that will rule out other potential causes, but if the signs point to juvenile arthritis, he or she may suggest you make an appointment with a pediatric rheumatologist.

There is no cure for juvenile arthritis; however, a number of treatments can improve your child’s quality of life, including:

•    Nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, and analgesics to help relieve inflammation and control pain

•    Disease-modifying anti-rheumatic drugs (DMARDs) and a biologic response modifiers (biologics), which can alter the course of the disease, put it into remission, and prevent joint damage

•    Splints to help keep joints in the correct position and to relieve pain and orthopedics or shoe inserts to compensate for any difference in leg length or to improve balance

•    Physical therapy to help restore motion and flexibility in joints that have become stiff and occupational therapy to help children learn how to do basic activities without aggravating their arthritis

And, of course, it’s super important for kids with juvenile arthritis to eat healthy foods and get regular moderate exercise, to keep joints strong and flexible.

Does your child have juvenile arthritis? How does your family cope? We welcome your questions and feedback in the comments section below.

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Act Now to Prevent Joint Pain Later

June 26th, 2012 By Emory Orthopaedics & Spine Center

Prevent Joint PainAnyone putting their little toe in the waters of middle age has a glimmer of what joint pain feels like. It’s no fun. But there are things you can do to ease joint pain now and prevent future joint pain. Here are some joint-smart steps you can put into action:

Maintain a health weight. Carrying extra weight can cause significant joint pain over time, particularly in weight-bearing areas like the hips, knees, and ankles. Prevent problems now and down the line by maintaining a healthy weight. Talk with your doctor if you need help starting a weight-loss program.

Get regular exercise. Low-impact activities such as walking or hiking, swimming, and stationary cycling are great options for building bone-supporting muscles, keeping weight down, and improving joint mobility. Just 30 minutes a day can have a real impact on your long-term health and comfort. Exercise has been proved to ease arthritis pain, as well.

Keep your skeletal system strong. Help prevent osteoporosis (more common in women) by getting plenty of calcium, which you’ll find in dairy products and leafy green vegetables or in supplement form. Calcium builds bone density and makes bones less susceptible to arthritis. Consider reducing or eliminating caffeine, as it can weaken your bone structure.

Eat more fish. Fish is high in omega-3 fatty acids, which have been shown to reduce joint pain and stiffness in people suffering from arthritis. If you don’t love fish, take fish oil supplements instead.

Get plenty of vitamin C. Vitamin C may help speed the recovery of damaged muscles by repairing tissues, easing joint pain. These 10 fruits and veggies are rich in vitamin C: oranges, guava, red bell peppers, kiwi, grapefruit, vegetable juice cocktail, oranges, Brussels sprouts, strawberries, and cantaloupe.

Wear sensible shoes. OK. We know that one’s no fun. But joint pain is a high price to pay for fashion. Eschew the high heels and look instead for flexible shoes that provide support. You want the shoe to bend with your foot as you walk. These days, there are plenty of good-looking shoes out there that will be kind to your feet and joints.

Already experiencing joint pain? If you put our suggestions to the test and still feel the pain, make an appointment to see us at the Emory Orthopaedics & Spine Center.

Do you suffer from joint pain? If so, what treatments have worked best for you? We welcome your questions and feedback in the comments section below.

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Takeaways from Running Injury Live Chat

May 25th, 2012 By Tara Humphries

Dr. Amadeus MasonOn Tuesday, Dr. Amadeus Mason of Emory Sports Medicine, held a live chat that answered your questions about preventing running injuries. Dr. Mason provided some great answers to some very interesting questions; from how to prevent running injuries to the ideal length of time one should consider when training for a 5k and other long distance races.  Dr. Mason also provided participants with resources on things like: knee pain and strengthening and IT Band Syndrome.

The following is a recap of the live chat, or you can check out the transcript from Dr. Mason’s Preventing Running Injuries chat.

Q. Is it better to stretch before a run? After a run? Or Both?

A. For runners stretching for flexibility, it’s better to stretch after their run, because muscles are looser and more receptive to the stretch at that time. Dr. Mason also noted that while stretching before a run doesn’t hurt, runners should keep in mind that it’s best to spend at least ¼ of the time you spend running on stretching. As an example, Dr. Mason suggests if a runner trains for an hour, it’s best to stretch for at least 15 minutes.

Q. How does a runner prevent shin splints from reoccurring and preventing the pain’s longevity?

A. Runners experiencing recurrent shin splints, or moderate to severe pain in the shin that lasts for a long period of time, should see a specialist. Make sure not to train too much, too quickly, that’s one of the most common causes of shin splints, according to Dr. Mason. If shin splints occur, it’s recommended that a runner modifies their training regimen to accommodate for pain relief. Females, who experience shin splints on a fairly regular or recurrent basis, should contact their Physician.  Continuous shin pain is a possible indication that there’s some sort of hormonal imbalance or insufficient caloric intake from a female runner’s diet.

For more information on preventing running injuries, check out Dr. Mason’s chat transcript. You can also download the resources he shared in the chat by using the links below.

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At-Home Workouts Ease Osteoarthritis Pain

April 19th, 2012 By Emory Orthopaedics & Spine Center

Osteoarthritis at home workoutsIf you have osteoarthritis, you already know that exercise can help reduce pain and improve mobility. But did you know that working out at home with a DVD may bring even more relief?

According to a study presented at the 2012 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), 107 people with osteoarthritis in the knee were randomized to either a DVD-based exercise group or a control group. The DVD group received a DVD-based exercise program along with verbal and hands-on exercise instructions for the first four to eight weeks. Participants in the DVD group reportedly exercised 5.3, 5.0, and 3.8 times per week at three-, six-, and 12-month intervals and had significantly greater improvement in pain and physical function than those in the control group.

While exercise did not make a significant difference in the progression of osteoarthritis, the reduction of pain and mobility among the DVD group speaks to the benefits of adding a video-based home exercise program to an existing exercise regimen.

When you exercise regularly, you strengthen the muscles around the arthritic joint, which helps decrease the pain of osteoarthritis and improve function. We suggest you do whatever keeps you on track to exercise regularly, whether it’s a video-based exercise program or exercising with a friend. But first, we recommend that you have an exercise program designed specifically for you by a physical therapist who understands osteoarthritis, to avoid injuries from overdoing it or doing the wrong exercises. The physical therapists here at the Emory Orthopaedics & Spine Center have the experience and the expertise to develop an exercise plan that meets your unique needs and helps bring relief from osteoarthritis pain.

Do you have osteoarthritis? Has a regular home-based exercise program helped ease your pain? We welcome your questions and feedback in the comments section below.

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Why Are Women Over 50 More Likely to Suffer From Knee Pain?

February 23rd, 2012 By Emory Orthopaedics & Spine Center

Knee Pain in womenIf you have knee pain, you know how debilitating it can be. And if you’re a woman, you have an even greater chance of developing knee pain after you reach 50. In a recent “Health Minute” spot, CNN’s Elizabeth Cohen spoke with Emory orthopedic physician Dr. Ken Mautner about knee pain in women over 50.

According to Dr. Mautner, knee pain in younger women tends to come from tendonitis or irritation issues around the knee. However, as women age, earlier knee injuries may lead to arthritis. The American College of Rheumatology reports that nearly two-thirds of women ages 50 and older have some degree of knee pain, and that pain is often due to osteoarthritis. And, Dr. Mautner says, women are more at risk for arthritis than men.

“We think that estrogen may have some protective effect on the cartilage of the knee,” Dr. Mautner says. That translates to a greater chance of experiencing knee pain after menopause.

Overuse injuries can cause knee pain, as can weight. If you have knee pain, your first step is to see your primary doctor to start determining the cause. He or she may then send you to a specialist. Treatment options may be as simple as taking acetaminophen or anti-inflammatory medications or using exercise as medicine, to strengthen the stabilizing muscles around the knee. Physical therapy may also be an option. When working out, avoid high-impact exercises that can further injure the knee. Low-impact exercises, like swimming, are a good alternative.

To watch Cohen’s “Health Minute,” visit: http://www.cnn.com/video/#/video/health/2012/01/26/hm-womens-knees.cnn

Are you over 50 and suffering from knee pain? Would you like to learn more about knee pain treatment at Emory? We welcome your questions and feedback in the comments section below.

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