Posts Tagged ‘Knee Injuries’

Learn all about Hip or Knee Replacements

The decision to get a hip or knee replaced is a difficult one for many patients.  Hip and knee replacements are typically advised only when all other options have not worked for you.  If you are considering a hip or knee replacement or already have had one and want to speak to a physician, join Emory Orthopedic Surgeon, Thomas Bradbury, MD on Tuesday, June 11, 2013 at noon for an online web chat on Hip and Knee Replacements.  He will be available to answer questions such as:

• What are hip and knee replacements?
• Why have the surgery?
• Who are candidates for hip or knee replacements?
• What are the newest advances in Hip and Knee replacements?
• What is Emory’s approach on when to get knee or hip replacement surgery?
• What is the recovery after a hip or knee replacement?
• What types of exercise are suitable for someone with hip or knee replacements
• What kind of outcome can you expect?

Come prepared to ask your questions and learn more about your options!

CHAT TRANSCRIPT

About Dr. Bradbury

Thomas Bradbury, MD

Dr. Bradbury is an Assistant Professor of Orthopaedic Surgery at Emory.  He specializes in hip and knee arthroplasty.  He really enjoys this area of orthopaedic surgery because of the consistency of success in the properly selected patient. Dr. Bradbury’s professional goal is the improvement in quality of life for patients with pain secondary to hip and knee problems.

His research interests center around infections involving hip and knee replacements which are rare, but difficult problems. Dr. Bradbury is researching the success rate of current treatment methods for hip and knee replacement infections caused by resistant bacteria (MRSA). Through his research, he hopes to find better way to both prevent and treat periprosthetic hip and knee infections.

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ACL Injuries and Young Female Athletes

Thank you for joining me for the live chat on ACL injuries last week!  We had some excellent questions. One participant asked a key question about young females and ACL injuries and I would like to expand on my response to this important subject.

There are a growing number of  female athletes who are tearing their ACLs.  In fact, young female athletes (under 20 years old) are four to eight times more likely than males to injure their ACL.  Even though extensive research has been done on the reasons why this could happen, we are not exactly sure why females tend to injure their ACL easier. Luckily, if a young woman injures her ACL  we are able to get most athletes back to their previous level of play due to advances in arthroscopic surgery and specialized physical therapy.

Full recovery may take about eight to 10 months but important to note, is in rehabilitation, experienced physical therapists are working with the athlete to help them avoid re-injury.  The physical therapists and athletic trainers are teaching young girls how to jump, how to land, how to contract muscles correctly as well as specific exercises that will help strengthen the knee.  Some of the things we are teaching young female athletes are not instinctual but will greatly help reduce the risk of future injury if implemented correctly when the athlete starts participating in their sport again.

If you have had a ACL injury please make sure to work with your physical therapist to make sure you are working some of these aspects into your recovery.  If you have not had an ACL tear but you are a young female athlete, do some research on how to avoid injuries so you can excel in your sport without injury. One recommended source is the PEP Program which seeks to prevent ACL injuries.

For the full transcript on the chat visit - http://advancingyourhealth.org/orthopedics/past-doctor-chats/acl-injuries-chat/

About Dr. Sam Labib

Dr. Labib is an Emory Sports Medicine orthopaedic surgeon with special 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 Faclcons, 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 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.

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Back to Life After an ACL Injury!

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

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.

Returning to Competition after an ACL Injury and Surgery

ACL Rehab ProgramBecause our sports medicine specialists have created a new program dedicated entirely to ACL injuries and your successful recovery from them, we’ve been sharing blog posts that correspond with the stages of the program. In first post, we helped you identify goals and prepare for ACL surgery after an injury and also introduced you to the concept of prehabilitation, which is equally as important as rehabilitating after surgery. For more on that topic, check out part I of our ACL injury blog series. After helping you prepare for surgery, we then moved on to identifying your post-ACL surgery recovery goals week-by-week in part II of our series. Today, we’ll be covering the last stage of the program and the portion that’s probably most important to those who consider themselves athletes: Returning to Play.

The goals and exercises outlined below will guide you from 3 months until 8 months post surgery. It is vital to faithfully adhere to the following program to avoid re-injury to the ACL reconstruction. Having a physical therapist or certified athletic trainer to help hide you through this program is often helpful. If you’ve had ACL surgery, but are still in the early stages of rehabilitation, check out part I and part II of our ACL injury blog series before moving forward.

Months 3-4: Jogging Phase

During months 3 and 4 of your recovery after ACL surgery you will work on improving functional strength with forwards and backwards movement, increasing your cardiovascular fitness and starting a jogging progression, core strengthening and overall lower extremity flexibility. Tip: when performing exercises such as Schlopy Mini Jumps, use a mirror for feedback. Your hips should stay even and knees should not buckle in, you should flex at your knees not your hips.

Months 4-5: Agility Phase

Building agility in months 4 and 5 of your recovery is a key step in returning to play. During months 4-5, focus on your strength, cardio, flexibility, core, and agility workouts. From the exercises outlined by the program, lower extremity strength should all be done on same day and make sure you get 48 hours rest between strength exercises. Cardiovascular exercises should be done 3-5 times per week.

Months 5-6: Return to Drills Phase

Throughout months 5-6 you will continue to work on improving strength and balance and start getting back to your game. You can add the BOSU ball with your strengthening exercises and start sport specific drills and start to be a part of your team.

Months 6-7: Return to Practice Phase

During months 6-7 of your post-ACL surgery recovery, you can start practicing your sport with your team. You can get physical in practice but only progress to play when you are fully confident. You will need both the physical strength and mental confidence before you start to compete and play.

Months 7-8: Return to Competition Phase

Congratulations! Once you’ve made it this far through the ACL surgery and rehabilitation program, you are ready to return to competition!  Make sure you are in the best shape possible to return both physically and mentally. Your ACL strength and flexibility will only improve as long as you continue to challenge yourself and continue your strengthening.

Remember you won’t be 100 percent, fully recovered until 12 to 18 months. Professional athletes take one year to return to high level competition. Be patient!

If you’ve injured your ACL, whether or not you’ve had surgery yet, check out our ACL rehabilitation program website. All of the phases listed above are outlined on the site with detailed instructions, exercises and tips for making your recovery after ACL surgery as effective as possible.

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Top Four Ways PRP Therapy is Different at Emory Sports Medicine

Dr. Amadeus MasonFootball fans are anticipating a competitive Super Bowl match-up between the Pittsburgh Steelers and Green Bay Packers this Sunday. Steelers’ fans might remember that the last time the Steelers were in the Super Bowl—in 2009— wide receiver Hines Ward was very close to being unable to play because of a sprained medial collateral ligament of his right knee. Fortunately, he was able to contribute to his team’s victory over the Arizona Cardinals with the help of a cutting-edge procedure called platelet-rich plasma (PRP) injections.

Since Ward’s high-profile recovery, PRP therapy has become a popular treatment for those suffering from ligament and tendon injuries—and Emory Sports Medicine has become a leader in the PRP therapy field.

Here’s how it works: PRP therapy is an outpatient procedure, in which blood is drawn and placed in a centrifuge for 15 minutes to separate out the platelets. The layer of platelet-rich plasma is then injected into the diseased portion of the tendon with the guidance of an ultrasound machine. Patients are then put on a program of relative rest followed by physical therapy for the first six weeks. After about 6 to 12 weeks, patients are re-evaluated for improvement. (Many patients require only one treatment.)

Sounds simple, right? It can be, but only if it’s performed properly and with the right expert guidance. Below we’ve outlined four factors that allow Emory Sports Medicine to excel at PRP therapy:

  1. We’ve been doing this since the beginning. PRP therapy is a fairly new procedure, and Emory has two doctors on staff who are skilled in performing it: Dr. Kenneth Mautner and myself. Both of us are dedicated to keeping up with the latest developments in the field.
  2. A vital step in the PRP process is the separating of platelets. We use only the most advanced centrifuge systems to ensure the highest concentration of platelets harvested from the process.
  3. We use ultrasound guidance to place the PRP into the affected tendon. Many other practices don’t use ultrasound—and the difference can be compared to dropping an atomic bomb vs. using a laser-guided missile. Although utilizing PRP in a generalized area can be helpful, placing it in a specific area will give the best chances at a positive result, proper healing, and full recovery.
  4. Emory Sports Medicine has developed a standardized post-injection protocol – a daily and weekly follow-up program designed to give patients the best chance at recovery.

While PRP therapy is still a relatively new procedure, when a skilled team of physicians does it properly, the results are remarkable. Just ask Hines Ward!

Are you considering PRP therapy? Do you have any questions regarding this procedure? If so, be sure to leave a comment here, or contact Emory Sports Medicine for an evaluation today.

About R. Amadeus Mason, MD:
Dr. Mason specializes in family practice and sports medicine. His areas of clinical interest include ankle, foot, shoulder, sports injuries, wrist, and ultrasound. Dr. Mason holds organizational leadership memberships with the American Academy of Family Physicians, the American College of Sports Medicine, and the Georgia State Medical Association.

New Technology for Reducing Risk & Recovery Times for Young Athletes

John Xerogeanes MDWhether your child plays football, basketball, soccer or gymnastics, a common worry for many parents is the looming possibility of a sports injury. In many of these sports, anatomic anterior cruciate ligament (ACL) tears are one of the most common injuries young athletes experience. For most children who injure their ACL, treatment consists of rehabilitation, wearing a brace, and reducing athletic activity levels until they stop growing (usually around their mid-teens), at which point ACL reconstruction surgery can safely be performed.

Why do we wait until kids stop growing to perform the surgery? ACL operations are typically conducted with extensive use of X-rays in the operating room, which often leads to a large margin of “chance” when working around growth plates. Essentially, performing ACL surgery on a young child significantly increases the risk of causing a growth plate disturbance.

To help ease this fear and risk, we’ve developed a new 3-D MRI technology at Emory Sports Medicine Center. The 3-D MRI technology makes it possible for surgeons to reconstruct ACL tears in young athletes without disturbing the growth plate. This technology allows us to better pre-operatively plan and perform ACL surgery with more precision and less risk.

As one of the four major ligaments in the knee, the ACL is somewhat like a rubber band, attached at two points to keep the knee stable. In order to replace the ligament, a tunnel is created in the upper and lower knee bones (femur and tibia) and a new ligament (typically taken from a hamstring or allograft tissue) is slid between those tunnels and attached at each end.

With the new 3-D technology being used at Emory, we can actually see from one end to the other on either side of the knee, and can correctly position the tunnels so we are able to place the new ligament with more precision. With this technology, ACL surgery can be done in less time than the traditional surgery, and we have great confidence that the growth plates in our young patients will not be damaged.

Kids who undergo this type of operation will still have at least one year of recovery time. The good news, is that it does allow them to eventually pursue normal activity much sooner than they would with the traditional surgery. This new method of ACL reconstruction is able to be performed on children and adults alike. My hope is that this new technology will aid us in preventing future re-injury for athletes who have suffered from ACL tears.

About John Xerogeanes, MD:

Dr. Xerogeanes, or Dr. “X”, is chief of Sports Medicine at the Emory Orthopaedic & Spine Center. He is also head orthopaedist and team physician for Georgia Tech, Emory University, and Agnes Scott College. As a member of a number of professional societies and organizations, including the American Orthopaedic Society for Sports Medicine, and the American Academy of Orthopaedic Surgeons, Dr. Xerogeanes has contributed to many textbooks and has received numerous research awards. Dr. Xerogeanes’ work has been featured on CNN, ESPN and network television news

When Doctors Operate on Doctors

A Chat with Dr. Sameh Labib and Dr. John W. Xerogeanes

Four years ago, Dr. X, a popular surgeon at Emory Sports Medicine, suffered a knee injury that required surgery. Who did he turn to? Dr. Sameh Labib of Emory Sports Medicine. The two doctors recently chatted about the surgery and recovery.

DR. X: I started to have back pain when I turned 40. Around that time, the football and basketball teams we treat at Georgia Tech were doing yoga classes with Diamond Dallas Page, the former wrestler. They all told me that it helped their flexibility and joint pains. I started taking the class once a week. As promised, I felt better and the back pain went away.

One year later, my wife was making fun of me for being the “Yogi Kudu.” (For those around my age, you might remember him as the yoga practitioner who made appearances in the 1980s on the TV show “That’s Incredible,” folding his six-foot frame inside small glass boxes.) In playful response to my wife’s comment, I showed her a new pigeon pose. Upon transitioning from one pose to another, I heard a pop in the knee and I had pain.

When the pain continued, I had an MRI, which showed a meniscal tear. To others who might have suffered this injury: When you tear your meniscus, you twist and feel sharp pain on the side of your knee—this is sometimes accompanied by a click.

DR. LABIB: Yoga is not a common cause of knee injuries. Football, basketball, soccer and tennis injuries are much more common. It’s best to have an experienced yoga instructor guiding you to avoid injury. Meniscus injuries usually happen due to twisting and pivoting. In yoga, it happens due to excessive knee bending or flexing with certain poses, such as the lotus pose.

When John injured himself, I remember thinking that doing knee surgery on the busiest knee surgeon at Emory was going to be a challenge! As you may know, sometimes doctors make the worst patients, and they can be noncompliant – as doctors, we tend to think that we’re bulletproof.

For that reason, I try to treat my “doctor” patients exactly as I treat everyone else and hope for them to follow instructions. Is this wishful thinking? Naive? Of course, there is also the “Doctor Curse,” where all the weird complications happen.

With the above in mind, I agreed to do John’s surgery. It went great and, to my surprise, he was very cooperative.

DR. X: My wife told me to listen to Sam, period! It still did not get me out of doing household chores …

Actually, it was no problem being operated on by someone else. The good thing about being a knee surgeon is that you KNOW who you think is the best guy to fix you. Thus, I had Sam take care of me.

If I hadn’t gotten surgery, I would have continued to experience pain. Doing athletic activities would have been painful, and the bending of my knee would be limited. Since I’m an athletic person, this wasn’t an option for me. I wanted to get better.

DR. LABIB: Once the surgery was complete, I told John to ice, elevate and avoid prolonged standing or walking for the first week or so. Also, he needed to start early motion.

I recommend making a gradual return to low-impact sports such as cycling and stepping. Swimming is allowed after the wounds have healed (approximately three weeks after). Knee swelling and stiffness are common in patients. Usually patients see that the incisions are small, and they feel good after the procedure so they end up “overdoing” it. We are often telling our patients to slow down and let the inside heal before they increase their activity. Three to four weeks are often needed before they can return to their sport.

I’m happy that John was a great patient. His knee has healed and he’s doing yoga again. I hope other doctors follow his example!

About Shaina Lane, MEd, ATC, LAT, OTC:

In 2006, Shaina applied and was accepted to the Emory Sports Medicine-Ossur Fellowship. She spent that year working alongside the physicians at Emory Sports Medicine, enhancing her clinical evaluation skills as well as learning how to assist in the operating room. After the fellowship, she spent several months working at a private practice in Tennessee before returning to Emory Healthcare as a clinical coordinator in the sports medicine department and program coordinator for the Emory Sports Medicine-Ossur Athletic Training Fellowship.