Posts Tagged ‘Knee Injuries’

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.