When is a Meniscus Tear Repairable?

When is a Meniscus Tear Repairable?

According to the American Academy of Orthopaedic Surgeons, one of the most common knee injuries is a tear in the meniscus. These rubbery pieces of cartilage act as shock absorbers in the knee to cushion and stabilize the knee joint. There are two menisci in each of your knees: one on the inside of the knee and one on the outer side.

Treatment of a meniscus tear depends on a number of factors, including the type of tear, its size and where the tear is located on the meniscus. Most meniscus tears result either from trauma or are degenerative. Traumatic tears come about from a twisting of the knee, often while engaged in sports and physical activity. Degenerative tears can occur as the body ages and tissue gradually breaks down over time.

The outer one-third of the meniscus has a rich supply of blood flow, which is important for any part of the body to heal. The inner two-thirds, however, have little to no blood flow. Nutrients from blood are necessary for the body to heal naturally, so when there are tears in the inner part of the meniscus, surgical trimming and removal of the torn piece is generally the best option.

Tears in the meniscus that are located near the outer edge of the knee are typically the result of trauma and are longitudinal – basically following parallel to the long side of the meniscus. This makes these injuries the best candidates for surgical repair.

Arthroscopic surgery for such tears can be very successful at repairing the damage. This is a minimally invasive treatment, as only a few small incisions in the knee are needed. A miniature camera is inserted in one incision, and surgical instruments are inserted in the others, allowing the surgery to all take place within the knee. The tear is closed by stitching the torn pieces together.

Recovery time from a meniscus repair is longer than for surgery where part of the meniscus is removed because the tissue must heal together, requiring 3-4 months away from sports. However, you can expect to fully return to your previous level of activity once healing is complete.

If you have sustained a knee injury or are experiencing knee pain, contact us at Missouri Orthopedics and Advanced Sports Medicine. Dr. Irvine has extensive experience in treating knee pain and injuries, and is trained in the most advanced techniques in arthroscopic surgery.

General Orthopedic Care – Caring for Broken Bones

General Orthopedic Care – Caring for Broken Bones

There are many ways a bone can be injured or broken. Car accidents, contact sports, falls, and workplace accidents are some of the most common ways bones sustain injuries. Regardless of the cause, broken bones should be treated as soon as possible to avoid complications. The best way to treat an injury to a bone is to ensure proper alignment and stabilization.

Leaving a bone break or injury untreated can result in complications including bone deformity and permanent nerve damage. An untreated break may also cause damage to surrounding muscle and ligaments. These complications occur because bone is living tissue that attempts to heal itself in stages:

  • The trauma of the break damages blood vessels within the bone resulting in bleeding inside the tissue. Within hours this blood forms a clot. The blood clot associated with a broken bone contains specialized cells known as fibroblasts.
  • In a few days, these cells begin to manufacture granulation tissue. This tissue begins to form a web of cartilage and fibrocartilage and is known as the soft callus stage. This stage may last from about four days to as long as three weeks in most cases.
  • At this point cells known as osteoblasts begin to make new bone tissue. Usually, this process begins at about two to three weeks and ends at about six to eight weeks. This is known as the hard callus stage and depending on the location and severity of the break, may continue for months.
  • The final process is remodeling. Specialized cells called osteoclasts begin to break down excess bone in the fractured area, reducing the size of the callus and replacing it with hard, compact bone tissue. As this happens, the bone returns to its original size and shape. During this time, the bone functions as well as before the break; however, the process of complete remodeling can take years to complete.

Because bone begins to heal itself almost immediately after an injury, it is vital to see a doctor as soon as possible in order to assure correct healing and avoid complications.

When you visit our office for a broken bone, an X-ray of the affected area would be done to determine the type and severity of the break. For the majority of simple fractures, the bone is able to be gently manipulated back into place. If a more complex or severe break is found, the bone may require stabilization with pins, screws, or plates. Once the bone is back to the correct alignment, immobilization with a cast, splint, or in some cases, traction is essential in order to minimize pain and allow the bone to continue to repair itself in the correct position.

Once the bone is stabilized, recovery and rehabilitation can begin. Dr. Irvine and his team will devise a plan to suit your specific needs. A proper rehabilitation program promotes blood flow to assist in healing and maintaining muscle tone, while also reducing stiffness and helping prevent blood clots.

No matter what the cause, Missouri Orthopedics & Advanced Sports Medicine is here to help. Our clinic can diagnose and treat all types of breaks to get you back to your day-to-day activities. Contact us if you suspect you may have a broken bone or other orthopedic injury. We provide prompt, professional care to minimize further damage and get you back to a healthy, active lifestyle.

Elbow Arthroscopy Recovery: How to Help Yourself Recover Stronger

A large majority of people who need to undergo surgery are curious about the recovery times, the level of pain they may experience, and what they will need to do to recover afterwards. The good news is, there are many things patients can do to recover stronger after a surgery such as Elbow Arthroscopy.

Elbow Arthroscopy can be performed to diagnose and fix many problems, such as releasing scar tissue or resurfacing the bone. It is often a very successful surgery, providing patients with less ongoing pain and a better range of motion. Immediately after the surgery, patients will notice the improved range of motion available in their elbow as there are very few limitations placed upon movement at this point. A sling is often given for comfort only.

As this is a surgical procedure, some pain and discomfort is to be expected, but the method of using only a small incision means this will generally only last the first week of recovery. If the surgery was more extensive, it will likely be several more weeks before the pain subsides. In either case, patients may be prescribed pain medication to help with any discomfort. Icing and raising the elbow for the first 48 hours after surgery as directed by the doctor will also help with the pain and recovery.

The doctor may ask the patient to leave on the post-surgery dressing for several days and to keep the area dry. After its removal, bathing can continue as normal, but always ensure that the wounds are covered with antibiotic ointment and bandages after bathing as directed by the doctor. Sutures are removed after one week.

Once the initial recovery time is complete, physical therapy will begin and lasts for approximately 4-6 weeks or until maximum range of motion is accomplished, allowing the patient to return to normal activities such as playing sports and moving regularly again!

To learn more about this simple recovery process or to schedule your Elbow Arthroscopy procedure, contact us.

The Remarkable Hand

What makes humans so “human”? While there are certainly many factors – spiritual, emotional, physical – that make us human, the human hand is a unique appendage that opened up amazing possibilities in our becoming human.

From our opposable thumbs to the amazing sensory receptiveness of our fingertips, the human hand is ideally sculpted for exploration and manipulation of this incredibly complex world. A study at the KTH Royal Institute of Technology in Stockholm, Sweden in 2013 determined that the human finger can find an irregularity as small as 13 nanometers, which is less than 1/1000th the thickness of a human hair. With sensory tools like that at our disposal, it’s not surprising we humans have done as well as we have!

Let’s spend a minute and look at the basic set-up of the hand.

The eight bones of the wrist are called the carpal bones. The carpal tunnel is the narrow passage through which passes all of the blood and nerve supply for the hand. You’ve probably heard of carpal tunnel syndrome. Carpal tunnel syndrome occurs when, for a variety of reasons, that passageway no longer allows for friction-free passage of the tendons, nerves and blood supply to the hand, causing pain and dysfunction.

The five long bones that stretch from your wrist to the base of your fingers are called metacarpals, and the individual bones of your fingers are called the phalanges (phalanx is singular). The muscles and tendons that move your hands and fingers are incredibly sensitive, allowing us to pick up tiny objects, while they are strong enough to lift frying pans and carry babies!

It’s amazing all that we can do with our hands! However, when we begin having pain or discomfort in our hands, it can be difficult to function in the day-to-day. If you are experiencing pain in your hands or wrists, please contact us to set up an evaluation.

Ouch! What’s going on with my elbow?

You are used to doing everything you want to do. Lately, though, just picking up a gallon of milk with your right hand hurts so much it almost makes you cry. You made an appointment with your primary care provider, who thinks you are developing osteoarthritis in that elbow. She referred you to us, the Missouri Orthopedics & Advanced Sports Medicine Center.

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After hearing your story, reading your history and reviewing some plain x-rays your PCP had obtained, one of the tools our board-certified surgeons may use to both diagnose and treat your elbow pain and dysfunction is elbow arthroscopy.

What is Elbow Arthroscopy?

The elbow, like all the joints of the human body, is a truly amazing anatomical structure. Through small spaces between the bones pass all of the nerves and blood supply for your hand. In addition to the pain symptoms you are currently experiencing, problems in the elbow can cause pain, numbness and weakness to everything past the elbow – your forearm and hand. Compromised blood flow from the elbow to the hand can cause even more serious symptoms.

Arthroscopy is ideally suited to examine the elbow. Instead of a large, open surgical procedure, one or more tiny incisions are made in the elbow to pass a small fiber-optic camera and various small instruments into the elbow space to both diagnose and potentially treat your pain.

While the x-rays your PCP ordered rule out obvious fractures, elbow arthroscopy can also treat arthritis, loose bodies in the elbow, stiffness, tennis elbow and many other conditions of the elbow.

Because arthroscopy does not use large incisions, less soft tissue has to heal, leading to less post-operative pain and speedier recovery times.

To set up an appointment, please contact us. There’s no need to put up with the pain and limitations! We look forward to hearing from you soon.