ACL Injury: Should it be fixed?
An ACL will often not repair itself as it is surrounded by synovial joint fluid which washes away healing clot and does not allow the ligament to heal. The ACL is important for sports in which people change direction at speed, such as sidestepping, pivoting and twisting on a fixed foot. In general anyone who engages in sports such as soccer, rugby, basketball, tennis or anything requiring significant pivoting will require their ACL reconstructed.
This decision also depends on the age and wishes of the patient and the general state of their knee, because many people can run for long distances in a straight line when they do not have an ACL.
Activities After a Knee Replacement
Studies show that a knee replacement does not feel the same as a normal knee but it's much better than a worn out knee. The replacements are find for walking long distances, bushwalking, bicycle riding, tennis, yoga, skiing, gardening, kneeling and most other activities. It Is generally not recommended that people run on their knee replacement as this may lead to increased wear of the prosthetic joint.
There are various different disorders of the paediatric and adolescent knee which require treatment. Common problems such as Osgood-Schlatters disease (pain at the insertion of the knee cap tendon to the shin bone), cartilage or meniscal tears and knee cap dislocations require investigations and, occasionally, surgery. If pain is severe or physically limiting and has lasted for a few months, it is definitely worth being checked.
Adolescent Anterior Knee Pain
Arthritis of the knee refers to loss of the articular joint cartilage which is the fixed shock absorber of the knee. When this is severe it is known as 'bone on bone', and generally requires surgery to deal with this. Operations include half or total knee replacement, or realignment procedures such as a high tibial osteotomy to unload the arthritic joint. There are non-operative treatments such as glucosamine or chondroitin, fish oil, tumeric, paracetamol and anti-inflammatory tablets such as Nurofen. Knee guards are often helpful and walking sticks can reduce the load on the joints and increase walking distance. Weight loss is probably the most valuable intervention available to improve the pain and function of arthritis of the knee, and exercise is also been shown to be excellent for reducing pain and function. Surgery is generally the last resort after all other modalities of treatment have been exhausted.
Arthritis of the Knee
DVT refers to a blood clot in one of the deep veins of the leg. This can occur after surgery as the body tends to make the blood thicker to stop bleeding as a reaction to trauma, fractures or surgery. The risks of DVT depend on the extent of the surgery, the ability to weight bear after surgery, the amount of immobility which the patient has, and can also be related to inherited factors which increase the risk of people plotting. Surgeries such as knee arthroscopy do not require anticoagulation to prevent DVT as the likelihood is low, whereas bigger operations such as knee replacement or hip replacement may require calf pumps, stockings and medications such as aspirin, heparin or other blood thinners. Your surgeon will make a decision based upon your history and risk profile as to what anticoagulation maybe necessary if surgery is indicated.
Deep Vein Thrombosis DVT