I have a meniscus tear, now what?
Many patients who come to my clinic with an MRI that shows a meniscus tear are looking for advice on what to do next. Another physician may have told them that they need surgery because the MRI is abnormal. Some people just want another opinion. Not all meniscus tears need surgery.
I first want to understand the patient’s symptoms, and I look to see if the knee is locking, catching, or if it feels unstable. Meniscus tears that are unstable create these problems, which may indicate that more damage is being done to the articular cartilage in the rest of the knee. An additional concern here is that the knee could give way at a bad time, causing a fall or buckle leading to another injury. Be careful.
One of the most common operations in orthopaedics and sports medicine is surgery for a torn meniscus. I get a lot of questions about what this surgery involves, how long it takes to recover, and when it should be done.
While there are seemingly countless spinal surgical approaches and techniques, all spinal surgeries fall into one of two categories: decompression or stabilization. Decompression involves taking pressure off neurologic structures including the spinal cord and, more commonly, nerve roots to improve function and relieve pain. Stabilization involves restoring structure to one or more spinal segments, i.e. two adjacent vertebra and the intervening disc, by creating an environment for bone to grow from one vertebra to the next. This may be performed to treat gross instability from a traumatic fracture or chronic instability from a degenerative spondylolisthesis.
When I speak with a patient regarding knee replacement or hip replacement surgery, he/she often asks in detail about the post-surgical rehab. In my specialty of orthopaedics, rehabilitation is critical to the success of the surgery. However, one of the major risks, although uncommon, facing surgery patients is the formation of a blood clot within a deep vein. This complication is often overlooked, and can be fatal when symptoms are ignored.
I work with Chris Heck, MD an orthopaedic spine surgeon. We have developed an interest in treating osteoporosis, as a result of patients with have seen with broken bones.
As a hand and upper extremity Orthopaedic surgeon, I see many patients that present to my office with pain in their elbow and forearm. For a certain subsets of these patients, I ultimately diagnose them with lateral epicondylitis, or tennis elbow. Oftentimes, their reaction is the same. They say, “Doc, I don’t even play tennis, how could I have tennis elbow?!” Unfortunately, many people assume that lateral epicondylitis will only affect those individuals that are active in racquet sports, when in reality; tennis elbow can affect both men and women regardless of their hobbies.
The AAOS (American Academy of Orthopaedic Surgeons) has recently sponsored some remarkable multimedia public service campaigns. You may remember the recent “Decide to Drive” initiative about distracted driving /texting. Well, their newest is “Painkillers are easy to get into. Hard to escape.” Included in the AAOS statement, the U.S. Department of Health and Human Services reports on an average day in the U.S., more than 650,000 opioid prescriptions are dispensed and 78 people die from opioid-related overdose. It is considered an “epidemic.” We all have relatives, friends, and patients who have been caught up in and succumbed to the detrimental effects of drug addiction.
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