FAQs

The posterior cruciate ligament (PCL) is one of two ligaments that criss-cross inside the knee joint to hold the two leg bones (femur and tibia) together. The second (more commonly injured) ligament is the anterior cruciate ligament (ACL). These two ligaments provide stability to the knee joint while still allowing motion.There is interest in knowing if non-surgical treatment has a higher rate of osteoarthritis later in life. A second question is whether surgery to reconstruct the PCL yields bet...

It is estimated that one-quarter of a million ACL injuries occur each year in the United States. As you know, players can be sidelined for months (sometimes longer). This is a concern to many people at all levels from high school to professional sports.Preventing ACL injuries not only protects people from pain and suffering, it can also protect the pocketbook for the individual and for society. The fact is that many of these injuries are accompanied by damage to the surrounding tissues as well. ...

Is it possible to rehab a PCL injury and still remain active? I like to golf, play tennis, and even pickup a game of basketball now and then. The posterior cruciate ligament (PCL) is one of two ligaments that criss-cross inside the knee joint to hold the two leg bones (femur and tibia) together. The second (more commonly injured) ligament is the anterior cruciate ligament (ACL). These two ligaments provide stability to the knee joint while still allowing motion.Results of nonoperative treatment...

Can you please explain to me the main reasons why people who have ACL reconstruction surgery end up rupturing the new ligament and having to start all over again? Up to 10 per cent of all patients who have a primary (first) reconstruction of the anterior cruciate ligament (ACL) will experience a failed result. This could mean the graft failed/re-ruptured or it could mean the knee joint remained unstable after the reconstructive surgery.Experts from the Mayo Clinic in Rochester, Minnesota sugges...

What kind of rehab program should I expect to follow after reconstruction surgery for a chronically dislocating kneecap? I'm prepared for just about anything but thought I'd ask around a bit to see what the standard programs might be. Your postoperative rehabilitation program will be highly dependent on the surgical technique used to reconstruct the soft tissue structures. The patella or kneecap is a very complex structure. Anatomists are still exploring and learning how the patellar tracking me...

We allowed my aging father to have a knee replacement. He's diabetic and overweight so we weren't sure this was such a good idea. Then he got an infection in the joint and the new knee implant had to be removed. Afterwards, we were told that men do have a higher rate of infection after knee replacements . We also found out that diabetics have more problems like this. What's your take on all this? Researchers at the very large and very well-known Kaiser Permanente health care system in California...

Do you think exercising in a pool for my knee arthritis is really worth all the mess and fuss of getting wet, having to shower, and redo my hair and makeup? It seems easier to just walk on the treadmill but my knees do hurt afterwards. Many studies show the benefit of exercise for people with knee osteoarthritis. But pounding the pavement (or treadmill) can increase pain as you have noticed. Aquatic therapy in a pool of warm, supportive water is one way to get the needed exercise without the add...

The health club I go to has several different pools to choose from. I like going in the water because it makes my arthritic knees feel better. They have a pool with a treadmill in it that I could use. Is that easier or harder than walking on the bottom of the pool? Good for you to include regular exercise in your week! There are many studies that have shown the value of exercise for people with knee osteoarthritis. Pounding the pavement (walking outside the pool) can increase pain. Aquatic ther...

My doctor told me after my total knee replacement, I won't need any special therapy or rehab. My sister who lives in a different state told me she had a special exercise program they called "functional." She says the reason she is doing so well is because they pushed her not to be afraid to move. Do I need that program too? Each surgeon has his or her own post-operative "protocol" (way of doing things) after a total knee replacement. Physiotherapy is an important part of the immediate post-opera...

I'm young and healthy but I have a bad knee. Dinged it up playing handball. Got a big hole in the cartilage that goes down to the bone. Too young for a knee replacement. Looking into these new treatments with Matrix cartilage transplantation. What does this do? How does it work? Does it work? What can you tell me? When you say "matrix cartilage" treatment, we assume you are referring to matrix-assisted autologous chondrocyte transplantation (MACT). There are three goals in mind when using this p...

I had ACL surgery two weeks ago. The physiotherapist was there right after the operation getting me up and going. The next day, she set me up on a home program and I go see her 3 times a week. It seems like a lot of work. Is this kind of rehab really necessary? Won't the knee just heal and get better on its own? There are many different ways to approach the rehabilitation of ACL injuries. Sometimes it is possible to complete a conservative plan of exercise without surgery. This approach is most ...

I'm 21 years old. I've been active all my life. Lately I've been noticing that my left knee cap slides off to the side and then pops back. I never know when it's going to happen. I did fall while hiking last summer. Could this be the cause of the problem? It is possible that you have injured some of the soft tissues around the patella (knee cap). A little bit of anatomy will help explain this injury. The patella moves up and down in front of the knee joint along a built-in track called the pate...

How Well Does Arthroscopic Surgery Work for Knee Osteoarthritis? Degenerative knee osteoarthritis (OA) can be treated with physiotherapy, medications, or surgery when appropriate. The focus of this study was the effectiveness of arthroscopic surgery for knee OA. The specific procedure studied is called debridement.The surgeon shaves away any uneven areas of the joint surface and smoothes any jagged edges in the cartilage. If there are any loose fragments in the joint, these are removed as well. ...

I saw a report on a health show that showed how many people who have an ACL tear also have bone bruising. Why is that such a big deal and how do I know if I had it? Bone contusion or bruising may be an indication of the severity of the injury. It can be viewed on MRI as edema or swelling inside the bone where the bone marrow is located.Bone contusion has long been suspected as part of knee injuries severe enough to rupture the anterior cruciate ligament (ACL). And recently, a study from South K...

Our 16-year-old daughter was just diagnosed with patellofemoral pain syndrome. What can you tell us about this? Was she born with it? Or is she doing something wrong in her exercise routines that have brought this on? Athletes aren't the only ones to develop knee pain from a condition called patellofemoral pain syndrome (PFPS). Many people of all ages in the general public develop this problem, too. It sounds like your daughter has joined in as well!The patella, or kneecap, can be a source of kn...

I had a meniscus that was repaired arthroscopically five years ago. I'm just checking to see how long they think this repair job will last me. Different studies report success rates that vary from 70 to 90 per cent. How do they tell whether the meniscus is holding up or not? There are three ways to measure long-term success or results from meniscal repairs. First is the patient's own report. Is the knee stiff or painful? Can you move the knee joint through its full motions?Are there any activiti...

I tweaked my MCL playing soccer twice so I went to see a Doctor and was told it would heal on its own and to give it some time. Is really the best advice. Should I wear a brace? Will I need surgery? The MCL or medial collateral ligament is located in the knee on the side closest to the other knee. It helps stabilize the knee joint and prevent injury when force is directed through that side of the knee. An isolated injury to this ligament could very well heal with rest and activity modification.N...

How does the strap work that athletes wear around their knees? I'm not an athlete but my knees hurt and I'm wondering if something like this would help me.

I keep dislocating my left kneecap. I've tried exercise, taping, yoga, and kinesiotherapy but nothing keeps it from popping out. What's next? You may be a good candidate for surgery but it's best to see an orthopedic surgeon for an evaluation before going down that road. A review of your history, injury, time since the injury, conservative efforts tried, and length of time carrying out conservative care are all important factors in the success (or failure) of nonoperative care.Studies show that ...

I had my ACL repaired two years ago and just reinjured it again. My surgeon wants me to try physiotherapy for a few months. If that doesn't work, I can have surgery again. Can they repair this a second time? Revision surgery for failed anterior cruciate ligament (ACL) rupture is uncommon but sometimes a necessary procedure. The surgeon confirms there is ACL deficiency with clinical testing and (if necessary) arthroscopic examination.Physiotherapy can be helpful to correct any postural issues rel...

I have a torn meniscus in my knee confirmed by MRI. Can I avoid surgery and just do some kind of knee exercises until it heals on its own? There's a lot of confusion right now about the best treatment for tears of the knee meniscus. For sure, we know that removing this C-shaped cartilage in the knee is a bad idea. That just leads to degeneration of the joint and painful arthritis. Repairing the damage and letting the body heal has proven to be a much better alternative.But even with a partial me...

I was with my elderly aunt when she tore her knee meniscus. She was just crossing the street with me and pop goes the weasel! The doctor says these things can happen just like that but there must be a reason. Do you know what is really going on? It might help you understand what is happening if we review the anatomy of the meniscus (menisci for more than one). In each knee, the menisci sit between the femur (upper leg bone) and the tibia (lower leg bone). These structures are sometimes referred ...

I'm the only one in a family of eight children who has a knee problem called patellofemoral pain syndrome. We are all involved in sports of some kind. What am I doing wrong that I have this problem but no one else in the family does? Patellofemoral Syndrome (PFS) is a condition that causes pain in and around the patella (knee cap). In the normal, healthy adult, the patella moves smoothly up and down over a groove on the femur (thigh bone) as the knee bends and straightens. PFS can develop when t...

If I lost weight, would it have any effect on my knee pain? I've been told I have something called patellofemoral pain syndrome. I'm 16 years old and probably 65 pounds over weight. Patellofemoral Syndrome (PFS) is a condition that causes pain in and around the patella (knee cap). In the normal, healthy adult, the patella moves smoothly up and down over a groove on the femur (thigh bone) as the knee bends and straightens. PFS can develop when the patella is not moving or tracking properly over t...

Mother complains about her aching arthritic knees. We can even hear them creaking when she stands up. Her doctor keeps telling her to stay active and exercise. But how can she when she hurts so much? People with knee osteoarthritis are encouraged to maintain an active lifestyle and to exercise those arthritic knees. But as you point out, that seems counter intuitive -- if your knees hurt, why would you move and exercise them more? But study after study confirms that this is good advice. For exam...

My 16 year old son is a long-distance runner. He started having a lot of knee pain and his doctor said it was Runners Knee and prescribed rest. What is it and is there anything else he can do for it? Runner's knee, or chondromalacia patellae, can be caused by several things. In young people, it's most often caused by overuse, such as running. It can also be caused by injury, misalignment of the kneecap or arthritis.The standard treatment for this problem is rest and limited activity. Nonsteroid...

Q: My 18-year-old son is in need of an ACL reconstruction. The surgeon laid out all of the different choices -- hamstring tendon graft, patellar tendon graft and choosing from using his own tissue or going with a donor bank. What's best in regards to quick recovery and returning to sport? Anterior cruciate ligament (ACL) reconstructions are one of the most commonly performed surgical procedures among young athletes today. Rehab is often advised first in order to save the athlete from having su...

Our 14-year-old daughter was involved in figure skating. She ended up with an ACL tear that required surgery. Despite our concerns, she went back to practice before she was done with the rehab program. Now the surgeon says the knee is too loose. Is that just a coincidence, or could it be because she disregarded all advice to wait on returning to the ice? The number of athletes who injure their knees and need anterior cruciate ligament (ACL) repair or reconstruction is on the rise. Every year, al...

I need a little advice. I'm 42-years-old and I tore my ACL skiing. I'm pretty much ready to hang it up anyway, so I'm wondering if I really need to do all the exercises the therapist has given me. I just don't want to work that hard but I'm a little embarrassed to say so. You are not alone in this dilemma. Rehabilitation after ACL injuries is often a lengthy process with therapy two to three times a week for several months and a home program for much longer than that. Studies show that athletes ...

What's the latest on taking glucosamine for knee arthritis? One health magazine says, Take it, an article in today's newspaper says, Don't bother. Which is it? Despite all the media hype around taking glucosamine and/or chondroitin, guidelines for the nonoperative treatment of knee osteoarthritis from the American Academy of Orthopaedic Surgeons (AAOS) do NOT support the use of these supplements. There simply isn't enough evidence to show any clinical benefit of these supplements for individuals...

I am a 13 year old girl with knee pain that only goes away when I sit and do nothing. The doctor says I have osteochondritis dissecans. I looked this up on-line and found out it's from an injury or repetitive sports activity. I'm not a sports freak, ballerina, gymnast, or athlete of any kind. So why do I have this problem? Osteochondritis dissecans (OCD) is a problem that affects the knee, mostly at the end of the big bone of the thigh (the femur). The problem occurs where the cartilage of the k...

I'm not a super athlete but I do like to compete in several areas such as soccer, cross country, and tennis. I notice whenever it's soccer season, I seem to have the most problem with my patellar tendon. I keep tweaking it and it never heals all season long. This doesn't happen with any of the other sports I engage in. Can you help me figure out what I'm doing wrong?

My knees seem to be kinda wobbly. I never know when they are going to go out from underneath me. Are there some exercises I can do to get them back in shape? Quite frankly, I'm worried about taking a fall.

Mother seems to be awfully stiff in the mornings. Once we get her up and moving, she seems to do much better. She does have some knee pain, but it's the stiffness that really holds her back. What can be done about this -- anything?