Orthopedic Treatment For Kneecap Instability

by Craig W. Goodhart, MD 26. October 2016 08:23

Kneecap or Patella, is one of the three bones that constitute the knee joint. When the knee bends and straightens, the kneecap smoothly slides up and down within a v-shaped groove at the end of the thigh bone. Sometimes, due to a fall or a blow, the patella can dislocate, either completely or partially.
When the patella slides out of place, it causes pain and loss of activity. It is necessary to seek medical attention, even if the patella slides back into position on its own.
Causes
There are several causes that result in kneecap instability. People having an abnormality in the knee, are more prone to kneecap instability. Some of the common causes of instability are:
The femur (thighbone) may be shallow or uneven, increasing the chances of dislocation.
 Loose ligaments make the joints extremely flexible, thus increasing the chances of patellar dislocation. Girls are more prone to this type of kneecap instability in caparison to boys.
Children with cerebral palsy and Down syndrome have weak muscles. This may cause their kneecaps to dislocate frequently due to imbalance.
In some rare cases, children can be born with unstable kneecaps that cause their kneecaps to dislocate at a very young age. This is usually painless.
Symptoms
Symptoms vary with the severity of the damage caused due to dislocation. Some of the common symptoms associated with kneecap dislocation are:
Shifting or sliding of the kneecap out of the grove
Sitting and simple activities cause pain
Patella usually dislocates with a popping sound
Swelling and/or stiffness
Deformity of the knee
Cracking sound on movement or while changing direction
Treatment
Non-surgical treatment
The first step in treating an unstable knee requires taking the child to the Emergency Room. The doctor may perform the ‘reduction’ treatment. This involves giving pain medication to the patient which helps relax the knee muscles. Then the doctor applies a gentle pressure to move the kneecap back into place. In some cases, reduction may occur naturally.
Wearing a brace. The doctor may recommend wearing a brace for about a month to help stabilize the knee, while it slowly heals.
Crutches. Putting weight on the knees can slow down the healing process and increase the pain in the knee. Thus, the doctor may suggest using crutches for a couple of weeks following the injury.
Once dislocated, the possibility of recurring instability of the kneecap increases. Regular exercise may help straighten the thigh muscles and reduces the risk.
Surgical treatment
In chronic cases, the patella may not stabilize with the help of non-surgical treatment. The doctor may recommend surgery to line up the kneecap into place and to tighten the loose tendons and knee muscles. The type of surgery depends on the extent of damage occurred.

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Shoulder Instability: Orthopedic Carrollton

by Craig W. Goodhart, MD 23. April 2016 10:37

The shoulder is one of the most mobile joints in the human body as it enables the movement of the arm in many directions. This extensive range of motion also makes it prone to dislocations and injuries. The shoulder joint comprises of the humerus (upper arm bone), scapula (shoulder blade) and the clavicle (collar bone). The humerus is rounded at the top and rests in a socket shaped cavity within the scapula.

Shoulder Instability or loose shoulder is a condition that occurs when the upper part of the humerus slips out of the socket in the shoulder joint. It is termed as partial dislocation or subluxation if the humerus is partially displaced and total displacement if it slips out completely. Patients with Shoulder Instability, are more likely to suffer from repeated injuries and joint dislocation.

Causes

  • Shallow or flattened socket
  • Muscle weakness
  • Stretching and consequent loosening of ligaments
  • Prolonged immobilization of the joint
  • Sudden trauma or injury to the shoulder or arm
  • Bankart Lesion- tearing of the cartilage that lines the socket
  • Repeated overhead movements such as in swimming or tennis
  • Inherent anatomical disorders
  • Impaired neuromuscular control
  • Lifting a heavy weight or an awkward position while moving the arm

Symptoms

  • Pain
  • Weakness and instability in the arm and shoulder
  • Numbness
  • Swelling
  • Repeated instances of the shoulder giving away
  • Tenderness in the shoulder when touched
  • Inability to lift things or move the arm away from the body
  • Discomfort while sleeping on the affected shoulder

Diagnosis

  • Evaluation of the patient’s medical history and daily activities
  • Physical examination of the dislocated shoulder
  • X-ray imaging
  • MRI scan may be done to evaluate the condition of muscles, ligaments, tendons and nerves

Treatment

  • Activities that may aggravate pain or discomfort should be avoided
  • Heat or ice packs may be used to reduce swelling and pain
  • Prescription of anti-inflammatory drugs and painkillers to provide relief from the symptoms
  • Torn or loose ligaments may be surgically stitched back to enhance stability
  • The shoulder and arm may be immobilized for a specific period of time post-surgery to aid healing
  • Range of motion exercises may be recommended by a physical therapist to regain strength and restore movement in the joint.

Dr. Goodhart, a leading orthopedic surgeon in Carrolton, TX, provides effective treatment for Shoulder Instability and other medical conditions. To schedule an appointment, you can call at (972) 492 – 1334.

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Osgood-Schlatter Disease: Causes, Symptoms And Treatment

by Craig W. Goodhart, MD 23. November 2015 13:16

Osgood-Schlatter Disease involves inflammation of the lower front of knee, where the patellar tendon attaches to the shinbone. The medical condition often occurs during growth spurts when the bones, tendons, cartilages are developing rapidly. People who participate in activities that involve a lot of running, jumping and swift changes in direction are more susceptible suffering from this condition. Boys have more probability of being affected by Osgood-Schlatter Disease as they actively participate in sports.

Causes:

Quadriceps muscle is used in contraction and relaxation of the knee muscles. Overusing these muscles puts strain on the patellar ligament which is attached to the shin bone. This results in pulling of the tibia (shin bone) and formation of a bony bump, leading to Osgood-Schlatter Disease. It may also be caused by trauma or injury to the knee.

Symptoms:

  • Knee pain
  • Tenderness
  • Tight muscles in the front or back of the thigh
  • Swelling

Diagnosis:

An orthopedic doctor may physically examine the knee for the symptoms and inquire the patient about his medical history. He may apply pressure to the tibial tubercle and check for tenderness. He may also ask the patient to move the knee to see if it causes pain. Imaging tests such as X-rays, MRI or CT scan may be conducted to determine severity of the knee injury. Ultrasound may also need to be conducted in some conditions.

Treatment:

  • Medication: An orthopedic doctor may prescribe anti-inflammatory medications to reduce swelling and pain. 
  • Rest: Rest should be provided to the affected area to speed up the healing process. Avoiding strenuous activities such as running, jumping etc. may be suggested by the doctor.
  • Exercise: Exercises, as recommended by a physical therapist, may improve flexibility and strength of quadriceps as well as hamstring muscles.
  • Supportive devices: Wearing a cast or brace may be advised by the physician to provide support to the knee and reduce discomfort.
  • Ice pack: Ice pack can be applied below the kneecap to reduce pain and swelling. Heat therapy may also be beneficial in providing relaxation to the stiff muscles.

Surgery may be needed if there is no improvement from non-surgical methods.

Prevention:

  • Stretching exercises should be done before performing any strenuous activity in order to avoid stressing the joint.
  • Wearing protective equipment, such as knee pads, while playing football, basketball, baseball etc. can prevent injury.

For treatment of Osgood-Schlatter Disease and other knee conditions, visit Dr. Goodhart in Carrollton, TX. To schedule an appointment with the orthopedic sports surgeon, you can call at (972) 492 – 1334.

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Rotator Cuff Injury: Orthopedic Treatment In Carrollton

by Craig W. Goodhart, MD 26. October 2015 15:05

The rotator cuff comprises of four muscles: supraspinatus, infraspinatus, subscapularis and teres minor that surround the shoulder joint. These muscles help in stabilizing the shoulder joint. Damage to any or all of these muscles and the ligaments can limit the movement of the joint and can lead to rotator cuff injury. There may be a partial or a complete ligament tear depending on the severity of the condition.

Causes:

  • Major injury to the shoulder
  • Degeneration of the tendon tissue
  • Heavy lifting over a long period of time
  • Development of bone spurs in the bones around the shoulder
  • Playing sports that require repetitive arm movements such as baseball and tennis
  • Occupations such as house painting and carpentry
  • Genetic factors

Symptoms:

  • Dull ache that penetrates the shoulder
  • Limited shoulder movement
  • Inability to reach behind your back
  • Difficulty in combing hair
  • Pain when lying on the side of the affected shoulder

Diagnosis:

Physical examination is done to locate the exact areas of swelling and pain. X-Rays are conducted to see if there are any broken bones or if you suffer from Arthritis within the shoulder joint. Advanced imaging tests such as MRI scan, arthrography or ultrasonography may also be conducted depending on the severity of the condition.

Treatment:

Persistent pain in the shoulder cuff needs to be immediately examined by a shoulder specialist. Following treatment options could be utilized:

  • Application of ice packs may help in reducing swelling. Rest is recommended along with administration of anti-inflammatory medications as it may help in eliminating pain.
  • Physical therapy: Gradual rehabilitation is enhanced by exercises that help in strengthening the rotator cuff. These may also help in providing flexibility to the shoulder joint.
  • Injection: Cortisone injections are given in case a patient suffers constant pain and extremely limited shoulder motion.
  • Surgery: Surgical intervention is required in case of severe injuries. Open surgery and arthroscopy are two available options.

For diagnosis and treatment of rotator cuff injuries, consult Dr. Goodhart. To schedule an appointment with the orthopedic sports surgeon in Carrollton, TX, you can call at (972) 899-4679 or visit 4780 North Josey Lane, Carrollton, Texas 75010.

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Sports Related Knee Injuries

by Craig W. Goodhart, MD 16. September 2015 07:31

The knee is the largest joint and supports the entire weight of the body. It is responsible for all movements such as walking, jogging, running etc. which makes it quite susceptible to injuries. Knee injuries are common while playing sports and can be caused due to a fall, direct blow, injury or overuse.

The common sports related knee injuries are:

  • Sprains/ Strains: A strain is caused due to the stretching or tearing of the muscle tissues in the knee. A sprain occurs when the ligaments in the knee are stretched, twisted or torn. Both the conditions may cause inflammation, tenderness, bruising and pain in the knee. Sprains and strains are usually caused due to running, jumping, falls, slips and twists.
  • Runner’s Knee: The condition, also known as Patellofemoral Pain Syndrome, is caused due to overuse of the knee. The condition is common among runners and weight lighters. Direct blow, incorrect landing from a jump, Flat Feet, weak muscles and misaligned bones may lead to this condition. Runner’s Knee causes pain behind the knee which increases while walking or running.
  • Iliotibial Band Syndrome (ITBS): This overuse injury causes a sharp pain at the outer part of the knee. The condition is caused due to swelling in the Iliotibial band leading to pain and restricted range of motion of the knee joint). Runners, athletes or people who need to squat frequently are prone to the condition.
  • Cartilage damage: Cartilage is a flexible and tough tissue that acts as a shock absorber to the knee. Injury to the cartilage can cause swelling, pain, stiffness and reduced range of motion. This occurs due to sudden fall, injury or direct blow to the knee joint.
  • Patellar Tendonitis: Also known as Jumper’s Knee, this condition is caused due to injury to the tissues that join the kneecap and shinbone. Repetitive jumping, landing or twisting in sports such as basketball, gymnastics and football can lead to Patellar Tendonitis.
  • Ligament Injuries: The knee is formed of four ligaments namely medial collateral ligament (MCL), lateral collateral ligament (LCL) anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). These ligaments can be partially or fully injured due to incorrect landing, direct blow, accident or extending the knee beyond its range of motion.
  • Bursitis: This condition is characterized by the inflammation of the bursa, a fluid filled sac that provides cushioning to the knee bones. Athletes involved in sports such as football, wrestling, or basketball are prone to the condition due to the increased probability of falls or direct blows to the knee.

You can consult Dr. Goodhart for comprehensive diagnosis and treatment of knee injuries. To schedule an appointment with the orthopedic sports surgeon in Flower Mound, you can call at (972) 899-4679.

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Knee Pain Prevention: Orthopedic Carrollton, TX

by Craig W. Goodhart, MD 19. August 2015 11:07

The knee is the largest and one of the most important joints in the body. It also consists of several ligaments and tendons that hold the bones together in place. Since the joint bears the entire body weight, it is quite prone to wear and tear. When any of the joint structures get affected due to an injury or medical condition, it may lead to knee pain. The condition can cause severe discomfort while walking, bending or running.

Here are some useful tips that can help to prevent knee pain:

  • Maintain Weight- With each step you take, two or four times your body weight is transmitted through the knee joint. Thus, the more you weigh, the harder is the impact on your knees. Keeping one’s weight under control can help avoid knee pain in the long run as there is less stress on the joint.
  • Wear Proper Footwear- Wearing proper fitted (and comfortable) shoes can help to maintain body balance and proper alignment of the legs. This will ultimately prevent knee pain.
  • Warm Up- Before starting any exercise, it is important to warm up properly. Stretching of the outer and inner thigh muscles will put less pressure on the knee joint while doing strenuous exercises like tread mill, cycling, skipping etc. Also, a sudden shift to a high impact exercise can cause trouble in the knee. Hence, one must gradually move towards intense workouts starting from low impact ones.
  • Exercise Properly And Regularly- Keeping yourself physically active can help to maintain the strength and endurance of the knee joint. Swimming, walking and climbing the stairs can help in this regard. Giving up on exercise may cause the joint to become weak and result in pain. You must avoid sedentary lifestyle and keep the knee joints moving.
  • Proper Diet- Dietary changes can also help in keeping muscles and ligaments fit as nutrition is important for healthy living. For instance, including Omega-3 rich food like fish, Green vegetables and proteins can help to strengthen muscles and improve the general well-being of musculoskeletal system.
  • Posture- Maintaining a correct posture is also essential in putting pressure off the knees. You should keep your back straight while walking, avoid sitting for long spells of time and keep your feet planted on the floor. You should also walk steady so that the weight is distributed evenly through the knee joint.

If you are suffering from knee pain, visit Dr. Goodhart for proper treatment. To schedule an appointment with the orthopedic surgeon in Carrollton, TX, you can call at (972) 492 – 1334.

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Tips To Prevent Knee Injury

by Craig W. Goodhart, MD 23. July 2015 06:38

A knee injury can occur due to severe impact, hard fall, excessive workout, repetitive movements or poor posture. Knee injuries are common among athletes due to tough training routines and regular intense workouts. It is crucial to remain cautious and adopt the right techniques to avoid undue stress on the knees.

Here are some tips to prevent knee injury:

  • Warm up before working out: If you are going for an intense workout or physical activity, make sure you warm up and cool down properly after the session. This will raise the body temperature and prepare you for the workout. Warming up makes the muscles more flexible and increases the oxygen supply to the tissues, thus reducing the chances of a sprain and other knee injuries.
  • Do not increase the miles abruptly: To avoid overuse injuries while running, you should limit the increase in mileage to 10 percent of the previous week. Increasing the number of miles covered too quickly puts the muscles under strain and leads to injuries. 
  • Run on even surface: Often knee injuries occur when you run or walk on an uneven surface, which puts undue stress on ligaments. Rough terrain can lead to ankle sprain or strains, so it is important to be extra cautious on these trails.
  • Stay in the right form: You must use correct exercising and running techniques. It is also crucial to work on your posture to prevent any knee injuries.
  • Replace your sports shoes regularly: Wearing ill-fitted and worn out shoes can also lead to knee injuries due to wrong placement of weight on the foot. You must replace your shoes after certain period and choose shoes that offer the right support to your feet.
  • Go for strength training: You should strengthen your muscles, tendons, bones and ligaments with the help of weight lifting, which increases structural fitness. You must also ensure that you use the right equipment according to your individual strength and comfort.
  • Avoid overtraining: Often, athletes tend to over-train their muscles and tendons, which makes them susceptible to overuse injuries. It is essential to take regular breaks to avoid knee injury.
  • Healthy weight: You must maintain the right body weight as being obese puts undue pressure on the knees and leads to injuries.

In order to keep your knees healthy and avoid knee injuries, make sure you do strengthening and stretching exercises in routine.

For more tips, consult Dr. Goodhart at OrthoTexas, Flower Mound. To schedule an appointmnet with the orthopedic sports surgeon, call at (972) 899-4679 or visit 4951 Long Praire Rd, Ste 100, Flower Mound, Texas 75028.

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ACL Tear: Orthopedic Treatment In Carrollton, TX

by Craig W. Goodhart, MD 18. June 2015 04:29

ACL, Anterior Cruciate Ligament, is a tough ligament located in the center of the knee joint. It runs diagonally in the center of the knee and provides it rotational stability. The femur, the patella and the tibia meet at the knee joint and the ACL controls the movement of tibia under the femur. An ACL tear occurs due to over stretching or straightening of the knee beyond its normal limits. Sportspersons playing football and basketball are prone to suffer from an ACL tear.

Causes

  • Sudden slowing down while running
  • Stopping abruptly
  • Changing directions suddenly
  • Collision
  • Landing incorrectly after a jump
  • Twisting or hyper extending the knee
  • Falls from height

Symptoms

  • Intense pain
  • Tenderness
  • Swelling
  • Popping sound
  • Loss of full range of motion
  • Inability to walk
  • Knee gives way or feels instable

Diagnosis

If you experience the above stated symptoms, you should immediately consult an orthopedic doctor. He may ask you questions related to your medical history and how the injury occured. A thorough physical examination assists the doctor in diagnosing ACL tear and prescribe a line of treatment. The physician may also recommend imaging tests such as X-ray, MRI scan, CT Scan to rule out any fracture in the knee.

Treatment

The physician often recommends surgery to young athletes who are involved in high demand sports so that they can recover quickly. However, elderly patients and those who live a quieter lifestyle are recommended non-surgical treatment options.

Non-surgical treatment

  • Rest: The patient can be advised to take rest to reduce pain.
  • Physical therapy: Exercises and physical therapy can assist in healing and promoting flexibility in the joint.
  • Bracing: The non-surgical ACL treatment includes bracing, which provides stability to the knee.
  • Crutches: The patient may be advised to use crutches to avoid putting weight on the knee.
  • Surgical treatment: In case of severe damage, the ligaments are rebuilt to repair the ACL and restore knee stability. The orthopedic surgeon reconstructs the torn ligament with a tissue graft. This minimal invasive surgery is performed with the help of Arthroscope. The doctor may advise physical therapy and the patient may be recommended to follow a proper rehabilitation program to recover from the surgery.

After undergoing ACL tear treatment, the patient may need to undergo professional physiotherapy to get back to your normal routine and regain motion. Proper stretching and strengthening exercises advised by the physiotherapist helps to regain strength and movement in the joint.

For diagnosis and treatment of ACL Tear, consult Dr. Goodhart in Carrollton, TX. To schedule an appointment with the orthopedic surgeon, you can call at (972) 492-1334 or visit 4780 North Josey Lane, Carrollton, Texas 75010.

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Orthopedic Treatment For Knee Pain

by Craig W. Goodhart, MD 20. May 2015 05:30

Knee is the largest joint in the human body and is susceptible to pain due to injuries, wear and tear or overuse. Knee pain is a common problem that can be a result of injury to any of the structures comprising the knee joint, the kneecap or the ligaments and cartilage of the knee. Knee pain can range from mild pain to severe discomfort and can occur at any age. It can be localized or diffused all over the knee and an orthopedic doctor should be consulted for proper diagnosis and treatment.

Causes:

  • Age
  • Sprains
  • Strains
  • Muscle Overuse
  • Excess Body Weight
  • Knee Fracture
  • Tear in the Meniscus
  • Ligament Tear such as ACL and MCL
  • Kneecap dislocation
  • Knee joint dislocation
  • Bursitis
  • Osteoarthritis
  • Tendinitis
  • Iliotibial Band Syndrome

Symptoms

  • Redness
  • Inflammation
  • Discomfort
  • Limping
  • Weakness
  • Instability
  • Swelling
  • Stiffness
  • Inability to straighten the knee

Diagnosis

The orthopedic surgeon may physically examine the knee to determine the extent of the injury and pain. He can recommend certain imaging tests like X-ray and MRI to rule out the possibility of a fracture. The doctor may also ask details about the nature of any injury and previous medical history. The orthopedic surgeon devises a treatment plan considering the level of injury and pain, age and activity level of the patient.

Prevention

There are certain measures that can help in the prevention of knee pain:

  • Maintain proper weight
  • Exercise regularly and stay active
  • Wear knee guards during sports
  • Maintain proper posture
  • Avoid over exertion of the knees

Treatment

  • Rest: Having proper rest assists in getting relief from knee pain.
  • Ice Packs: The orthopedic surgeon can recommend using ice packs or the R.I.C.E therapy.
  • Medication: The orthopedic doctor may prescribe anti-inflammatory medication to reduce pain and swelling.
  • Braces: The orthopedic surgeon may prescribe using braces to offer support to the knee.
  • Physical therapy: The orthopedic surgeon can recommend physiotherapy to promote flexibility and strength of the joint.
  • Assistance: If the pain is causing difficulty in movement the doctor may recommend using a cane or assistance while walking and performing basic daily activities.
  • Surgery: If non-surgical methods do not provide relief, the orthopedic surgeon can recommend surgery. This is followed by rehabilitation and post-surgical care, which must be followed as prescribed by the surgeon.

In case of knee pain you must visit an orthopedic surgeon for proper diagnosis and treatment of the condition.

For comprehensive diagnosis and treatment of knee pain, you can consult Dr. Goodhart in Flower Mound, TX. To schedule an appointment with the orthopedic surgeon, you can call at (972) 899 – 4679.

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Knee Ligament Injury: Orthopedic Carrollton

by Craig W. Goodhart, MD 16. April 2015 10:40

Knee injuries are common among athletes and sports persons who put lot of pressure on the knees. Most of the sports related knee injuries occur due to tearing of Anterior Cruciate Ligament or ACL, which is a painful and debilitating situation.
Knee has a number of muscles, tendons, and ligaments to keep it together and working. Ligaments are tough bands of tissue, which connect the bones and are susceptible to injuries. Two major ligaments in the knee are more prone to injuries and these include Anterior Cruciate Ligament (ACL) and the Posterior Cruciate Ligament (PCL). These ligaments connect the thighbone with the lower leg bone. Stretching and snapping of these ligaments due to huge pressure often leads to knee ligament injury.

Causes of Knee Ligament injuries

  • Landing on the bent knees while jumping or due to other reasons such as falling from height
  • Twisting of knee
  • Stopping suddenly while running
  • Getting hit on the knee
  • Extending the knee too far
  • Suddenly shifting weight from one leg to another

Symptoms

The most common symptoms of Knee Ligament injury include

  • Sudden and severe pain
  • Restricted movement of knee
  • Popping sound during injury
  • Feeling of looseness
  • Inability to put weight on the knee
  • Swelling
  • Knee giving out when you twist

Diagnosis

When you visit orthopedic doctor with the above-mentioned symptoms he may physically examine the knee and recommends some imaging tests to confirm a Knee Ligament injury. These tests can include X-ray, MRI, and CT Scan, etc.

Treatment

You may not require any surgery if the Knee Ligament injury is mild. In such cases the orthopedic surgeon often refers the patients to physiotherapists who help in speeding the healing process. The Knee Ligament injury is often treated with R.I.C.E treatment, which includes rest, ice packs, compression, and elevation techniques. This helps in reducing swelling along with anti-inflammatory medications prescribed by the doctor. You may also need to keep your knees elevated and wear braces to promote healing and to avoid putting weight on the joint.

However, if the ligament tear is too severe, you may need surgery to attach the ligament. Repairing a completely damaged ligament involves reconstruction. The process involves taking tendons from other parts of the leg to replace the torn ligament. The surgeon reserves surgery for extreme cases when non-surgical techniques didn’t provide relief.

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