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 the condition. 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

  • 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 exercises 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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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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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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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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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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Adhesive Capsulitis

by Craig W. Goodhart, MD 13. February 2015 16:14

One most painful conditions experienced in the shoulder is adhesive capsulitis.  This is defined as pain and loss of motion in the shoulder, which occurs for no reason. It usually is a result of inflammation and contracture of the shoulder resulting in pain. It is oftentimes associated with diabetes, thyroid disorders, previous surgery (long and rest), prolonged immobilization and extended hospitalization.

Symptoms of adhesive capsulitis are the slow onset of pain and stiffness. There is pain within the range of motion of the shoulder specifically with internal and external rotation.

A physician following a thorough physical examination and radiographs taken of the shoulder makes the diagnosis of adhesive capsulitis. An MRI is performed to rule out other possibilities causing the capsulitis.

The treatment for adhesive capsulitis is generally non-operative. It begins with a gentle structured program of physical therapy working towards a pain-free range of motion. NSAIDs, physical therapy, and intra-articular injections are oftentimes helpful in the early treatment of adhesive capsulitis. The majority of patients will improve over time though it may take many months before pain resolves and range of motion returns to normal.

The operative treatment for adhesive capsulitis occurs only after 3-6 months of supervised medical care. Various forms of treatment are available. Most commonly an arthroscopic surgical release is performed and in some cases a simple manipulation under anesthesia. All surgery has risks and as a result this should be the last option in the treatment of the shoulder pain.

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Runner's Knee: Orthopedic Treatment In Carrollton, TX

by Craig W. Goodhart, MD 19. January 2015 07:18

Runner’s knee causes pain in the knee, particularly around the kneecap, which is called Patella. The condition is common among runners due to the high activity.

Causes:

  • Repetitive bending of the knee
  • Injury to the knee caused by a fall or blow on the knee
  • Flat feet are also known to cause Runner’s Knee
  • Lack of physical activity that strengthen the legs, knees and thigh muscles
  • Lack of warm-up before exercising
  • Misalignment of kneecap
  • Arthritis
  • Excess of physical activity

Symptoms:

  • Pain while walking, kneeling, running, standing or bending your knees
  • Swelling, redness and itchiness on the knee
  • Pain that worsens when you are walking, running or climbing
  • Inability to stretch your leg
  • Feeling of tightness or imbalance in calf muscles or knee

Prevention:

Following a healthy lifestyle can prevent runner’s knee. You may need to lose weight in order to prevent any severe injury in the event of a fall. Wearing a proper running gear while running or performing sports will prevent injury to your knee.

Diagnosis:

The knee doctor will perform a physical examination in order to determine the severity of the condition. He can prescribe certain tests like X-ray or magnetic resonance imaging (MRI), blood samples or computed tomography (CT) to diagnose the runner’s knee. The doctor also questions the patient’s medical history to confirm the condition.

Treatment:

If Runner’s Knee is not severe, it can be treated with the help of non-surgical methods. However if it is causing an acute pain or is disrupting daily activities, the doctor may advise you surgery to get rid of any deformity.

Non-Surgical treatment:

  • Applying ice wrapped carefully in a towel at the affected area, several times a day, can offer relief.
  • Keeping your knee elevated by keeping a pillow below it and taking proper rest will reduce inflammation and reduce pain.
  • Avoid exercising and physically straining yourself.
  • You should take proper rest and should avoid exerting pressure on the knee.
  • The doctor may also prescribe anti-inflammatory medicines to reduce pain.
  • Follow an exercise program that your doctor prescribes you.
  • The doctor may also recommend putting an elastic bandage around your knee to prevent swelling.

Surgical treatment:

In case relief is not sought though non-surgical methods, the orthopedic doctor may advise you to undergo surgery in order to restructure the misalignment of the kneecap. During the surgery, the doctor will realign the kneecap or he may remove parts of damaged kneecap cartilage with the help of an incision.

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Kneecap Dislocation: Causes, Symptoms & Treatment

by Craig W. Goodhart, MD 20. November 2014 09:42

A knee dislocation is an orthopedic condition that involves dislocation of the bones of the knee due to a sudden impact. The bones of the knee are joined with a strong band of ligaments that stabilize the knee in a position. When these ligaments tear, they fail to hold the knee in position and cause dislocation. Often injuries lead to disruption of kneecap and its ligaments, and the condition needs to be treated immediately to avoid adverse consequences.

Causes

  • High speed injuries
  • Sports
  • Major traumas
  • Falling from height
  • Motor accidents
  • Sudden change in the direction
  • Twisting of knee
  • Direct blow to knee

Symptoms

  • Pain
  • Acute swelling
  • Inflammation
  • Lack of sensation below the knee
  • Accumulation of fluid in the knee
  • Inability to move
  • Pain while movement
  • Deformity in leg
  • Discoloration at the site of ligament injury
  • Sense of instability

The patient should keep the knee outstretched and still while he gets medical attention. With a kneecap dislocation one should immediately consult an orthopedic doctor.

Diagnosis

The orthopedic doctor examines the kneecap and asks the patients questions to find out the cause of the injury or dislocation of the kneecap. He also recommends X-ray, MRI, or other imaging tests to find out the exact condition of the kneecap. X-ray shows the dislocation clearly and helps the physician decide how the kneecap can be manipulated to place it in the right position.

Treatment

The first treatment that an orthopedic physician can offer is moving the lower leg back into position so that the kneecap can be manipulated and placed in its position. Relocation is an important step that repairs the damage to the nerves. To reduce pain and swelling, the physician prescribes certain medications that include painkillers and anti-inflammatory medicines. To treat the kneecap dislocation non-operatively, the physician often places the knee in splints, casts or braces. This immobilizes the knee and accelerates healing as the splints avoid bending of the knee and promote healing of tissues.

If the kneecap cannot be relocated non-surgically, the patient may require surgical treatment in which the kneecap is re-constructed to regain its functionality and movement. The patient is also advised to do certain stretching and strengthening exercises that help the patient recover quickly and regain the muscle strength. While rehabilitating, the patient is suggested not to put weight on the leg and take certain precautions.

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Common Knee Injuries

by Craig W. Goodhart, MD 21. July 2014 12:06

The knee joint gives us most of the strength and stability that enables us to do everyday activities like standing and walking. It is one of the strongest and most stable joints of the body which has to bear a large percentage of our body weight at all times. The importance of healthy knee joints cannot be overstated and any problem affecting the knee has the potential to be seriously debilitating and inconvenient. The knee, due to the heavy use it sustains, can be particularly vulnerable to a number of different problems. Here are some of the causes and lines of treatment for knee injuries.

Fractures

The knee joint can face serious damage from heavy impact, resulting in fracture of the knee. Falls from great heights or vehicle accidents are most often the cause behind knee fracture which can cause major pain, loss of strength and stability of the affected leg. Most often, the bone patella gets fractured, but fractures might also occur at the end points of the femur or the tibia. To treat a knee fracture, prolonged rest and immobilization of the area might be prescribed, along with the use of pain medication and ice packs. For severe fractures, orthopedic doctors might prefer to go the surgical route.

Dislocations

A dislocation in the knee happens when the bones in the area fall out of alignment, due to impact damage or trauma. Mostly the tibia or the femur might fall out of their natural positions and sometimes even the patella can slip out of place. Dislocations are mostly caused due to impact damage but they can also affect people who already have structural abnormalities of the knee. Treatment usually consists of reduction, a process in which gentle pressure is put on the affected bone to snap it back into place. This is followed by a period of rest, gentle exercise and physical therapy to restore full functionality to the injured knee. Serious cases of dislocation may be treated with surgery.

Meniscus Tear

A very common knee injury is a meniscus tear. Any sudden abnormal motion of the knee like twisting, flexing or pivoting can cause the meniscus to tear and get damaged. Menisci also tend to get weaker with age related deterioration and due to conditions like arthritis, which makes them vulnerable to get damaged easily. Nonsurgical lines of treatment include rest, the use of ice packs, compression and elevation to reduce swelling. In serious cases, an orthopedic surgeon can go for a surgical procedure.

For complete treatment of knee injuries in Carrollton, visit Dr. Goodhart at 4780 North Josey Lane, Carrollton, Texas 75010. to schedule an appointment, call at (972) 492-1334.

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Carrollton Orthopedic Treatment For ACL Injuries

by Craig W. Goodhart, MD 21. April 2014 09:01

The ACL or Anterior Cruciate Ligament is one of the four important ligaments which are attached to the human knee joint. The ACL has a big part to play when it comes to imparting strength and stability to the knee joint. Any injury to the ACL can be a serious problem as it can cause massive loss of balance and stability, and considerable pain. Depending on the gravity of the situation orthopedic surgeon in Flower Mound can choose to implement several healing measures to alleviate this condition. These might include non-surgical or surgical lines of treatment.

Causes

An injured or torn ACL is usually viewed as a sports-related condition. However, they can also occur in people who do not indulge in sports or related activities. Common causes are situations where the leg faces impact and damage resulting from falls, major collisions and specific injuries. The ACL can also tear partially or completely during pivoting on a knee or due to a bad landing from a height. Most commonly ACL injuries occur to sportsmen who indulge in sports involving a lot of physical contact.

Signs

One of the surest signs of an ACL tear is that fact that with a torn ACL, a person’s knees give way causing the person to collapse. This instability of the knee persists and people become completely unable to pursue any activity where pressure might be on the knee like walking or standing. There can also be a considerable amount of inflammation and pain when you sustain any kind of ACL injury.

Diagnosis

The extent of ACL injuries can be diagnosed by a knee injury doctor with the help of special medical examination where diagnostic tests like MRIs and x-rays can help assess the situation. Also orthopedic doctors use a special test called a Lachman test which involves working the leg and knee joint in a specific way so as to put pressure on the ACL to correctly diagnose the extent of the damage.

Treatment

For partial tears and with people who do not require heavy usage of the ACL, non-surgical avenues of treatment can be considered. In these cases, complete rest along with regular application of ice to the affected areas can be advised. Some oral medication for bringing down the swelling and reducing pain can also be prescribed. In more serious cases, the only option is ACL reconstruction surgery. The surgery is followed by suitable post-operative rehabilitation and pain management.

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