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The anterior cruciate ligament (ACL) is located in the knee. When it is torn, it can be extremely painful. The treatment for this sort of injury is reconstructive surgery. This procedure replaces your torn or damaged tissue with new tissue.

You may wonder where this tissue will come from. There are a couple of ways to get tissue for an ACL (anterior cruciate ligament) reconstruction. One way is to take the tissue from the patients body. This is called an autograft. The tissue is usually taken from the hamstring or the patellar tendon. This is the tendon at the front of the knee.

Another option is to receive an allograft. This is a graft of tissue harvested from a deceased person.

Both options have positive and negative aspects. Your surgeon will review these with you and work with you to decide which option suit you.

Arthroscopy is usually used when performing ACL (anterior cruciate ligament) reconstruction. In this type of surgery, a small incision called a poke-hole is created to allow the surgeon to insert a very small camera into the knee. This lets the surgeon see the condition of the interior of your knee.

While your surgeon is looking, he or she will check for damage to other tissues. If the cartilage or ligament in your knee has been otherwise damaged, that problem will also be attended to during your procedure.

Several types of anesthesia are used for arthroscopic knee surgery, but you will probably receive general anesthetic. This will allow you to sleep during the surgery. While you are sleeping, your surgeon will replace your ACL (anterior cruciate ligament).

Click here for more on ACL Reconstructive Surgery.

Small incisions will be made around your knee so that your surgeon can get your new ligaments into just the right places. A bone shaver or other instrument will be used to remove your damaged ligament. If you will be using your own tissues to replace the damaged tissues, your surgeon will make a larger incision in order to access it.

Your new ligament will be put into place using bone tunnels which will allow the surgeon to place the new ligament in exactly the same location as the old ligament. Once in place, the ligament will be secured with screws or some other type of fastener to prevent it from moving. When your surgery is done, your incisions will be closed, and your knee will be bandaged.

One advantage of arthroscopy is that your surgeon can create a complete and accurate video record of the procedure and review it with you afterwards. You will be able to watch the surgery on a video monitor and talk with the surgeon about any questions or concerns you may have.

If you have unstable knees, pain in your knees, or your knee gives out on you unexpectedly, you may be referred for ACL (anterior cruciate ligament) reconstruction. Additionally, if you are simply unable to play sports and/or participate in ADL (activities of daily living), ACL (anterior cruciate ligament) reconstruction may be the answer for you.

Complications are rare with this type of surgery; however, they do exist. Some things to keep in mind are the possibility of: Failure to heal, failure to relieve symptoms, stiffness and pain in the knees, continued weakness in the knees, infection at the site of the surgery, nerve damage, and bleeding.

Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, Portland SLAP Repair and Bicep Tears in Portland.

Of musculoskeletal injuries, rotator cuff injuries are one of the most frequent. A rotator cuff injury is quite painful and can cause shoulder weakness; however, it does not cause swelling. Interestingly, patients often do not have symptoms. Most of the time; however, the patient will experience pain and weakness during activities involving the arms. Raising the arm above shoulder level can prove particularly painful. On the bright side, there are quite a few ways to treat rotator cuff injuries. Your age and the type of injury you have will help determine which option will work best for you.

There are two categories of rotator cuff injury. One is rotator cuff tendonitis. The other is rotator cuff tear. Be aware that there are several other conditions that could be the cause of shoulder pain. The only way to get an accurate diagnosis of rotator cuff injury is to see a doctor. He or she will first look at the symptoms and perform a basic physical examination. After this, the physician may use a local anesthetic that will be injected into the injured shoulder. This will help determine whether the injury is a muscle tear or tendonitis. If the injury seems to be a rotator cuff tear, the doctor may order some imaging tests. These will help confirm that the injury is a tear and isolate the location of the injury.

The more common diagnosis is rotator cuff tendonitis. Treatment for rotator cuff tears and rotator cuff tendonitis is quite similar. Both may be treated conservatively with rest, ice, compression and elevation (known as RICE) therapy. Additionally, an over-the-counter anti-inflammatory like ibuprofen is recommended. The physician may make a referral to a physical therapist for exercise therapy and modification methods that will help with ADL (activities of daily living). Persistent pain caused by tendonitis may be treated with local injections of a steroid/anesthetic mixture. This will help relieve pain in the joint.

This sort of non-surgical intervention usually has a 50-50 chance of being effective. If it is to work, you will probably see results in 6 – 12 weeks. Using non-invasive techniques of this sort can be good in a number of ways. When you do not have surgery, you also do not have recovery time. Furthermore, you do not experience any of the risks commonly associated with surgery such as complications caused by anesthesia, permanent stiffening of the joint, or infection. One thing to realize, however, is that this approach can cause the original tear to increase in size. Additionally, even though there is not a set recovery time, you will be operating at less than your usual ability until you have completely recovered. Aside from these considerations is the fact that non-invasive techniques may not be effective. You may end up having surgery after all. If your injury is quite severe, your doctor may bypass the non-invasive option and recommend surgery right from the start.

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When rotator cuff injury is treated with surgery, there are generally three options.

The method that allows the surgeon to operate most freely is called open repair surgery. This method utilizes a full incision in the shoulder. This option can leave a rather large scar.

Another method that utilizes both an incision and arthroscopy is called mini-open repair surgery. This is an outpatient procedure in which the surgeon makes a smaller incision and uses an arthroscope to see the interior of the shoulder structure. This procedure leaves a much smaller scar.

All-arthroscopic surgery is the least invasive surgery. It is an outpatient procedure that leaves a very small scar.

The doctor will determine which procedure will work best based on the specific injury.

The majority of patients who have rotator cuff surgery experience a decrease in pain and an increase in ROM (range of motion) within four to six months following surgery. In fact, eighty to ninety-five percent of people who have this surgery report satisfaction with the results.

The expertise of the surgeon is a very important factor in the successful outcome of the surgery. However, there are some variables to keep in mind when considering speed and success of recovery. Among them are the type of tear, tissue quality, the patients age, and the amount the patient complies with the doctors instructions.

It is rare to experience complications with rotator cuff surgery. Tendon re-tear, which is the most commonly experienced complication, only occurs in about 6% of patients. One or two percent may have nerve injury. As little as one percent of patients may contract infection. Detachment of the deltoid muscle and/or stiffness are experienced by fewer than one percent of patients.

Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, Portland ACL Reconstruction and Portland Bicep Injuries.

One of the most frequent musculoskeletal injuries is the rotator cuff injury. Sometimes this type of injury is not associated with symptoms, but usually it is quite painful. A rotator cuff tear or rotator cuff tendonitis can cause you to experience pain and weakness in the shoulder when using your arms. It can be especially painful to lift the arm higher than shoulder level. Luckily, there are a number of ways to treat rotator cuff injuries – both surgical and non-surgical. The type of injury you have, your condition, and your age will be determining factors in deciding which type of treatment is right in your situation.

In addition to the two types of rotator cuff injuries already mentioned – tear or tendonitis – you should be aware that there are other conditions that may exhibit similar symptoms. Be sure to see your doctor to get the right diagnosis. He or she will give you a physical examination and will probably inject your shoulder with a local anesthetic. These procedures help your doctor to determine exactly what is wrong with your shoulder. If your doctor believes that you have a rotator cuff tear, the next step may be imaging tests to confirm the diagnosis and find the exact location of the tear.

Rotator cuff tendonitis is more common than rotator cuff tear, but the treatment is similar for both. Rest, ice, compression and elevation, also known as RICE therapy, is prescribed for both conditions. Your doctor may also tell you to take an over-the-counter pain medication like ibuprofen. You may also be referred to a physical therapist who will help you to understand how to modify your activities to avoid pain and may also give you instructions on exercises to help strengthen your shoulder. If these measures dont help, your doctor may give you a shot of a steroid/anesthetic mix. This injection will be made directly into the joint to help address your pain.

Of the patients who use this non-surgical intervention, about half report having a decrease of pain and an increase in range-of-motion within six weeks to three months. Aside from efficacy, there are a number of advantages to non-invasive therapy. Surgical risks such as permanent stiffness, anesthesia complications, and infection can be completely avoided. With non-invasive therapy, there is no down-time for recovery. On the other hand, use of non-invasive techniques may cause an increase in the size of the tear. While there is not a recovery period, there may be a time period when the patient is able to do less. Of course there is also the chance that the non-invasive technique simply will not work. In this case, your doctor may recommend surgery. Your doctor may also recommend surgery if your injury is so severe that he or she feels a non-invasive approach would not be effective.

Click here for more on rotator cuff tears .

There are three ways to treat a rotator cuff injury surgically:

1. Open repair surgery: With this option, the surgeon makes a full incision into the shoulder. This method gives the surgeon a great deal of freedom of movement; however, it is the largest incision option of the three available methods.

2. Mini-open repair surgery: This method is like open repair surgery, but it also utilizes arthroscopy. The advantages of this method are that it is an outpatient procedure that leaves a smaller scar.

All-arthroscopic surgery is the least invasive surgery. It is an outpatient procedure that leaves a very small scar.

After examining and diagnosing your injury, your doctor will be able to make a sound decision as to which method will work best for you.

Happily, rotator cuff surgery is a highly successful surgical procedure. Eighty to ninety-five percent of patients who have this type of surgery report successful results, improved range-of-motion and a significant decrease in pain in six months or less.

The expertise of the surgeon is a very important factor in the successful outcome of the surgery. However, there are some variables to keep in mind when considering speed and success of recovery. Among them are the type of tear, tissue quality, the patients age, and the amount the patient complies with the doctors instructions.

Some patients experience complications from surgery; however, these are rare. One to two percent may experience nerve injury. Approximately one percent may contract infection. Less than one percent may have detachment of the deltoid muscle. Less than one percent may experience stiffness. Tendon re-tear is experienced by approximately six percent of patients.

Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, Portland ACL Surgery and Portland Athletic Injuries.

The bones of joints are held together by ligaments. You will find the ACL (anterior cruciate ligament) at the center of your knee. Its purpose is to keep your shin bone from shifting forward on your thigh bone.

If your ACL (anterior cruciate ligament) is torn, your knee might give out when you are physically active. This is a danger in itself. If it happens too often, your cartilage will be damaged, and you will experience early arthritis.

ACL Reconstruction can resolve these problems. With this surgery, your damaged ligament can be replaced with new ligament. This ligament may come from a deceased donor (allograft) or from you (autograft).

If you decide to use an autograft, the tissue will probably come from your hamstring or the front of your knee (your patellar tendon).

Both types of grafts are good. There are different pluses and minuses to each. Be sure to discuss these with your doctor.

Click here for more on ACL injury .

Arthroscopy is the procedure that is usually used for ACL reconstruction. Although this type of surgery can be done using a variety of types of anesthesia, you will probably receive general anesthesia. This will let you sleep through the whole thing.

Arthroscopy allows your surgeon to see the interior of your knee via a tiny camera inserted through a poke-hole. This allows your surgeon to see, not only the torn ACL , but also any other problems you may be having with your knee. These problems can be addressed during your ACL reconstruction.

There will be a few other incisions in addition to the poke-hole. First, if you are using your own tissue, an incision will need to be made to remove it. This is rather a larger incision. Then a few smaller incisions will be made to access and remove your damaged tissue. Your new tissue will be inserted via bone tunnels. It will be placed perfectly and secured with screws or a variety of surgical fasteners as appropriate.

When your surgery is done and your incisions have been closed, your knee will be bandaged, and you will be given time to recover from your anesthesia. At this time, you may be able to see the video of your surgery and confer with your surgeon on his or her findings and any concerns or questions you may have in mind.

Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, Vancouver ACL Surgery and Vancouver Athletic Injuries.

The bones of joints are held together by ligaments. You will find the ACL (anterior cruciate ligament) at the center of your knee. Its purpose is to keep your shin bone from shifting forward on your thigh bone.

A torn ACL (anterior cruciate ligament) can cause your knee to collapse during strenuous activity. Not only is this immediately dangerous, it can lead to repeated collapse, causing cartilage damage and arthritis.

You can have this torn ligament replaced with ACL reconstruction. This surgery replaces your damaged ligament with a new ligament. Your surgeon could get a new ligament from you (autograft) or from a deceased donor (allograft).

An autograft is usually taken from the hamstring or the patellar tendon (front of the knee) of the patient.

There are pros and cons to both types of grafts; however, both are usually successful for most people. Talk with your surgeon to find out more.

Click here for more on ACL injury .

Your surgeon will probably use arthroscopy to perform your ACL reconstruction. This type of surgery is usually done using general anesthesia.

Arthroscopy allows your surgeon to see the interior of your knee via a tiny camera inserted through a poke-hole. This allows your surgeon to see, not only the torn ACL , but also any other problems you may be having with your knee. These problems can be addressed during your ACL reconstruction.

If you are using an autograft, there will be one large incision (also called an open incision) made to remove this tissue. Additionally, your surgeon will access the areas to be worked on via several small incisions around the knee. These will be used to place your new ligament. Your old ligament will be removed, then the surgeon will make bone tunnels to place the new ligament in the same position as the old one. The new ligament will be secured with surgical fasteners such as screws.

When your surgery is finished, your incisions will be closed, and a bandage will be put on. When you wake up from your anesthesia, you will probably be able to see pictures and the video of your surgery. Your surgeon will discuss the procedure with you and answer your questions.