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Denver MCL Specialists Help Skiers in Colorado

Denver MCL Specialists Diagnose MCL Injuries to Keep Coloradans Active

Denver MCL specialists continue to see a high volume of MCL injuries. The medial collateral ligament (MCL for short) is in fact the most frequently injured ligament of the knee – accounting for as many as 40% of knee ligament injuries. And because minor MCL injuries often go undiagnosed, this number is likely low. But with proper diagnosis and individualized treatment, MCL patients typically have a solid path to recovery.

What is an MCL injury?

Let’s start with what the MCL does and where it’s located. The MCL is tissue connects your thigh bone (femur) to the top of your tibia, (your shin bone), on the inside of your knee. It stabilizes your knee to keep it from bowing too far inward.

Anyone can damage their MCL, but it’s also more common among men and athletes – even recreational athletes. Direct content is the most common cause, so it’s no surprise that Denver MCL specialists see a higher incidence of MCL injuries in patients who participate in contact sports, such has rugby, football, soccer and ice hockey. 

But here in Colorado, skiing is one non-contact sport where MCL injuries also tend to occur. This is typically the result of sudden twisting or stress on the knee that is common with frequent ski turns, starts and stops.

If any of these types of situations have resulted in knee pain that doesn’t improve with a bit of rest and ice, it’s probably time to see a doctor. MCL diagnosis involves a physical evaluation which includes checking for swelling, bruising and evaluating range of motion. An MRI or X-ray may also be needed. Our Denver MCL specialists help patients classify MCL injuries into grade I, II or III and determine the best course of treatment.

  • Grade I (Mild) injuries can be addressed at home (with ice, rest and mild pain reliever like Advil) and improve in just a couple of weeks
  • Grade II (moderate) may require the use of a brace to stabilize the knee. Your doctor may also ask you to minimize weight bearing activities for a few weeks.  
  • Grade III (Severe) injuries may require surgery, especially if other parts of the knee are also injured (such as your ACL, which occur with an MCL injury about 95% of the time, when there is more than one injury), or at a minimum require patients to brace the leg and limit weight-bearing activity for at least 6 weeks

Knee pain can also be the result of conditions other than MCL tears, so it’s important to recognize the signs and symptoms of MCL injuries. Patients typically have pain and lack of mobility around the knee joint and many report hearing a “pop” at the time of the injury.

Advanced Orthopedics’ Denver MCL specialist team frequently performs MCL repair or reconstruction – a procedure where the damaged ligament is either repaired or removed and replaced with tissue harvested from the hamstring or patellar tendon. The replacement tissue – called a graft – restores knee stabilization while aiding the growth of new tissue.

As with all MCL strains, physical therapy plays a vital role in the restoration of long-term strength and range of motion. Although individual recovery time varies, many MCL patients who opt for surgery return to their sports in six to nine months.

Have questions? Advanced Ortho’s team of Denver MCL specialists are available to answer your questions.

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Knee arthritis

Non-surgical treatments for knee arthritis

As we outlined in our first knee arthritis post in this three-part series, there is no cure for knee arthritis, so beware of ‘miracle cures’ that claim otherwise.

If you have knee pain and think it might be knee arthritis, getting treatment can still reduce pain and minimize or delay long-term damage.

There are many non-surgical treatments for knee arthritis, and your orthopedic doctor should first consider the most conservative approaches. This may include rest, avoiding vigorous or weight-bearing activities, and the use of anti-inflammatory medicine.

Your doctor may also recommend occupational therapy or physiotherapy for your knee arthritis, which includes exercises and heat treatment. Depending on the severity of your knee arthritis,

If your symptoms warrant, your doctor may recommend a cane or a knee brace or an injection of cortisone into the knee joint. This is very helpful to relieve pain an allow for other treatments such as physical therapy and exercise.

Exercise is essential for knee arthritis treatment because it increases joint lubrication and strengthens surrounding muscles, which reduces stress on joints. Exercise in a heated pool can bring enormous pain relief and improve range of motion. Many studies have shown that exercise helps people with knee arthritis by reducing pain and stiffness and increasing flexibility, and muscle strength.

Treatment of osteoarthritis focuses on decreasing pain and improving joint movement, and may include:

  • Exercises to keep joints flexible and improve muscle strength
  • Many different medications are used to control pain, including corticosteroids and NSAIDs. Glucocorticoids injected into joints that are inflamed and not responsive to NSAIDS.
  • For mild pain without inflammation, acetaminophen may be used.
  • Heat/cold therapy for temporary pain relief
  • Joint protection to prevent strain or stress on painful joints
  • Surgery (sometimes) to relieve chronic pain in damaged joints
  • Weight control to prevent extra stress on weight-bearing joints

When conservative measures have been exhausted and are no longer helpful, and if your knee arthritis has become disabling, surgery may be recommended.  The type of surgery will depend on your age and severity of the disease. In the elderly with severe knee arthritis, joint replacement can give good results.

Read more information on arthritis treatment or learn about surgical options.

knee arthritis

Will it snow soon? Why your knee arthritis lets you know and how it impacts your joints.

Did you know that in the past 60 years, it has snowed on either Halloween or November 1st a whopping 41 times? While it looks like we’ll buck the trend this year with forecasts in the 70s for both days, winter is still coming! Maybe you can even feel it. Are you one of those people who can tell when a storm front is coming into Colorado even before the local weatherperson can? If so, you know that increased pain from knee arthritis serves as a pretty consistent weather barometer!

It is, in fact, the barometric pressure that causes many sufferers of knee arthritis (or any other arthritis) to feel more joint pain as the pressure changes and a weather pattern moves in.

But what is that pain actually doing to your joints? In the first of a three-part series, we’ll examine how knee arthritics impacts your joints, provide non-surgical treatment options, and look at the option of knee replacement surgery and rehabilitation.

What is knee arthritis?

Arthritis is joint inflammation that causes pain, swelling and stiffness. Knee arthritis is a particularly common form of arthritis and can be especially painful and can really limit your ability to be active because of the load-bearing nature of the knee joint.

While there are multiple types of arthritis, osteoarthritis is the most common type of arthritis in the knee. Osteoarthritis causes the knee cartilage to slowly wear down, and as this happens, it becomes damaged and rough. It’s known as a degenerative condition because the ongoing wear on your cartilage causes it to degenerate and eventually wear away.

Eventually there is no more cushion left between bones, and the bone-on-bone friction causes a great deal of pain as well as bones spurs.

What causes knee arthritis?

Osteoarthritis is typically causes from wear and tear on the body. This can be exacerbated by overuse or injury, and is more prevalent in patients who also have rheumatoid arthritis. When knee arthritis develops, it’s usually in both knees. It’s also more common among after age 40, and also among women, especially after age 50.

In the event of a knee injury, it’s referred to as posttraumatic knee arthritis. When the knee is injured, makes the joint less stable which often leads to additional wear and tear that, over time, turns into arthritis.

Can you cure knee arthritis?

There is not a cure for knee arthritis, but it’s still imperative to get treatment. There are many treatment options that contribute to the two most important things: 1. Reducing pain so that you can be active. 2. Minimizing or slowing the long-term damage to your cartilage and bone.

If you have knee pain and think it might be knee arthritis, learn about non-surgical treatment options, or contact our office to schedule a consultation.

Do you miss your meniscus? Q&A with Dr.Wayne Gersoff

At Advanced Orthopedics, we know that active lifestyles are a way of life in Colorado, and knee pain shouldn’t get in the way of your day-to-day activities or your fitness. There are multiple causes of knee pain and today we’ll answer 3 questions about one commonly damaged area: meniscus cartilage.

What are the menisci? They are two c-shaped cartilage sections that sit on top of the tibia – the lateral and the medial meniscus. The menisci play a pivotal role separating and cushioning your femur (thigh bone) from your tibia (shin bone). When a meniscus is damaged (or removed, if beyond repair), only the articular cartilage is left to protect your knee, but articular cartilage alone cannot cushion the movement long term and it becomes fragmented as is wears away. The result is the painful feeling of bones rubbing against the rough, fragmented cartilage – osteoarthritis.

If I tear or damage my meniscus, what are my options? The timing, severity and type of meniscus tears can greatly influence your options. If you are younger than 55, active, and have no damage to your articular cartilage, there are many options. In younger individuals, the peripheral third of the meniscus has a relatively good blood supply. Tears smaller then 5 mm in this area have the potential to heal on their own with appropriate rest and protection.

When surgical intervention is required, options include knee arthroscopy with either partial resection of the torn meniscus or repair of the torn meniscus. In situations where a portion of the meniscus is removed, new technology allows for the segmental replacement of that portion of the meniscus with a collagen meniscal implant (CMI). In the event that there is loss of the majority of the meniscus, another  option – meniscal allograft transplantation – is an increasingly viable option as well.

How does meniscal transplantation work? Healthy donor meniscus cartilage called an allograft is harvested, frozen and reviewed for fit and viability. Once a match is determined, arthroscopy guides the procedure as the donor meniscus tissue is secured in the anatomically correct position in the knee.

What can I expect with a meniscus transplant? Expectations can be summarized in four key stages: procedure, recovery, rehabilitation and outcome. As with most arthroscopic procedures, meniscus transplants are often outpatient procedures. After the initial post-operative recovery, patients begin a very detailed and progressive rehabilitation process. The goal of the rehabilitation process is to allow for healing of the meniscus while progressively increasing motion and regaining strength. Due to the slow healing process of the meniscus allograft, patients can expect there full recovery to take up to 6 months. Successful outcomes are marked with pain relief, increased activity and prolonged knee function.

Meniscus transplants aren’t for everyone, but for qualified patients who adhere to the prescribed rehabilitation protocols and activity modifications, the outcome yields significant benefits. Meniscus transplants relieve knee pain and prolong the longevity of your knee while using the healthy donor meniscus cartilage to optimize your knee’s function and restore an active lifestyle. Ask your doctor if meniscus transplantation is right for you. Your specialist can guide you through the options and offer the most effective treatment to keep you AO active instead of kneeling down to pain.

Denver back pain specialists

Does your golf buddy have the solution to your knee or hip pain?

Knee or hip pain can be excruciating and when you are in pain, you want relief – pure and simple. And there is no shortage of advice on how to fix your joint problem, right? If your pain is keeping you from being active, you’ve probably had plenty of advice from well-meaning friends, fellow sports enthusiasts or family members – “you need surgery!” says one, “avoid surgery at all costs!” says another.

Knee and hip pain is very common, so it’s highly relatable, and everyone wants to empathize and help. But understanding what your pain means and determining your best treatment requires a partnership between you and your orthopedic physician.

We take great care to understand the story that your pain is telling and provide the care that is right for your personal situation. Sometimes, surgical procedures are the best solutions. But, sometimes, a non-surgical solution is the better course of action.

How can non-surgical solutions be better? Let’s start with the understanding the mechanics of both joints, knowing that both solutions have the potential to provide great relief and meaningful quality of life improvements.

Hips

The hip is one of the largest weight-bearing joints in the body. When it’s working properly, it lets you walk, sit, bend, and turn without pain. Unlike the shoulder, the hip sacrifices degree of movement for additional stability. To keep it moving smoothly, a complex network of bones, cartilage, muscles, ligaments, and tendons must all work in harmony.

Knees

The knee joint is very complex and consists of the femur (thigh bone), tibia (lower leg bone) and patella (the kneecap). The knee relies on the surface cartilage of these three bones as well as the menisci to serve as shock absorbers and stabilizers that allow for a smooth, low friction surface for the knee to move on. The knee is further stabilized by ligaments inside and outside the joint and is surrounded by a capsule (envelope) that produces a small amount of lubricating fluid to help with smooth motion. We tend to ignore our knees until something happens to them that causes pain.

Understanding Your Options

As physicians, we’re committed to looking at all options in the priority that best fits what your body is telling us. Both knee and hip pain can occur for many reasons, and common causes include injury to or damage within the joint, arthritis, or from the incremental burden that excess weight puts on these weight-bearing joints. When pursuing non-surgical treatment, I often provide patients with a combination of solutions that best fits their situation, lifestyle and objectives. The following three solutions provide excellent outcomes for many patients.

Physical Therapy:

Our in-house physical therapist partners create custom therapy regimens to build strength, increase range of motion, and ultimately, reduce pain. Therapy sessions are frequently paired with heat, ice or even nerve stimulation to reduce inflammation and increase circulation.

Injectables:

There are a number of treatments that involve injections into the joint site. Some, like lidocane are designed to control pain by masking the sensation. Others, such as steroids reduce inflammation and pain. Another category of injections involve gel-like fluids, such as hyaluronic acid (known as viscosupplementation). Hyaluronic acid is a naturally occurring substance found in the synovial fluid surrounding joints. It can act as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads. People with osteoarthritis have a lower-than-normal concentration of hyaluronic acid in their joints. For some patients, adding hyaluronic acid to the arthritic joint can facilitate movement and reduce pain. Every patient’s circumstances and outcomes are different, but all of these non-surgical solutions have the potential to play a different role in helping to enable mobility and decrease pain.

Move More

It may sound counter intuitive, but we often find that the solution for some patents with chronic knee or hip pain is to move more. Paired with improvements in nutrition, exercise generates a dramatic reduction in pain through weight loss and enhanced mobility. Increasing movement – even if gradually over several weeks or months – significant increases many patient’s range of motion, strength, and flexibility. And the impact can be exponential: for every 10 pounds of weight loss, there’s a decrease in joint pressure equivalent to 50 pounds!

We work with patients to identify plans that can alter the body’s weight or muscle strength to relieve joint pain without ever requiring surgery. In tandem, pain management can reduce inflammation, and allow your body the time to recover, repair, and rebuild the strength to better support your body and relieve the condition.

Patients want to know their options and, too often, they are not aware of non-surgical options that can greatly improve their daily life. We are able to collaborate with a patient to achieve results without ever undergoing surgery. Physical therapy and treatments such as acupuncture and other non-surgical therapy options are also viable options. It’s all about your situation and what’s best for you.
Sometimes surgery is required. When it is, wouldn’t you prefer to have the peace of mind that your physician has educated you about all of your options and helped you determine whether non-surgical or surgical treatment is best for you?