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Suffering from an ACL Tear?

The ACL or the Anterior Cruciate Ligament in the knee can be injured in several ways:

  • Sudden stopping or change of direction
  • Abruptly slowing down while running
  • Landing from a jump incorrectly
  • Direct collision

ACL tear

The ACL is one of the four important knee ligaments. These ligaments hold the knee together.  It connects the thigh bone to the shin bone.

The ACL is a tough band of tissue that runs diagonally through the inside of the knee and gives the knee joint stability. An ACL tear is often a result of excessive stress due to one of the reasons explained above.

ACL Injury Symptoms

ACL injuries are often accompanies by a “popping” noise and/or the knee may feel giving out from under you. Other symptoms include:

  • Swelling and pain
  • Limited range of motion
  • Tenderness along the joint
  • Discomfort while walking

You may observe swelling within a day of the injury. In some cases, the swelling and the pain may subside on its own but if you attempt to return to activity, the knee is likely to remain unstable. This can result in further damage to the meniscus or the cartilage that cushions your your knee.

To learn more about ACL tear and treatment options or to consult an experienced knee doctor in Gilbert, AZ, call OSPI (Orthopedic and Sports Performance Institute) at 480-899-4333. OSPI offers modern, cutting edge treatments including minimally invasive orthopedic surgery as well as regenerative medicine, such as PRP Therapy in Gilbert, AZ.

Ever too old for Knee Replacement?

If you are wondering whether you are too old for knee replacement surgery, you should know that more than 500,000 people undergo total knee replacement in the United States alone. Generally, people with chronic joint pain and debilitating arthritis are considered candidates for total knee replacement.

Total knee replacement can help these people regain lost confidence and independence. A knee replacement can go a long way in restoring your ability to lead a normal life.

Read on to know more about knee replacement surgery and get answers to the most commonly asked questions.

Arthritis and Knee Pain

The knee joint has a layer of smooth cartilage on the ends of thigh bone, shinbone and the kneecap. This cartilage cushions the gliding surface facilitating smooth knee motion. Arthritis involves wear and tear of this cartilage. This leads to bones rubbing against each other, causing pain, inflammation, swelling and stiffness.

Total Knee Replacement

Total knee replacement involves cartilage replacement with an artificial surface, using metal and plastic implants. This creates a new smooth cushion and a functioning joint that does not hurt.

Success Rates

More than 90% patients achieve good to excellent results with pain and symptom relief and improved activity and mobility.

Candidates for Total Knee Replacement

Based on your history, physical examination, X-rays and conservative treatment results, your orthopedic surgeon will discuss with you if you are a candidate for total knee replacement surgery.

In general, you may not be a good candidate if you –

 

  • have poorly-controlled diabetes
  • are an active smoker
  • are morbidly obese
  • have experienced infections in the affected arthritic joint in the past

Can a person be too old for knee replacement?

Age is not a big issue if you have good overall health and wish to continue living an active life. There are cases of patients in their 90’s who get knee replacements and do well. Your orthopedic may ask you to consult your personal physician about your readiness for surgery.

To learn more or to consult an the best knee replacement doctors in Gilbert, AZ, call OSPI (Orthopedic and Sports Performance Institute) at 480-899-4333.

4 Top Reasons you can’t straighten your Knee

Knee injuries are often a result of a twisting or a direct impact injury to your leg. The severity of the injury can vary but loss of bending in the knee is common after an injury. An inability to straighten and bend your knee is a sign you have been injured badly.

Here is a look at the top reasons why you are unable to straighten your knee after an injury.

Swelling

Swelling is common after injuries that cause bleeding, inflammation and pain, making it too painful to straighten the knee.

Tendon Injuries

Injuries to the quadriceps or patella tendon do not allow you to straighten the knee and also cause significant weakness. Such injuries are more common in professional sports.

Meniscus Tear

A tear in which the torn piece of meniscus flips into the center of the knee joint, can lock your knee and prevent it from straightening.

ACL Tear

ACL tear do not cause the knee to be locked but it hurts too much to straighten it. Within a few days, the swelling will reduce and you may be able to straighten your knee. But sometimes ACL tear is accompanied by a meniscus tear. In such cases, it will be hard to straighten the knee and you should see an orthopedic surgeon.

If you have suffered an injury to your knee and are not able to straighten or bend your knee, it could be due to a severe knee injury. Consult an orthopedic surgeon to find out the root cause and begin treatment.

To learn more or to consult the best orthopedic surgeons in Mesa, AZ, call OSPI (Orthopedic and Sports Performance Institute) at 480-899-4333.

Why do I have to Undergo Hip Arthroscopy?

Hip arthroscopy is the new minimally invasive treatment option for patients suffering from hip pain, hip injuries and degenerative hip conditions.

If you have been recommended hip arthroscopy, read on to know more about the procedure.

Hip Arthroscopy

Hip arthroscopy involves making a small incision to insert a tiny camera in the joint. The images from the small camera or arthroscope enable the surgeon see examine the joint. This is done by transmitting the images to a large television screen. The orthopedic surgeon can visualize the inside of your joint and identify problems. Surgical tools are then inserted through other small incisions to repair the damage or treat your condition.

The advantage of hip arthroscopy is that repairs can be made with minimal trauma to surrounding tissue, less pain and less risk of complications. The recovery time is also significantly shortened and the patient can get back to normal activities faster than in traditional surgery.

Hip Arthroscopy is recommended in the following conditions.

Hip Injuries

The hip is a ball and socket joint in which the head of your upper leg bone fits into a hollow in your pelvic bones. Both are covered with a slippery cartilage to allow them to slide across each other, and the entrance to the socket has a thick ring of cushioning cartilage.

Damage to any of these tissues caused by various hip injuries, can be treated with hip arthroscopy.

Hip Dysplasia

In hip dysplasia, the ball and socket of the joint don’t fit together properly. This results in excessive wear and tear on the bones, cartilage, and other connective tissue.

Snapping Hip Syndrome

In the snapping hip syndrome, you can feel a snapping or popping when you move it. This is often caused by a muscle or tendon sliding over one of the bony protrusions of your hip or due to an injury to the cartilage in your hip.

Synovitis

An inflammation of the synovium or the lining of the hip joint can also be a reason to perform hip arthroscopy.

Loose Bodies in the Joint

Loose bodies can be bits of cartilage, bone chips, or even foreign objects, floating in the joint. These can occur due to osteoarthritis, fractures or injuries.

Hip Joint Infection

In case of an infection in your hip joint, arthroscopy can remove the infected tissue.

Consult leading East Valley orthopedic surgeons if you or a loved one is suffering from chronic pain. To schedule an appointment at the top orthopedic clinic, call OSPI (Orthopedic and Sports Performance Institute) in East Valley at 480-899-4333.

FAQs on Outpatient Knee Replacement (Rapid Recovery)

Outpatient joint replacement surgery does not require an overnight stay at the hospital. This procedure is known as a rapid recovery surgery, which means the patient is back to usual activities soon after the surgery.

What is knee replacement surgery?

Outpatient knee replacement surgery is a surgical procedure in which the damaged, worn joint surfaces are removed and replaced with artificial components (prosthesis). This rapid recovery procedure is done on an outpatient basis, allowing the patient to go home soon after the surgery.

Who is a candidate for rapid recovery knee replacement surgery?

Your doctor may consider this knee replacement procedure if you:

  • Have severe pain that limits your daily activities
  • Suffer pain that is not relieved with physical therapy, medications, and knee injections
  • Have an active lifestyle that requires you to be on your feet
  • Are in relatively good health otherwise
  • Have a high level of motivation during the rehabilitation process
  • Good family support

What are the benefits of rapid recover knee replacement surgery?

The benefits of outpatient knee joint replacement surgery include:

  • No overnight hospital stay
  • Earlier mobilization
  • Rapid recovery
  • Fewer complications
  • Improved pain scores
  • Increased patient satisfaction

How do I prepare for the rapid recover knee replacement procedure?

Before surgery, the doctor will do some preliminary tests and have you hold certain blood-thinning agents for several days. You should arrange to have someone drive you home, and leave all valuables at home. When you arrive at the surgical center, a nurse explains the procedure, and you must sign a consent form. After changing into a procedure gown, the nurse places an IV catheter in your arm.

How is the rapid recovery joint procedure performed?

The rapid recovery knee replacement procedure is performed almost the same as traditional joint replacement surgery. Smaller incisions and less tissue manipulation allows the patient to recover at home instead of in the hospital. The procedure is done under general anesthesia. The surgeon makes 1-2 small incisions, removes damaged joint components, and inserts the prosthesis. After making necessary repairs, the incisions are closed with sutures.

What can I expect after the procedure?

You will be monitored in the recovery area for around 1 hour. After being discharged, a nurse comes to the patient’s home to monitor the condition, and a physical therapy visits several days a week to instruct the patient on flexibility and range of motion exercises. We emphasize ambulating and weight-bearing as tolerated with a cane or single crutch. Pain medications are only to be used as needed, and we stress the use of short-term anti-inflammatory drugs.

What do the research studies show?

A group of researchers studied the safety and feasibility of outpatient knee replacement surgery in a group of individuals with unicompartmental knee osteoarthritis. All 105 patients (100%) were discharged on the same day of surgery, and none of them required readmission to the hospital. The researchers concluded that rapid recovery knee replacement was a feasible, safe procedure for the majority of patients.

In a review of 4,500 total hip and knee replacements, researchers found that following a strict multimodal enhanced recovery protocol reduced the 30-day death rate, length of hospital stay, requirements for blood transfusion, and chance of heart attack, stroke, and pulmonary embolism. The protocol involved behavioral, procedural, and pharmacological modifications, such as use of certain medications before surgery and physical therapy after surgery.

Resources

Cross MB & Berger R (2013). Feasibility and safety of performing outpatient unicompartmental knee arthroplasty. Int Orthop, 38(2), 443-447.

Malviya A, Martin K, Harper, I, et al. (2011). Enhanced recovery program for hip and knee replacement reduces death rate: A study of 4,500 consecutive primary hip and knee replacements. Acta Orthop, 82(5), 577-581.

How is an Outpatient Joint Replacement Possible?

Outpatient total joint replacement, also called total joint arthroplasty (TJA), is now being performed in the U.S. at many medical facilities. These surgeries are only done on people who are healthy and have a high motivation during the recovery period. Orthopedic surgeons all agree that outpatient rapid recovery joint preplacement is the wave of the future.

Who is a candidate for outpatient joint replacement surgery?

Your primary care physician should agree that you are medically able to tolerate the outpatient procedure. In addition, the orthopedic surgeon must deem you a suitable candidate for the surgery. Optimal candidates include:

  • Those persons in fairly good health.
  • Anyone with mild-moderate joint damage.
  • People who are motivated during rehabilitation.
  • Persons with a supportive family.

What are the advantages of the outpatient total joint arthroplasty procedure?

The benefits and advantages of rapid recovery outpatient joint replacement include:

  • Reduced chance of hospital-acquired infections
  • Reduced hospital stay
  • Increased patient satisfaction
  • Reduced cost to the healthcare system

When did outpatient joint replacement become a possibility?

Over the last 20 years, new protocols regarding arthroplasty have allowed for a decreased length of stay in the hospital. These pre- and post-operative protocols, along with improved surgical techniques, make going home soon after the procedure a realist option.

What is involved in the outpatient joint replacement protocols?

A successful rapid recovery joint replacement procedure involves:

  • Orthopedic assessment – This consists of a medical history and comprehensive physical examination. It is important for the surgeon to motivate the patient and explain the home situation.
  • Preoperative medical clearance – This decreases risks and complications following the orthopedic surgery. The patient must undergo certain laboratory and diagnostic tests to assure he/she is able to undergo the procedure.
  • Preoperative physical therapy assessment – This allows the physical therapist to educate the patient regarding what to expect after the surgery. This involves how to use crutches or a cane, how to move the surgical extremity, and exercises to help with range of motion and flexibility.
  • Preoperative education – This is done to reduce fears and anxiety. The doctor informs the patient about the procedure, expected pain management protocols, and what to do at home. Reading material is given to help further educate the patient about the procedure and post-surgical recovery period.
  • Analgesia – The anesthesiologist makes the patient comfortable before and during the procedure. For a total joint replacement surgery, the patient will receive pain medications to control pain after the procedure.
  • Rapid rehabilitation pathway – This is started immediately after the procedure, and patients have the option to go home the same day. This involves following rehabilitation protocols set by the operating surgeon.

What is the success rate for outpatient total joint replacement surgery?

In a recent study, 181 patients reported decreased pain scores following surgery. The procedure improved range of motion in the patients’ knees and enhanced quality of life. Furthermore, the success rate of the procedure is around 97%, with the majority of patients reporting high satisfaction with their surgical experience.

Is the rapid recovery joint replacement surgery cost effective?

One of the main reasons for outpatient surgery is reducing costs after surgery. In a recent study, researchers examined costs with outpatient joint replacement compared to traditional surgery. They found a reduction in cost by around $8,000 based on non-itemized bills.

Resources

Aynardi M, Post Z, Ong A, Orozco F, Sukin DC. Outpatient surgery as a means of cost reduction in total hip arthroplasty: a case-control study. HSS J Musculoskelet J Hosp Spec Surg. 2014;10(3):252-255. doi:10.1007/s11420-014-9401-0.

Berger RA, Sanders SA, Thill S, et al. (2009). Newer Anesthesia and Rehabilitation Protocols Enable Outpatient Hip Replacement in Selected Patients. Clin Orthop Relat Res, 467(6), 1424-1430.

Lovald ST, Ong KL, Malkani AL, et al. Complications, mortality, and costs for outpatient and short-stay total knee arthroplasty patients in comparison to standard-stay patients. J Arthroplasty. 2014;29(3):510-515. doi:10.1016/j.arth.2013.07.020

Smith, A.J., Wood, D.J, & Li, M. G. (2008). Total knee replacement with and without patellar resurfacing: a prospective, randomized trial using the profix total knee system. Journal of Bone and Joint Surgery, 90(1), 43-49.

FAQs on Outpatient Hip Replacement (Rapid Recovery)

Rapid recovery outpatient hip replacement surgery is fast becoming a common orthopedic procedure. This surgery involves the replacement of damaged hip joints with metal or plastic parts (called prosthesis). With advanced, proven-safe techniques, it is now possible to perform this procedure on an outpatient basis.

Is this surgery common?

Total joint replacement surgery will increase during the next decade, with 80 million baby-boomers coming of age. This means around 1 million total joint replacements will be performed in the U.S. each year.

How is the outpatient procedure different than traditional surgery?

Outpatient rapid recovery hip replacement surgeries use the same implants as traditional surgery, but involve smaller incisions and new exposure techniques compared to traditional procedures. This type of procedure is less invasive to the bones and tissues involved, and allows the patient to go home the same day instead of staying overnight.

Who is a candidate for outpatient hip surgery?

The rapid recovery hip replacement procedure is less invasive to the bones and tissues, involving a much shorter hospital stay. It is indicated for:

  • Damage to the hip due to autoimmune disease or accidents
  • Erosion of the joint cartilage
  • Bone death that leads to destruction of cartilage
  • Persons who are motivated during the rehabilitation process
  • People who are in good health

How is the outpatient hip replacement surgery done?

The patient is put out with general anesthesia. The surgeon makes 1-2 small incisions to make necessary repairs. The tendons and muscles are separated to expose the femoral head (thigh bone top) and the hip socket. Lesser tissue movement is involved. The stem and ball prosthetics are fitted into the joint once the hip socket is cleaned. The hip then can be rejoined with the surrounding tissues brought back to normal position. Because the incisions are small, there is less tissue trauma, allowing for a faster recovery.

What are the benefits of the rapid recovery hip replacement procedure?

The benefits include:

  • Less scarring
  • Smaller incisions
  • Less blood loss
  • Shorter hospital stay
  • Shorter recovery period
  • Less tissue trauma
  • Earlier return to work

How is pain controlled during the procedure?

The first stage of pain control begins before the procedure. The patient receives medications that are already working when the patient awakens after surgery. The second stage of pain control occurs during the procedure. The patient is given an anti-inflammatory medicine into the hip tissues, as well as a long-acting local anesthetic. The final stage of pain control is following surgery where the patient receives medicines that target different pain pathways to minimize the use of narcotic agents.

What can I expect after the rapid recover hip replacement procedure?

Following the outpatient procedure, you will be monitored by a nurse for around 1 hour. Once you are stable, you are discharged home, where a nurse comes to visit you. A physical therapist will work with you on range of motion and flexibility activities soon after arriving home.

How effective is rapid recovery hip replacement?

The success rate of hip replacements for 10 years is around 95%, according to studies. For 20 years post-procedure, the success rate is around 85%. In a study involving 150 same-day hip surgery patients, all but 6 patients were highly satisfied with their experience (a success rate of around 97%). Overall, most same-day procedures offer a cost-effective, safe alternative to traditional hip replacement surgery.

Resources

Berger RA, Sanders SA, Thill ES, Sporer SM, Della Valle C. Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients. Clin Orthop. 2009;467(6):1424-1430. doi:10.1007/s11999-009-0741-x.

3 Top Ways an Orthopedic Doctor Can Help You through the Pain

Orthopedic doctors treat injuries and diseases that affect the musculoskeletal system. After they diagnose your injury or disorder, they’ll create a treatment plan that could include medicine and/or surgery. They may also recommend physical therapy to restore movement, and function to your body and to prevent further issues.

Orthopedic doctors help you overcome pain, compromised functionality, fatigue and anxiety. Here are the top ways an orthopedic doctor helps you through the pain.

Treat Multiple Problems

Experienced orthopedic doctors offer a wide range of treatment and care related to all forms of orthopedic problems involving the shoulder, elbow, hand, wrist, hip, knee, ankle, leg, and foot.

Offer Several Solutions

The best orthopedic doctors provide a wide range of solution for all musculoskeletal problems. That includes –

  • Complete joint replacement of the ankle, knee, hip, or shoulder
  • Arthroscopic surgery for the knee, ankle, shoulder, or elbow
  • Surgical procedures related to fractures
  • Treatment of sports injuries resulting in damage to cartilage, ligaments, or bones
  • Carpal tunnel syndrome treatment through endoscopic carpel tunnel release surgery
  • Anterior approach hip replacement procedures
  • Joint restoration surgery

Patient Centric Approach

Orthopedic doctors know that for the patient and their family, procedures such as surgery, can produce anxiety, confusion, and insecurity. That is why they adopt a patient centric approach and customize the treatment plan keeping your specific condition, symptoms and state of health in mind.

To know more about how orthopedic doctors help you through the pain, call OSPI Arizona at 480-899-4333.

FAQs on Accelerated Rehab after ACL Reconstruction

Accelerated rehab after (ACL) anterior cruciate ligament reconstruction offers significant benefit to younger, active adults and athletes, who cannot afford prolonged downtime.  Customized to individual patient needs, it helps in rapid recovery, faster recuperation, less discomfort, and quick return to training.

What is accelerated rehab?

Accelerated rehab refers to faster recovery and post-surgical recuperation without compromising the healing process. It accelerates the restoration of the full movement of the knee and its biomechanical strength allowing return to work sooner than traditional rehabilitation ensures.  The recovery duration is almost halved.

The key element of accelerated rehab is the reduced recovery time after ACL reconstruction.  The rehabilitation regimen in designed in such a way that it provides all benefits of traditional post-surgical rehab, but with significantly reduced downtime.

Patients are able to achieve full functional movement of the knee as soon as possible without any risk of future reinjury or compromise with their physical safety.

What is ACL reconstruction?

The anterior cruciate ligament or ACL prevents extreme, inward twisting of the knee joint and ensures its stability. However, excessive load or stress, too much landing pressure, sudden knee maneuver, forceful contact, excessive knee joint twisting, or sudden change of direction ruptures or damages the ligament. This leads to restricted knee mobility and pain requiring surgical reconstruction of the ligament.

ACL reconstruction involves rebuilding of the damaged ligament. The torn ligament is removed and a new ligament is rebuilt from tissue harvested from patellar or quadriceps tendons.

What is the need for a structured post-ACL reconstruction rehab?

Rehabilitation after ACL reconstruction is key to restore the lost knee joint structural and functional strength and avoid the risk of reinjury. It helps reduce inflammation, increase biomechanical motion in an orderly manner, and restore optimum knee joint agility and strength equal to the uninvolved knee and with focus on patient safety and freedom from injury. This also provides psychological boost to reinforce physiological attributes to lead an injury-free life and have better muscle leg control.               

Why should I go for accelerated rehab after ACL reconstruction?

Going for accelerated rehab after ACL reconstruction offers a number of benefits, including

  • faster recovery
  • reduced post-surgical downtime
  • career saving for athletes , as they are able to return to sports
  • best suited for young people undergoing ACL reconstruction
  • progressive approach to post-ACL surgery rehab
  • improved final outcome in lesser time frame recovery
  • return to excellent stability and strength and full range of motion and function in quickest possible time
  • custom-made rehab protocol ensures low chance of postoperative complications, such as knee joint pain and stiffness
  • maximum outcome following ACL reconstruction

 

How good is accelerated rehab compared to traditional rehab?

Researchers suggest a number of benefits associated with accelerated rehab after ACL reconstruction when compared to traditional rehab. It assures early healing, faster muscle activation, reduced time for rest and recuperation, and faster return to work. The recovery time is almost halved allowing athletes to resume their career without any difference in long-term knee joint stability offered by traditional rehab.

Accelerated rehab ensures early knee muscle control. Studies indicate such early control is vital to regain complete quadriceps muscle strength without any flaw. The multi-modal approach of accelerated rehab ensures early pain relief and decreased dependent on painkillers.

A Spanish study links accelerated rehab after ACL reconstruction to greater muscle force, faster compensation for muscle atrophy, reduced hamstring muscle strains, and better muscle isokinetic performance. This plays a crucial role in subduing swelling, allowing enhanced knee agility and strength, and providing good range of movements.

According to a 2011 study reported in the American Journal of Sports Medicine, accelerated rehab after ACL reconstruction produce same benefits as traditional rehab while reducing the downtime considerably. Functional performance, knee strength, and proprioception achieved by accelerated rehabilitation are no way inferior to non-accelerated rehab.

How is a regimen for accelerated rehab after ACL reconstruction developed?

Accelerated rehabilitation after ACL surgery takes into cognizance three factors – the actual condition of a patient, the surgical process, and the ability to cope with accelerated rehab. Based on these considerations, a customized, scientific, and multi-modal regimen is developed. The approach focuses on early healing, rapid recovery, swift regaining of knee strength, faster return to normalcy, and prevention of reinjury.

What are important components of accelerated rehab after ACL reconstruction?

  • Advanced pain management
  • Progressive rehabilitation to help patients up and moving sooner than expected
  • Comprehensive and customized planning and education
  • Early discharge and post-operative care
  • Rapid Recovery coaching
  • Expert orthopedic guidance
  • Regular follow-up

What does accelerated rehab after ACL reconstruction include?

Accelerated rehabilitation after ACL reconstruction is a multi-faceted approach that includes several techniques to ensure rapid and swift recovery.

When should I join accelerated rehab?

Accelerated rehabilitation begins at the pre-surgery stage. Pre-surgical conditioning is provided to ensure that there is no need for extended downtime after the ACL reconstruction and patients experience minimum pain, regain maximum knee stability, get up and moving soon after the surgery, and respond positively to the rapid recuperation techniques.

During the surgical process, procedures that assure fast recuperation and early return to normalcy are preferred over more invasive ones.

 

How is accelerated rehab after ACL reconstruction performed?

 

Accelerated rehabilitation starts immediately after ACL reconstruction as soon as the patient wakes up in the recovery room. Long-acting anesthetic and anti-inflammatory medication administered to tissues surrounding the knee to block pain pathways and allow the patient to start rehab right from the recovery room without feeling pain. This also minimizes the dependence on narcotic painkillers and reinforces the ability to join the rehabilitation.

 

A combination of physiotherapy, medication, nutrition, and other non-medical therapies is used to lessen complications and fatigue while fast tracking recovery, restoration of knee joint strength, and recuperation. The rehab process continues during the hospital stay and even after the patient is discharged under expert supervision. Continued follow up for a few months ensures the patients is on the right track and remains injury free.

 

Do I need to stay in the hospital during accelerated rehab after ACL reconstruction?

No need to stay in the hospital for the entire duration of the accelerated rehab after ACL reconstruction. You can continue it in consultation with your therapist while recuperating at home. However, you may have visit the therapy center regularly to take a stock of your progress.

Is my therapist licensed?

Yes, all therapists are certified and licensed. Accelerated rehab after ACL reconstruction must be carried on under the guidance of expert and experienced therapists.

Is accelerated rehab painful?

No. Pain management is an integral part of accelerated rehab. It offers freedom from pain and healing after ACL reconstruction at the earliest. As pain and swelling subside rapidly, recovery becomes quick.

Do I need to take any precaution?

Accelerated rehab after ACL reconstruction requires patients to strictly follow the suggestions by therapists. Pushing your knee ligament beyond the level f tolerance may affect the functional strength of the knee joint at the early stage. Usually, muscles shut down after a surgery. Rehabilitation aims at restoring the functional strength of these muscles connecting to the knee. However, excessive stress or forced movements beyond what rehab regimen prescribes may cause chronic knee instability.

Is bracing necessary during accelerated rehab after ACL reconstruction?

The focus on developing protective factors, such as muscular potency, functional movements, and proprioceptive stability, for knee joint reduces the need for bracing.

Does accelerated rehab after ACL reconstruction contribute to knee arthritis?

There is no evidence linking accelerated rehab after ACL reconstruction to knee arthritis. It does not contribute to the degenerative disorder. Proper rehab, rather, has the potential to prevent occurrence of any degenerative disease.

Does the type of graft used influence accelerated rehab?

No, everyone can undergo accelerated rehab irrespective of the type of graft used.  The only requirement is that the graft is of right size, at right tension, firmly fixed, and in compliance to isometric requirements.

Does it help to tackle pain?

Yes, accelerated rehab offers best possible way to get rid of pain and swelling after ACL reconstruction.

How long does accelerated rehab take?

Accelerated rehab almost haves the downtime required for recovery.  Athletes undergoing accelerated rehab after ACL reconstruction returns to training in 4 to 6 months compared to 9 to 12 months required by traditional rehabilitation.

References

Shelbourne KD, Gray T. Anterior cruciate ligament reconstruction with autogenous patellar tendon graft followed by accelerated rehabilitation. Am J Sports Med. 1997;25:786-795.

A Jesus, s Igor, I Fernando, et al. 2015 ISAKOS Biennial Congress ePoster #1321: MRI Study of Changes in Muscle Volume in ACL Reconstructed Knees Following Conventional or Accelerated Rehabilitation Programmes. Clínica San Miguel / Sports Medical Study and Research Center, Pamplona, Navarra, Spain

Beynnon BD, Johnson RJ, Naud S, et al. Accelerated versus nonaccelerated rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind investigation evaluating knee joint laxity using roentgen stereophotogrammetric analysis. Am J Sports Med. 2011 Dec;39(12):2536-48.

Pilot P, Bogie R. Draijer WF, et al. Experience in the first four years of rapid recovery; is it safe? Injury. 2006; 37 Suppl 5:S37-40.

Brownstein, B., Bronner, S. Patella fractures associated with accelerated ACL rehabilitation in patients with autogeneous patella tendon reconstructions. Journal of Orthopaedic and Sports Physical Therapy. 1997;26:168–172.

De Carlo, M., Klootwyk, T.E., Shelbourne, K.D. ACL surgery and accelerated rehabilitation: Revisited. Journal of Sport Rehabilitation. 1997;6:144–156.

FAQS on Best Treatment Options for Frozen Shoulder

About 2 to 5% Americans mostly beyond their forties suffer from frozen shoulder syndrome. Availability of a range of minimally or non-invasive treatment methods helps them overcome the pain, stiffness, disability, and loss of motion associated with the disorder.

What is frozen shoulder?

Frozen shoulder refers to inflexibility and stiffness in the shoulder joint. Known as shoulder adhesive capsulitis in the medical annals, it causes a feeling of adhesion and substantial loss of shoulder joint motion in all directions. The cause of frozen shoulder is traced to swelling and stiffening of loose capsule around the shoulder joint due to scarring.

How does frozen shoulder occur?

The shoulder joint comprises of bones, tendons, and ligaments. A sac of ligaments or articular capsule lubricated by synovial fluid provides cover to the structure. It is loose enough to facilitate shoulder motion in all directions.

Any injury to the shoulder capsule results in inflammation and scar formation on it. This causes the capsule to thicken and shrink leading to tightening of the shoulder joint restricting mobility. Patients feel stiffness and adhesion in the shoulder joint and develop a frozen shoulder.

Apart from shoulder injury, diabetes, tendinitis, bursitis, rotator cuff injury, long-term immobility, heart surgery, breast surgery, and arthritis increase the risk of frozen shoulder.

When should I explore treatment options for frozen shoulder?

Frozen shoulder starts with gradual stiffness in the shoulder joint and this is the appropriate time when you consult your doctor. Explore available treatment options for frozen shoulder if you have aching pain and restricted external rotation in the shoulder joint or feel frozen shoulder as you wake up.

How is frozen shoulder diagnosed?

An investigation of symptoms and evaluation of physical condition are the best possible ways to diagnose frozen shoulder disorder. Your doctor may suggest imaging tests to confirm the findings and rule out any other disorder.

What are the available treatment options for frozen shoulder?

Non-Invasive Treatment Options for Frozen Shoulder

  • Therapeutic Treatment for Frozen Shoulder

Focused on managing pain and stiffness, therapeutic treatment options for frozen shoulder offer relief at the initial stage. Conservative treatments, including physical therapy, and rehabilitation protocol help reinforce the rotator cuff and increase the range of shoulder motion. Passive stretching exercises also help overcome frozen shoulder symptoms at the initial stage.

  • Medication for Frozen Shoulder

Non-steroidal anti-inflammatory medicines reduce inflammation that cuts back pain and stiffness in the shoulder joint. Painkillers, mostly available over the counter, are also prescribed.

Minimal Invasive Pain Management Treatment for Frozen Shoulder

  • Shoulder Manipulation Under Anesthesia Injections

Forward flexion and crossover arm exercises restore the range of motion to some extent. In extreme cases, general anesthesia is administered to the patient to prevent pain and forced shoulder stretching or movement is carried on. This loosens the capsule stiffened due to inflammation.

  • Pain Management Injections for Frozen Shoulder

Pain management injections, also known as epidural injections, are quite popular with patients suffering from frozen shoulder. Minimally invasive, these injections provide relief for months at one go by inhibiting swelling and inflammation. Once pain is reduced, the range of motion improves allowing better mobility. Superior than painkillers, these injections are administered to the shoulder joint and thus, largely remain free from any adverse effect.

Now various types of pain management injections are used for the treatment of frozen shoulder.

  • Anesthetic injections, which contain lidocaine, a numbing medication
  • Corticosteroid injections, which have a steroid ingredient.
  • Anti-inflammatory epidural injections customized for glenohumeral joint pain
  • Hyaluronic acid injections to lubricate the scarred capsule and make movement of bones and tendons squeezed inside swift.

Surgical Treatment Option for Frozen Shoulder

Surgery is the last treatment option for frozen shoulder symptoms and suggested to those who fail to get any relief despite using all other methods. Shoulder arthroscopy is the most preferred way to treat frozen shoulder surgically. Guided by a miniature camera and using special equipment inserted into the shoulder joint through small incisions, surgeons cut through the part of the capsule responsible for causing stiffness. This loosens the contracted capsule and makes room for bone and tendon movements. Post-surgical recovery is quick and it takes about 6 to 8 weeks to recover fully.

References

Kwaees TA, Charalambous CP. Surgical and non-surgical treatment of frozen shoulder. Survey on surgeons treatment preferences. Muscles, Ligaments and Tendons Journal. 2014;4(4):420-424.

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