Preventing Knee Replacement Surgery (Total Knee Replacement, TKR)

Osteoarthritis of the knee can be a disabling and painfully condition. By definition, osteoarthritis is the loss of the articular cartilage that covers the ends of the bones within the knee joint.  The knee joint is made up of two major bones: the femur (thigh bone) and tibia (shin bone).  There should be approximately 5 mm of cartilage covering the ends of the bones within the knee joint. Osteoarthritis is a condition in which the articular cartilage that covers the ends of the bones breaks down.

The articular cartilage typically provides a cushion for the knee.  When it is lost, a variety of symptoms occur including pain, stiffness, swelling and loss of motion.  Additionally, the leg begins to deform in appearance and can become either increasingly bowlegged (varus) or more knocked kneed (valgus). Further, osteophytes also known as bone spurs start to form within the knee joint.

In order to treat osteoarthritis, some people opt for a surgical option like total knee replacement (TKR).  In addition, there are also many nonsurgical ways to treat the condition. (more…)

Smoking and Orthopaedics

Did you know that when you smoke that you are inhaling over 60 different carcinogens and 5000 chemical agents? Your lungs are being filled similar chemicals that are found in lighter fluid, batteries, insecticide, and toilet bowl cleaner, rocket fuel, poison, sewer gas, industrial solvents and paint. These chemicals include: butane, cadmium, hexamine, toluene, nicotine, ammonia, methanol, arsenic, methane and nicotine just to name a few.

Cigarette smoking is very detrimental if you have an orthopaedic condition in addition to causing orthopaedic injuries and conditions such as rotator cuff tears, delay in bone healing and post-surgery wound problems, just to name a few.


What is New in Knee Osteoarthritis


Three types of exercises that are recommended for patients with knee osteoarthritis: flexibility, resistance and cardiovascular flexibility exercises.  All three are very good for easing stiff joints which will help patients with their ADLs. It is recommended that the stretches be done in the morning. It may be easiest to perform them in warm bath water which eases the joint stiffness.

Resistance exercises are important to build the muscles around the arthritic joints. By building muscle it helps to absorb the shock and protect the joint from further injury. There are 2 types of resistance exercises: isometric and isotonic. Isometric are typically the most easy resistance exercise for the OA patient. The strengthening occurs with contraction of the different leg muscles without moving the joint.

Cardiovascular exercise uses big groups of muscles. The best recommendation for cardio fitness in the arthritic knee patient is water aerobics or cycling. The National Arthritis Foundation is a great resource for exercise DVD’s. A referral to the local physical therapist can also be helpful. I find my patients like the personal instruction and the P.T. also helps to maintain their technique.


How Many Pitches Should My Child Throw?

Stacie L. Grossfeld, M.D.

Board Certified Orthopaedic Sports Medicine

4001 Kresge Way Suite 330, Orthopaedic Specialists,  PLLC

Last year there were 3.5 million visits to the emergency room for sports related injuries that occurred in children under the age of 14. That is a 5 time increase in the number if sports related injuries compared to the previous 10 years. Why is this occurring? (more…)