This is why cleaning your gutters is dangerous! I saw this patient as a second opinion. He had surgery elsewhere. When he fell off the roof, he landed directly on his feet like a cat and shattered his talus which is one of the major bones in the ankle. He is going to need to have all the screws removed and his ankle fused. My medical advise is to hire a professional to clean out your gutters!!!

Proud to be chair of the campaign at the Norton Commons YMCA. We exceeded our goal!! The hardworking board raised money to support 171 children at Safeplace, 47 cancer survivors to workout with Lifestrong, 88 children for the swim access program and 77 children for the youth sports program. The YMCA is WAY more than just a gym!

Osteoarthritis can affect any joint in your body. When arthritis occurs the cartilage that covers the ends of the bones and make up a joint, break down leaving the ends of the bone exposed. This causes pain, deformity, swelling and loss of range of motion. When non surgical treatment has failed, surgery is an option.

If the arthritis involves more than one compartment of the knee, a total knee replacement is a surgical treatment option. A total knee replacement is a major surgery that requires a prolonged course of recovery. Knee replacement surgery can be a life altering procedure to restore range of motion, reduce pain and correct angular deformities. It can be a double edged sword in the sense that there is a high risk in patients who are morbidly obese, smokers, diabetics, and or have vascular disease. Some patients that undergo total knee replacements do not get good results, studies have revealed that up to 23% of patients are unhappy with their total knee.

It’s not good to completely dislocate your knee cap. When this occurs it can knock off pieces of the cartilage that covers the undersurface of the patella. Images below outlined in green show a piece of cartilage knocked off and were floating around the knee joint. The blue outline is the donor site.

In the spirit of the Hamilton tickets that went on sale in Louisville… I have never quite understood the phrase, “break a leg” as a good luck statement. Especially from an orthopedists point of view.

This is what I envision when I hear that phrase…

This image is of a person that broke a leg.

This is a normal femur.

This is after an intramedullary rod has been placed to fix the fractured femur.

#breakaleg #femurfracture #hamilton

Arthritis by definition is loss of the articular cartilage that covers the ends of the bone that make up different joints in your body. The knee is one of the largest joints in the body. Arthritis is caused by the natural aging process, morbid obesity, genetics and trauma.

When non operative or conversation treatment has been tried and failed the next option is surgical intervention. The knee is made up of 3 compartments. A total knee replacement is when all three compartments become replaced or resurfaced. A uni-compartment knee replacement is performed when only one of the three compartments are replaced.

The most minimally invasive surgical treatment for knee arthritis is a knee arthroscopy. This has fairly narrow indications. In some cases of knee arthritis when pieces of cartilage break off it can cause mechanical symptoms such as catching and locking. It can be extremely painful when the knee locks, catches or pops.

If this is the situation a knee arthroscopy is indicated. The knee scope is completed to remove the loose or unstable pieces of articular cartilage. This is a pretty quick surgical procedure that takes about 15 minutes to complete. It does require a general anesthesia and the patient does go complete asleep for the procedure. There is typically not much pain associated with it and a quick recovery is standard. Usually within 10-14 days return to normal activity is achieved.

The knee arthroscopy done in a patient for knee arthritis will not improve range of motion, stiffness, straighten out the angled leg or regenerate new cartilage. The scope is performed to get rid of mechanical symptoms. The red arrows in the following image point to loose cartilage.

This is an injection that is given for knee osteoarthritis. It is called by many names. Here are a few names my patients have called it: rooster comb injection, chicken fat shot, cock comb injection, jelly shot, gel shot, cushion injection, just to name a few… It’s brand name depending on the company that produces it is: monovisc, synvisc, gel one and its generic name is hyaluronic acid or shortened to HA.

What is this mysterious multiple named injectable material???

A little background information, first. HA is a naturally occurring fluid in your knee joint. It is a thick viscous fluid that lubricants the knee joint. The fluid is produced by the cells lining the wall of the knee called synoviocytes.

When a knee becomes arthritic the synoviocytes start producing a fluid that is very thin and water like which does not lubricate the knee very well. The principle behind injecting the HA into the knee is it tricks the synoviocytes to start producing a thicker fluid for 5-6 months which makes the knee feel better. Eventually the arthritic knee goes back to producing the water like fluid again which is why the injection is given about every six months.

HA is a “bandaid” in the sense that it helps for a while to reduce pain but eventually stops working and the injection will have to be repeated. As the osteoarthritis worsens or advances, which all arthritis does, the injection may become ineffective.