Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Common Knee Conditions by: Fred Huang


Published on

Valley Orthopedic Associates physician. Dr. Fred Huang gives a seminar on Common Knee Conditions

Published in: Health & Medicine
  • Be the first to comment

Common Knee Conditions by: Fred Huang

  1. 1. VMC Seminar April 28, 2011 Renton, Washington Fred Huang, MD Valley Orthopedic AssociatesA Division of Proliance Surgeons, Inc.
  2. 2.  Meniscal Tears ACL Tears Multi-ligament Injuries Tibial Plateau Fractures
  3. 3. Healthy Right KneeSource: Knee Ligament InjuriesThe Staywell Company, 2001
  4. 4. Meniscal Tears  Symptoms – what patients notice   Swelling   Catching and locking   Pain with pivoting and squatting  Exam Findings – what doctors find   Swelling (fluid on the knee)   Tenderness at the site of the tear   Pain with flexion/twisting
  5. 5. Meniscal Tears  Arthroscopic surgery to remove torn tissue Source:  Degenerative tears: associated with minimal or no trauma  Degenerative tears often associated with arthritis & not always treated with surgery Source:
  6. 6. Types of Ligament Injuries   ACL very common   MCL most common with ski injuries   Usually treated with bracing for 6 weeks   Combination injuries (ACL w/ MCL most common, but any combo possible)   PCL involved frequently in multi-ligament injuries
  7. 7. ACL TearsSource: Knee Ligament InjuriesThe Staywell Company, 2001
  8. 8. ACL Tears  Twisting and/or cutting – often a non-contact injury  Usually unable to continue sporting activity  Swelling within 1-2 hours Source: Knee Ligament Injuries The Staywell Company, 2001
  9. 9. MRI – ACL and Meniscal Tears
  10. 10. ACL Tears - Treatment  Non-operative treatment (Brace?)  Surgical treatment   Only after motion returns to normal   Graft options: hamstrings, patellar tendon, quad tendon, or allograft   Associated procedures: meniscal or cartilage procedures
  11. 11. ACL Reconstruction  Sources: Left: Right:
  12. 12. Multi-ligament Knee Injuries  Higher energy mechanism than ACL tears  Can be due to a complete knee dislocation  Nerve and/or blood vessel injuries possible
  13. 13. Multi-ligament Knee Injuries
  14. 14. Tibial Plateau Fractures  Wide spectrum of injury patterns  Often treated surgically to re-establish normal architecture at the joint surface
  15. 15. Tibial Plateau Fractures  CT scans helpful
  16. 16. Tibial Plateau Fixation withLateral Ligament Repair (Simple)
  17. 17. Tibial Plateau Fixation - Moderate
  18. 18. Tibial Plateau Fixation - Complex
  19. 19. Patello-femoral Pain  Frequent cause for ANTERIOR knee pain  Pain worsened by running, squatting, stair-climbing, and lunges  Often associated with grinding/popping at the kneecap  MRI’s often “normal”  Treatment consists of formal P.T., NSAID’s, weight loss, and occasional steroid injections
  20. 20. Knee Arthritis  Pain worse with standing and better with rest  Physical Exam:   Stiffness & swelling   Deformity (bow-legged versus knock-kneed)
  21. 21. Knee Arthritis – Treatment OptionsStandard treatments:   1. Medicines   2. Injections   3. Surgery (replacement usually)
  22. 22. Knee Arthritis Treatment – Tibial Osteotomy  Intermediate solution that improves pain and function usually for < 10 years  Allows for continued impact activities  Associated with a longer recovery time (to allow for healing of the osteotomy)
  23. 23. Total Knee Replacement  Reliable solution that improves pain and function usually for >15 years  Physical therapy and home exercises important after surgery  New interest in better pain management, smaller incisions, and accelerated rehab  Not designed for impact activities
  24. 24. Thank You  Fred Huang, MD