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Knee

Distal Femoral Osteotomy for Valgus Malalignment With Osteochondral Lesion

Tibial Tubercle Avulsion

Tibial Spine Avulsion Fractures

Normal Anatomy of the Knee Joint

The knee is made up of four bones. The femur or thighbone is the bone connecting the hip to the knee. The tibia or shinbone connects the knee to the ankle. The patella (kneecap) is the small bone in front of the knee and rides on the knee joint as the knee bends. The fibula is a shorter and thinner bone running parallel to the tibia on its outside. The joint acts like a hinge but with some rotation.

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Conditions

ACL Tears

The anterior cruciate ligament, or ACL, is one of the major ligaments of the knee that is located in the middle of the knee and runs from the femur (thigh bone) to the tibia (shin bone). It prevents the tibia from sliding out in front of the femur. Together with posterior cruciate ligament (PCL) it provides rotational stability to the knee.

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Deep Vein Thrombosis

The condition in which a blood clot forms in the deep veins of the body is referred to as Deep Vein Thrombosis (DVT). Clots form when blood thickens and clumps together. DVT occurs most often in the deep veins of the leg and thighs.

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Fractures of the Tibial Spine

Tibial eminence spine avulsion fracture is avulsion (tear away) of the tibial eminence (an extension on the bone for attachment of muscles) which most commonly involves the anterior cruciate ligament (ACL) insertion site. This injury represents the childhood equivalent of the anterior cruciate ligament (ACL) rupture and may occur as a result of abnormal outward bending or twist, injuries caused by sudden halt of moving joints, excessive flexion (bending inwards) and internal rotation as happens in skiing and also in motor vehicle accidents.

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Goosefoot Bursitis of the Knee

A bursa is a small fluid-filled sac found between soft tissues and bones. It lubricates and acts as a cushion to decrease friction between bones when they move. Bursitis refers to the inflammation and swelling of the bursa. Goosefoot bursitis or Pes anserine bursitis is the inflammation of the bursa present between the tendons of the hamstring muscle and the tibia (shinbone) on the inner side of the knee.

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Meniscus Tear

Meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A suddenly bend or twist in your knee cause the meniscus to tear. This is a traumatic meniscus tear. Elderly people are more prone to degenerative meniscal tears as the cartilage wears out and weakens with age. The two wedge-shape cartilage pieces present between the thighbone and the shinbone are called meniscus. They stabilize the knee joint and act as “shock absorbers”.

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Osgood-Schlatter Disease

Osgood-Schlatter disease refers to a condition of an overuse injury that occurs in the knee region of growing children and adolescents. This is caused by inflammation of the tendon located below the knee cap (patellar tendon). Children and adolescents who participate in sports such as soccer, gymnastics, basketball and distance running are at higher risk of this disease.

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Osteoarthritis of the Knee

Osteoarthritis, also called degenerative joint disease is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (cartilage).In a person with osteoarthritis, the cartilage becomes damaged and worn out causing pain, swelling, stiffness and restricted movement in the affected joint.

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Patella Fracture

The knee cap or patella is the largest sesamoid bone in the body and one of the components of the knee joint, present at the front of the knee. The undersurface of the kneecap and the lower end of the femur are coated with articular cartilage, which helps in smooth movement of the knee joint. The knee cap protects the knee and provides attachment to various muscle groups of the thigh and leg. Fracture of knee cap is rare and is more common in adult males.

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Patella Tendon Rupture

Patella tendon rupture is the rupture of the tendon that connects the patella (knee cap) to the top portion of the tibia (shin bone). The patellar tendon works together with the quadriceps muscle and the quadriceps tendon to allow your knee to straighten out.

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Patellofemoral Pain Syndrome

Patellofemoral pain syndrome, also called runner’s knee, refers to pain in the front of the knee, around the patella. The patella, also called kneecap, is a small flat triangular bone located at the front of the knee joint. It is a sesamoid bone embedded in a tendon that connects the muscles of the thigh to the shin bone (tibia).The function of the patella is to protect the front part of the knee.

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Kneecap Bursitis

A bursa is a small fluid-filled sac found between soft tissues and bones. It lubricates and acts as a cushion to decrease friction between bones when they move. Bursitis refers to the inflammation and swelling of the bursa. Inflammation of the bursa in front of the kneecap (patella) is known as kneecap bursitis or prepatellar bursitis.

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Quadriceps Tendon Tear

Quadriceps tendon is a thick tissue located at the top of the kneecap. The quadriceps tendon works together with the quadriceps muscles to allow us to straighten our leg. The quadriceps muscles are the muscles located in front of the thigh.

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Septic Arthritis

Septic arthritis, also called as infectious arthritis, is characterized by joint inflammation due to a bacterial or fungal infection that usually affects the large joints of the body such as knee. Normally, fluid lubricating a joint, called synovial fluid, is aseptic in nature. But with septic arthritis, microbes can grow in the affected joint fluid and make the condition worse.

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Shin Splints

“Shin splints” is used to describe the pain and inflammation of the tendons, muscles and bone tissue around the tibia or shine bone (a large bone in the lower leg). It occurs as a result of vigorous physical activity such as exercise or sports. The condition is also referred to as medial tibial stress syndrome (MTSS).

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Tibial Fractures

The tibia or shin bone is a major bone of the leg which connects the knee to the ankle. A tibial fracture is a break in the continuity of the shin bone (tibia).

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PCL Tear

Posterior cruciate ligament (PCL), one of four major ligaments of the knee is situated at the back of the knee. It connects the thighbone (femur) to the shinbone (tibia). The PCL limits the backward motion of the shinbone.

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Procedures

Anterior Cruciate Ligament ACL Reconstruction

The anterior cruciate ligament is one of the major stabilizing ligaments in the knee. It is a strong rope like structure located in the center of the knee running from the femur to the tibia. When this ligament tears unfortunately, it does not heal and often leads to the feeling of instability in the knee.

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ACL Reconstruction Hamstring Tendon

Anterior cruciate ligament (ACL) reconstruction hamstring method is a surgical procedure that replaces the injured ACL with a hamstring tendon. Anterior cruciate ligament is one of the four major ligaments of the knee that connects the femur (thigh bone) to the tibia (shin bone) and helps stabilize your knee joint. Anterior cruciate ligament prevents excessive forward movement of the lower leg bone (the tibia) in relation to the thigh bone (the femur) as well as limits rotational movements of the knee.

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Arthroscopic Chondroplasty

Articular or hyaline cartilage is the tissue lining the surface of two bones in a joint. It helps the bones to move smoothly against each other and can withstand the pressure of activities such as running and jumping. Articular cartilage does not have a direct blood supply so it has less capability of repairing by itself and can lead to degeneration of the articular surface (osteoarthritis). Chondroplasty refers to the surgical repair of torn or damaged cartilage.

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Autologous Chondrocyte Transplantation

Autologous chondrocyte implantation (ACI) is a procedure to treat the articular cartilage defects of the knee. This procedure is effective for treating small areas of cartilage damage that causes pain and swelling and restricts the range of motion. Autologous chondrocyte implantation is not indicated for those patients who have advanced arthritis of knee.

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Cartilage Repair

Articular Cartilage is the white tissue lining the end of bones where these bones connect to form joints. Cartilage acts as cushioning material and helps in smooth gliding of bones during movement. An injury to the joint may damage this cartilage which cannot repair on its own. Cartilage can be damaged with increasing age, normal wear and tear, or trauma. Damaged cartilage cannot cushion the joints during movement and the joints may rub over each other causing severe pain and inflammation.

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High Tibial Osteotomy

High tibial osteotomy is a surgical procedure to relieve pressure on the damaged site of an arthritic knee joint. The procedure involves bone removal and realignment of the knee bones. In high tibial osteotomy a triangular wedge of bone is removed from the upper end of the tibia. It is commonly used to relieve pain when non-operative treatments have failed.

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Meniscal Transplant

Meniscal transplantation is a surgical procedure to replace the damaged meniscus of the knee with healthy cartilage.

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Meniscal Repair

Meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A sudden bend or twist in your knees causes meniscal tear. This is a traumatic meniscus tear. Elderly people are more prone to degenerative meniscal tears as the cartilage wears out and weakens with age. The two wedge-shape cartilage pieces present between the thighbone and the shinbone are called meniscus. They stabilize the knee joint and act as “shock absorbers”.

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Microfracture Drilling Procedure for Isolated Chondral Defect

Autologous chondrocyte implantation (ACI) is a procedure to treat the articular cartilage defects of the knee. This procedure is effective for treating small areas of cartilage damage that causes pain and swelling and restricts the range of motion. Autologous chondrocyte implantation is not indicated for those patients who have advanced arthritis of knee.

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OATS cartilage Repair surgery

OATS stands for “osteochondral autograft transfer system”. It is one of two types of cartilage transfer procedures, the other is called “Mosaicplasty”. Cartilage transfer procedures involve moving healthy cartilage from an area of the knee that is non-weight bearing to a damaged cartilage area of the knee. In mosaicplasty, plugs of healthy cartilage and bone are taken from a healthy cartilage area and moved to replace the damaged cartilage area of the knee. Multiple tiny plugs are used and once embedded, resembles a mosaic, hence the name. With the OATS procedure, the plugs are larger. Therefore, the surgeon only needs to move one or two plugs of healthy cartilage and bone to the damaged area of the knee.

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Partial Meniscectomy

Partial meniscectomy is a surgical procedure to remove the torn portion of the meniscus from the knee joint. Meniscus is the C-shaped cartilage located in the knee that lubricates the knee joint, acts as shock-absorber, and controls the flexion and extension of joint. Meniscal tears can occur at any age, but are more common in athletes playing contact sports. These tears are usually caused by twisting motion or over flexing of the knee joint. Athletes who play sports, such as football, tennis and basketball are at a higher risk of developing meniscal tears.

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Patellofemoral Knee Replacement

Arthritis is a general term covering numerous conditions where the joint surface or cartilage wears out. The joint surface is covered by a smooth articular surface that allows pain free movement in the joint. This surface can wear out for a number of reasons; often the definite cause is not known.

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PCL Reconstruction

Posterior cruciate ligament (PCL), one of four major ligaments of the knee, is situated at the back of the knee. It connects the thighbone (femur) to the shinbone (tibia). The PCL limits the backward movement of the shinbone.

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Revision Knee Replacement

Revision knee replacement surgery involves replacing part or all of your previous knee prosthesis with a new prosthesis. Although total knee replacement surgery is successful, sometimes the procedure can fail due to various reasons and require a second revision surgery.

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Total Knee Replacement

During total knee replacement, the damaged cartilage and bone is removed from the knee joint and replaced with artificial components. Artificial knee joints are usually made of metal, ceramic or plastic and consist of the femoral component and the tibial component.

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Tibial osteotomy with open wedge

High tibial osteotomy is a surgical procedure to relieve pressure on the damaged site of an arthritic knee joint. The procedure involves bone removal and realignment of the knee bones. In high tibial osteotomy a triangular wedge of bone is removed from the upper end of the tibia. It is commonly used to relieve pain when non-operative treatments have failed.

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Tibial Tubercle Osteotomy

Tibial tubercle osteotomy is a surgical procedure which is performed along with other procedures to treat patellar instability, patellofemoral pain, and osteoarthritis. This is a quite safe procedure and provides excellent access and surgical exposure during a difficult primary or revision total knee arthroplasty. Surgical treatment is indicated when physical therapy and other nonsurgical methods have failed and there is history of multiple knee dislocations. Tibial tubercle transfer technique involves realignment of the tibial tubercle (a bump in the front of the shin bone) such that the knee cap (patella) traverses in the center of the femoral groove. The patellar maltracking is corrected by moving the tibial tubercle medially, towards the inside portion of the leg. This removes the load off the painful portions of the knee cap and reduces the pain.

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Arthroscopy of the Knee Joint

Knee Arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to look into the knee joint to diagnose or treat a knee problem. It is a relatively safe procedure and a majority of the patient’s discharge from the hospital on the same day of surgery.

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