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The anterior cruciate ligament (ACL) is located around your knee. It prevents the shin bone from moving forward over the thigh bone. If it tears, it can be instantly painful and can lead to structural damage.

If you tear your ACL, your knee may give out while you are engaged in physical activity. If you dont have this treated, your knee may give out time and again. This can cause early arthritis as well as damage to the cartilage.

ACL Reconstruction can resolve these problems. With this surgery, your damaged ligament can be replaced with new ligament. This ligament may come from a deceased donor (allograft) or from you (autograft).

If you use an autograft, it will probably be taken from the front of your knee. This is called the patellar tendon. It may also come from your hamstring.

There are pros and cons to both types of grafts; however, both are usually successful for most people. Talk with your surgeon to find out more.

Click here for more on treating ACL tears .

Your surgeon will probably use arthroscopy to perform your ACL reconstruction. This type of surgery is usually done using general anesthesia.

When arthroscopy is used, your surgeon will have a clear view of the inside of your knee. He or she will make one small incision to insert a tiny camera into the knee chamber. This camera will send a picture of the interior structure of the knee to a video monitor. In this way, your surgeon can see and repair any problems in the knee at the same time that he or she attends to your ACL damage.

If you are using an autograft, there will be one large incision (also called an open incision) made to remove this tissue. Additionally, your surgeon will access the areas to be worked on via several small incisions around the knee. These will be used to place your new ligament. Your old ligament will be removed, then the surgeon will make bone tunnels to place the new ligament in the same position as the old one. The new ligament will be secured with surgical fasteners such as screws.

When your surgery is finished, your incisions will be closed, and a bandage will be put on. When you wake up from your anesthesia, you will probably be able to see pictures and the video of your surgery. Your surgeon will discuss the procedure with you and answer your questions.

Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, ACL Surgery in Tigard and Tigard Knee Injuries.

Physicians see more rotator cuff injuries than almost any other musculoskeletal injury. A patient with a rotator cuff injury will experience pain and weakness in the shoulder, but not swelling. Sometimes the patient does not have symptoms. Usually, though, the patient will have increased weakness and pain when active. This is especially true when raising the arm higher than shoulder level. Fortunately, there are quite a few treatments available for rotator cuff injury. The type of treatment that is suitable would depend upon the patient’s age and the type of injury experienced.

There are two categories of rotator cuff injury. One is rotator cuff tendonitis. The other is rotator cuff tear. Be aware that there are several other conditions that could be the cause of shoulder pain. The only way to get an accurate diagnosis of rotator cuff injury is to see a doctor. He or she will first look at the symptoms and perform a basic physical examination. After this, the physician may use a local anesthetic that will be injected into the injured shoulder. This will help determine whether the injury is a muscle tear or tendonitis. If the injury seems to be a rotator cuff tear, the doctor may order some imaging tests. These will help confirm that the injury is a tear and isolate the location of the injury.

It is far more common for the diagnosis to be rotator cuff tendonitis; however, the treatment for tears is very similar to the treatment for tendonitis. Both can be treated conservatively with what is known as RICE therapy. That is: rest, ice, compression, and elevation. You may also want to use an over-the-counter pain medication like ibuprofen. Additionally, your doctor may give you a referral to a physical therapist to learn how to modify your movements and to get a list of exercises that may be beneficial to you. If your tendonitis pain persists, your doctor may give you injections of a steroid/anesthetic mixture. These would be administered to the joint to relieve pain.

About half the patients using this kind of non-surgical treatment experience an increase in ROM (range of motion) and a decrease of pain within 2 or 3 months. This kind of treatment has several advantages. First of all, non-invasive treatment avoids surgical risks such as infection, anesthesia complications, and permanent stiffness. Second, there is no recovery time involved. Of course, there is also a downside in that this route could lead to an increase in the size of the tear. Additionally, the patients activity level may be decreased during the healing period. And, there is the risk that a non-invasive method may simply not work. If this is the case, and the non-invasive option fails, then surgery may be the alternative. The doctor may also decide that surgery is the better option if he or she feels that the injury is severe enough to merit it as the first option.

Click here for more on rotator cuff tears .

When rotator cuff injury is treated with surgery, there are generally three options.

The method that allows the surgeon to operate most freely is called open repair surgery. This method utilizes a full incision in the shoulder. This option can leave a rather large scar.

2. Mini-open repair surgery: This method is like open repair surgery, but it also utilizes arthroscopy. The advantages of this method are that it is an outpatient procedure that leaves a smaller scar.

3. All arthroscopic surgery: This option is an outpatient procedure, and it uses the smallest incision.

After examining and diagnosing your injury, your doctor will be able to make a sound decision as to which method will work best for you.

After rotator cuff surgery, most patients have decreased pain and an increase in range-of-motion. Recovery is usually complete within 4 to 6 months. Results are usually quite satisfactory, with 80 – 95% of patients reporting good results.

The expertise of the surgeon is a very important factor in the successful outcome of the surgery. However, there are some variables to keep in mind when considering speed and success of recovery. Among them are the type of tear, tissue quality, the patients age, and the amount the patient complies with the doctors instructions.

Some patients experience complications from surgery; however, these are rare. One to two percent may experience nerve injury. Approximately one percent may contract infection. Less than one percent may have detachment of the deltoid muscle. Less than one percent may experience stiffness. Tendon re-tear is experienced by approximately six percent of patients.

Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, Vancouver ACL Surgery and Vancouver Athletic Injuries.

One of the most frequent musculoskeletal injuries is the rotator cuff injury. Sometimes this type of injury is not associated with symptoms, but usually it is quite painful. A rotator cuff tear or rotator cuff tendonitis can cause you to experience pain and weakness in the shoulder when using your arms. It can be especially painful to lift the arm higher than shoulder level. Luckily, there are a number of ways to treat rotator cuff injuries – both surgical and non-surgical. The type of injury you have, your condition, and your age will be determining factors in deciding which type of treatment is right in your situation.

In addition to the two types of rotator cuff injuries already mentioned – tear or tendonitis – you should be aware that there are other conditions that may exhibit similar symptoms. Be sure to see your doctor to get the right diagnosis. He or she will give you a physical examination and will probably inject your shoulder with a local anesthetic. These procedures help your doctor to determine exactly what is wrong with your shoulder. If your doctor believes that you have a rotator cuff tear, the next step may be imaging tests to confirm the diagnosis and find the exact location of the tear.

Rotator cuff tendonitis is more common than rotator cuff tear, but the treatment is similar for both. Rest, ice, compression and elevation, also known as RICE therapy, is prescribed for both conditions. Your doctor may also tell you to take an over-the-counter pain medication like ibuprofen. You may also be referred to a physical therapist who will help you to understand how to modify your activities to avoid pain and may also give you instructions on exercises to help strengthen your shoulder. If these measures dont help, your doctor may give you a shot of a steroid/anesthetic mix. This injection will be made directly into the joint to help address your pain.

About half the patients using this kind of non-surgical treatment experience an increase in ROM (range of motion) and a decrease of pain within 2 or 3 months. This kind of treatment has several advantages. First of all, non-invasive treatment avoids surgical risks such as infection, anesthesia complications, and permanent stiffness. Second, there is no recovery time involved. Of course, there is also a downside in that this route could lead to an increase in the size of the tear. Additionally, the patients activity level may be decreased during the healing period. And, there is the risk that a non-invasive method may simply not work. If this is the case, and the non-invasive option fails, then surgery may be the alternative. The doctor may also decide that surgery is the better option if he or she feels that the injury is severe enough to merit it as the first option.

Click here for more on rotator cuff surgery .

There are three ways to treat a rotator cuff injury surgically:

The method that allows the surgeon to operate most freely is called open repair surgery. This method utilizes a full incision in the shoulder. This option can leave a rather large scar.

2. Mini-open repair surgery: This method is like open repair surgery, but it also utilizes arthroscopy. The advantages of this method are that it is an outpatient procedure that leaves a smaller scar.

The third method is known as all arthroscopic surgery. This is the simplest option in that it is an outpatient procedure, and it also leaves the smallest scar.

Your doctor will need to give you a thorough examination and do complete testing to determine which type of surgery will be best in your case.

The majority of patients who have rotator cuff surgery experience a decrease in pain and an increase in ROM (range of motion) within four to six months following surgery. In fact, eighty to ninety-five percent of people who have this surgery report satisfaction with the results.

The expertise of the surgeon is a very important factor in the successful outcome of the surgery. However, there are some variables to keep in mind when considering speed and success of recovery. Among them are the type of tear, tissue quality, the patients age, and the amount the patient complies with the doctors instructions.

It is rare to experience complications with rotator cuff surgery. Tendon re-tear, which is the most commonly experienced complication, only occurs in about 6% of patients. One or two percent may have nerve injury. As little as one percent of patients may contract infection. Detachment of the deltoid muscle and/or stiffness are experienced by fewer than one percent of patients.

Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, Portland Meniscus Tears and Athlete Injuries in Portland.

A tear in the anterior cruciate ligament can be very painful to your knee. If this happens, you will probably be considered as a candidate for ACL (anterior cruciate ligament) reconstructive surgery. In this operation, your torn or damaged tissue will be replaced with new tissue.

You may wonder where this tissue will come from. There are a couple of ways to get tissue for an ACL (anterior cruciate ligament) reconstruction. One way is to take the tissue from the patients body. This is called an autograft. The tissue is usually taken from the hamstring or the patellar tendon. This is the tendon at the front of the knee.

Allograft is another type of graft. This tissue is harvested from a cadaver.

There are good and bad points about each choice. Your surgeon will talk with you about the options and help you decide which would work best in your situation.

Arthroscopy is usually used when performing ACL (anterior cruciate ligament) reconstruction. In this type of surgery, a small incision called a poke-hole is created to allow the surgeon to insert a very small camera into the knee. This lets the surgeon see the condition of the interior of your knee.

Your surgeon will examine the ligaments and the cartilage in your knee. If he or she finds that there has been other damage (for example, a meniscus tear) it will be taken care of during your surgery.

Several types of anesthesia are used for arthroscopic knee surgery, but you will probably receive general anesthetic. This will allow you to sleep during the surgery. While you are sleeping, your surgeon will replace your ACL (anterior cruciate ligament).

Click here for more on ACL Surgery .

Small incisions will be made around your knee so that your surgeon can get your new ligaments into just the right places. A bone shaver or other instrument will be used to remove your damaged ligament. If you will be using your own tissues to replace the damaged tissues, your surgeon will make a larger incision in order to access it.

Your new ligament will be put into place using bone tunnels which will allow the surgeon to place the new ligament in exactly the same location as the old ligament. Once in place, the ligament will be secured with screws or some other type of fastener to prevent it from moving. When your surgery is done, your incisions will be closed, and your knee will be bandaged.

With arthroscopy, your surgeon can film your entire surgery. Then the two of you can watch the procedure on a video monitor, and your surgeon can share information gathered and answer any questions you may have.

To be considered for ACL (anterior cruciate ligament) reconstruction, some symptoms you might be experiencing include, knees that give way, weakness and instability in the knees, and knee pain. If your ADL (activities of daily living) are affected and/or you are not able to participate in sports as you wish, these are further reasons to consider ACL (anterior cruciate ligament) reconstruction.

Of course, there are risks with any surgical procedure. Risks for ACL (anterior cruciate ligament) surgery include possible nerve damage, infection and excessive bleeding. Some patients experience knee stiffness, knee pain, and weakness in the knees. Additionally, there are times when the ligament fails to heal or the surgery does not alleviate the symptoms.

Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, Vancouver ACL Reconstruction and Vancouver Knee Doctor.