Knee Pain and Injury Care in Knoxville, TN
Knee problems such as meniscus tears, ACL tears, and arthritis are some of the most common problems we treat at OrthoKnox in Knoxville, Tennessee. Without proper evaluation and management, knee pain, swelling, and instability can prevent a person from getting back to work and sports.
With fellowship training in sports medicine and knee surgery, our surgeons’ goal is to return our patients to the active lifestyle that they desire. Often, we can achieve this with a nonoperative approach.
Sometimes surgery for ligament reconstruction, cartilage repair, or even knee replacement is necessary. Advancements in knee surgery, such as all-arthroscopic surgery and minimally invasive partial and total knee replacements, allow our patients to return to those active lifestyles as rapidly as possible.
If surgery is necessary, OrthoKnox orthopedic surgeons are experts in the following procedures:
The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) cross in the central portion of the knee joint. The ligaments have unique functions, but in general, both contribute to the anterior-posterior stability, as well as rotational stability of the knee joint.
The ACL is commonly injured during sports, causing knee instability and subsequent giving-way episodes. The goal of ACL reconstruction is to restore the function and stability of the knee, prevent further damage to cartilage in the knee, and return the patient to sports and activity.
One of the discussions the surgeon will have with you involves which graft will be used for the ligament reconstruction. In essence, there are 3 grafts we often use. The most common graft we choose is the patellar tendon graft, often called the bone-tendon-bone or BTB, due to the technique of harvesting the graft with a piece of bone attached on both ends.
Another commonly used graft is a hamstring graft, sometimes referred to by the names of the tendons, the semitendinosus and gracilis or simply “semi-T.” This graft requires a different fixation technique than does the patellar tendon, but also can produce excellent results.
Finally, a popular graft choice is an allograft, or cadaver graft. The allograft may be one of many different tissues depending on the surgeon’s preferences. The tissue may be patellar tendon bone-tendon-bone, hamstring tendons, Achilles’s tendon, or one of several other soft tissue graft choices.
The medial meniscus and lateral meniscus are cartilage structures in the knee joint that function as cushions between the bones. The healthy menisci are soft, supple, and mobile, yet they are vulnerable to injury during twisting motions in sports.
Arthroscopic surgery treats the damaged cartilage without opening the knee joint. The traumatically torn meniscus in a healthy young athlete can sometimes be repaired and saved. The exact location and pattern of torn cartilage is one factor that helps decide if the meniscus can be repaired and expected to heal or not. Some locations do not have adequate blood supply to heal and need to be removed.
Additionally, when the meniscus has “many years and miles on it,” it is typically degenerative and beyond repair. In these cases, we arthroscopically debride the torn part, preserving as much healthy meniscus as possible. Both the technique for resection and repair are highly successful at returning patients to activity and pain-free living.
A focus of our philosophy at OrthoKnox is to heal and preserve the patient’s own tissue when at all possible, rather than resorting to replacement. Unfortunately, there are still vast limitations to our abilities for re-growing or healing certain types of tissues, including cartilage.
However, in the properly chosen patient, there are several options for cartilage restoration that can achieve long-term results of pain relief and improved function. Some of these include:
Meniscus Transplantation: A cadaveric meniscus is transplanted to a knee that has undergone prior menisectomy.
Microfracture procedure: Multiple small holes are created in a region of cartilage damage with exposed bone. With this technique coupled to the appropriate rehabilitation, the bleeding bone is able to form a clot, termed the “superclot,” which can differentiate into a cartilage covering.
OATS (Osteochondral Autograft Transfer or Allograft Transplant): Healthy bone and cartilage is transplanted to a defect or area of arthritis.
All of these procedures are performed at OrthoKnox and are highly patient selective and individualized.
Unicompartmental (partial) knee replacement is a minimally invasive solution for knee arthritis designed for the patient with arthritis localized to only one aspect of the knee. With this technique, only the damaged area of the knee joint is replaced, preserving the healthy cartilage, ligaments, meniscus, and bone.
MAKOplasty® knee replacement is a technologically advanced unicompartmental procedure that utilizes the latest in computerized imaging, navigation, and robotic arm technology. These advancements allow the surgeon to perform a more accurate and precise placement of the implants through a smaller incision. Advantages include less pain, blood loss, and scarring. Therefore, hospital stays are reduced and the patient’s rehabilitation and recovery are faster.
Total knee replacement surgery involves removing the damaged portion of the knee and replacing it with artificial implants. Total knee arthroplasty is the most common type of joint replacement surgery. It is highly successful for relieving pain and restoring joint function in patients with tricompartmental or end-stage knee arthritis.
Our surgeons use the latest designs and technology for improving the accuracy of placement and increasing the lifespan of the implants.
High tibial osteotomy is a procedure for cutting and realigning the tibia to correct a “bowleg” deformity to the knee. By correcting the knee alignment, force is redistributed from the more arthritic part of the knee to the more normal and healthy part of the knee. Pain is relieved and the joint cartilage begins to wear more evenly.
High tibial osteotomy can help prevent or delay the progression of knee arthritis and the decision for knee replacement surgery.