Orthopaedic Trauma

What is anterior cruciate ligament?

Anterior cruciate ligament connects the upper part of the leg to the lower part of the leg and maintains knee stability. “Anterior cruciate ligament is on the middle of our knee and is located deep under the skin and tissue which cannot be felt from outside.” Rupture of anterior cruciate ligament can be felt with extensive pain and a sound from the knee.

Anterior cruciate ligament connects thigh and tibia. The task of this tissue is to maintain firmness on the knee. If there is a rupture on anterior cruciate ligament, the bone will move more independently and will have a higher turning degree than normal.

The person experiencing a rupture can feel slipping on the knee, a gap on the knee. The person will have an unstable knee and can feel like slipping all the time. Depending on cochlear pathology and other circumstances, the person can experience extensive pain. The person experiencing a rupture can feel pain when opening and closing the knee.

What Are the Symptoms of Anterior Cruciate Ligament Rupture?

When there is anterior cruciate ligament rupture, there will be abnormal movement between two bones. This abnormal movement can cause friction and degeneration on joint cartilage. Therefore, it is considered as an important injury and the treatment is surgical. The person experiencing anterior cruciate ligament rupture can hear the rupture and feel pain in that region.

Anterior cruciate ligament rupture can be experiences in many sport activities when the player makes an unusual movement.

After the rupture, a gap is felt on the knee and the knee becomes uncontrollable.

How long does the anterior cruciate ligament surgery take and how long does it take to go back to sports?

“There are some initiatives to decrease the recovery time. However, I recommend at least six months of rest. Because the person can feel good at certain moments but this is a biological process. For example, when you cut your hand and have a suture, there is some time for the suture to hold. You cannot decrease the recovery time significantly. If you decrease the time, you will take risks. In the hand example, when you remove the sutures early, you may open the wound again.

For anterior cruciate ligament, I would recommend going back to sports at least six months after the surgery. However, the professional sportsmen have a pressure from the club managers, and coaches and therefore, the player want to get back as soon as possible. These types of demand can lead to early recovery however there is a great risk.” After anterior cruciate ligament surgery, physical therapy should be made in a regular basis.

What are the risks, can the career of a football player end?

“If the rupture on anterior cruciate ligament repeats and a second surgery is necessary,

The chances of success decreases. Under these circumstances, come problems are inevitable and the chance of the patient decreases.”

 Exercises and Things to Be Considered After Anterior Cruciate Ligament Surgery

For patients who had anterior cruciate ligament surgery, first 2 weeks is extremely important:

Dressing and Wound Care

Before leaving the hospital, the knee will be bandaged with an elastic bandage and a immobilizer will be placed on your knee.

You can have a shower but you need to protect the dressing from water.

Before showering, you need remove elastic bandage and immobilizer that can effect from water.

The dressing of the wound should be controlled in every 2-3 days.

Your sutures should be removed on the 14th of the surgery.

There can be bruising on the back of your knee as well as on the lower knee for 3-5 days. This occurs as the bleeding due to surgery are becoming visible on the skin layer. Since the blood moves to the back and bottom side of the knee, the colour change is observed other than the wound. The bruising will change colour o green and yellow and will disappear in 1-2 weeks.

Pain Control After the Surgery

After checking out of the hospital antibiotics (should be taken in 1-2 hour interval), pain killers (should be taken in 1-2 hour interval), and blood thinners (should be taken one a day in full stomach) are recommended.

Antibiotics and pain killers should be taken for 3-4 days regularly. If you notice any kind of abdominal or stomach pain, you should stop taking the pain killers and contact your doctor.

After checking out of the hospital, blood thinner tablets are recommended for one a day. If you pain still continues at night, you can continue your pain killers.

After 3-4 days, pain killers can be used if you need any.

Dressing after anterior cruciate ligament surgery You should apply cold pressing on your knee for 20 minutes in each 2 hour. The ices should be packed in way that the water will not leak outside the package.

Standing Up, Walking and Walking Sticks

When you are standing up, you need to stand on your leg with the surgery by keeping your knee on a locked position and lean backwards.

Walking sticks should be used if you are having a problem with walking. You should try to avoid walking sticks and try to walk normally. Walking with walking sticks

Walking should be done by distributing your load on both sticks.

You should wear a sports shoe and have the bandage on your knee.

You should step on you heel (and keep your knee aligned) as you are taught and should distribute your weight over the two walking sticks to simultaneously move your leg with surgery.

When you are climbing ladders, you should first step with your strong leg and place your leg with surgery afterwards. When you are getting down the stairs, you should first step your leg with surgery and step your strong leg next to it.

You should try to walk as straight as possible without limping. If you are limping, you should continue to use your walking sticks.

Exercises

A rolled towel should be placed under the knee and should be pressed.

(3*60) 5 seconds each.

• Foot wrestling (3*60) 5 seconds each

• A towel and pillow should be placed between two knees and should be pressed. (3*60) 5 seconds each.

Roll pressing exercise

• In the alphabet exercise, try to draw the letters from A to Z while holding your leg high. You should repeat this for 5-6 times a day.

Work with exercise (Thereband) band in 4 ways (3*60 for each way) for 5 seconds.

Press on the foot ankle pump slowly on the downwards and upwards directions. You should repeat this exercise for 5-10 minutes for a couple of times. You can start this exercise after the surgery and continue until you fully heal.

* While you are resting, you should keep your feet high, and should place a pillow or a similar material under your knee not under your feet.

Knee Bending and Movements

The movements should be done with the help of someone while lying down.  When the pain starts, you should wait for 15-20 seconds, then when the pain is relieved you should continue the exercise. The leg should be pulled back for 20-30 seconds, and you should wait in this position for 1 minute. Then, you should release your leg. (3*20) repeats should be done after the surgery.

In addition to knee bending, extension of the knee for the first two weeks is important. In the first couple of weeks, loses in this extension is a common problem. To prevent this condition, you should place a pillow or a similar material under your knee rather than under your feet. If your knee is still not bend, you should place a sandbag of 1-1.5 kg on your knee and focus on something else (For example: You can read a book, newspapers or watch television). With gravitational force and the sandbag on your knee, your knee will extend.

You should revisit your doctor on the 14th day. If you have any problem regarding your knee, you should contact your doctor. If there is any redness, irritation on your wound or if you experience high-temperature, extensive pain or any fluid comes from your wound, or the radius of your leg increases, you should go to the hospital or contact your doctor.

What is the medial meniscus and meniscus? Questions and answers about meniscus disorders in general will be in this writing.

The meniscus, which we all know as words but I think we do not know the importance exactly, is that the bones fit together in the knee joint. C-shaped pillows that help to avoid damage during movement are 2 pillow cartridges, one inside and one outside.

Thanks to them, it is possible that the two bones forming the knee joint are in harmony with each other and can move without harm.

What happens to the meniscus tear, how is the meniscus tear?

The most common complaints in the series are meniscus related problems. Sudden sprains in the knee, tears can occur in meniscus on the back during rotation. Meniscus ruptured in the patient; Dizziness, stabbing, stabbing pain, cramping pain, occasionally locking in the joint.

The diagnosis of meniscus tear is made by the examination of the orthopedic physician and the MR film taken afterwards. Arthroscopy, which is a modern treatment method, is currently used in the treatment of meniscus tears. During arthroscopy, the patient is first anesthetized (general, spinal or local).

The knee joint is inserted into a tube connected to an optical system with a diameter of about 0.5 cm. The image of the knee is reflected on the screen. In this way meniscus, ligament and other structures in the knee are examined. Then a second hole of 0.5 cm diameter is opened and the torn meniscus part is seen on the screen by means of special tools released from this hole and it is intervened. Removing the torn part of the meniscus tears is sufficient for treatment. In meniscus external healing tears, meniscus is arthroscopically erected and recovery is expected.

What is the medial meniscus, is there any treatment?

The meniscus can be torn in different forms depending on the mechanism of both age and injury; Tears in longitudinal, transverse and parallel to each other are the tears we usually encounter.

An accidental or punctured knee can be torn in a sturdy meniscus as a structure with a different direction of movement due to normal movement. A poorly structured meniscus, for example due to old age or repetitive minor wear, can be torn more easily. In the ages, these tears are faded over time.

Younger patients are often confronted with sports injuries. Especially carpet areas are widespread in our country and most of us are faced with many injuries including meniscus rupture when unconscious, not warm enough to start the match before most of them are not done in suitable conditions. In the elderly, over time, there are negative changes in the meniscus texture, as well as tearing due to calcification and overweight and dizziness.

What are Meniscus Symptoms?

It is doubtful whether this is the case, although there are no definite findings. When you kneel, when you stand for a long time or when you step on the stairs, pain should bring to mind the meniscus tear. If the tear is free from one side to the other, it can also cause stabbing and locking.

Of course, as technology advances, many technical entities are emerging, but the most important diagnostic tool is the hands and experience of the physician. With a thorough examination, the diagnosis can be reached to a great extent. To arrive at a more accurate conclusion, we use an advanced examination showing magnetic waves and soft tissues by Magnetic Resonance or MR in short.

Occasionally, the MR may not be the main cause of pain despite meniscal rupture. Even if one has no pain, the meniscus can rupture if the MR is removed. That is, if arthroscopy is performed immediately without examination because of the tear in the MR of the patient who is suffering from a series of painful patients, and if the cause of the pain is another disease, of course the patient will not benefit from the operation. For this reason, a detailed examination should be made.

Treatment Methods Used in Meniscal Tears

There are two pathway combinations in meniscus tears; Surgery or “drug-exercise-rest” combination. In meniscal tears with mechanical indications such as stabbing and lock-ups detected by MR, it would be right to make a closed-surgery decision called direct arthroscopy.

If the patient is not fully segregated low grade rupture, pain and other complaints can be treated with medications and special exercises given by the doctor. Surgery may be considered if there is no reduction in complaints after at least 1.5 months of well-tolerated treatment.

Today, there are significant developments in treatment. The most important of these is “arthroscopy”. When open surgery is performed for meniscus tears, it is now possible to successfully treat these diseases with the closed method called arthroscopy. With the age of the torn meniscus and the type of rupture taken into account, the surgeon’s decision and the torn part can be taken or erected during the operation.

Meniscuses provide compatibility with the bones. If the meniscus is forced to be removed, the bones become deteriorated and calcification is happening at an earlier age than men who are healthy meniscus. In order to delay this, it is necessary to keep the load on the string low, that is, not to lose weight and not to be lifted too fast.

Exercise should become a lifestyle. The use of age appropriate sport, spore suit (shoe etc.) will also reduce sports injuries the most.

Although there is not a very high possibility, there is the same risk as how a normal meniscus is torn. Patients need to avoid compulsive movements, pay attention to their weight and give weight to the exerciser.

In the meantime, I want to emphasize once again the benefits of meniscus. When the knee is torn meniscus or surgically removed, the load and friction of the bones in the row increases because the shock absorption capacity is significantly reduced. This increases the risk of wear and arthritis in joint cartilages. If the meniscus is repaired, long-term results can be very good.

If the meniscuses are partially removed arthroscopically, good results are obtained in very large proportions. However, especially if the meniscus is preferred in open surgery, the results are not good and it may be necessary to change the life style of the patient. Weight loss, long road walking, heavy load carrying are some of these changes.

Questions and Answers Regarding Medial Meniscus and Meniscus

Question:  5 months ago when I was playing football I am writing down the result part of mr result.

Coronal, axial, sagittal plane T1, T2, PDA weighted.
– Femur lateral and medial condyle, widespread in the lateral condyle at the lateral condyle and medial condyle, edematous signal increases in the subchondral contusion of the tibia platoda
Massive intraarticular effusion with suprapatellar extension.
-ACL proximal is ruptured at the level of insertion.
-Lateral meniscus anteriorly, horizontally, slightly subluxed to the outside of the joint, and posterior hornda grade I degeneration.
-Liquid intensities in the linear style between the biceps and the lateral head of the gastrocnemius lateral to the plastic area and lateral to the knee. (Sprain?)

Mr Result said that a part of the doctrine crossover was broken so he gave mr again 3 months later he said he applied ice and exercise until mr.

Is it absolutely necessary for you to have surgery?

Answer: According to the findings you wrote, there is a partial tear, not partial. Surgery is necessary for someone of your age.

Question: I am a 19 year old man at 1.77 pounds. 4 months ago I went to the doctor on the carpet sahada left dizimbulktim nothing came out from the voyage MR sektirdim;

Mr end result:
– Intraarticular fluid has increased.
– Subchondral trabecular contusion was observed in posterolateral part of lateral femoral condyle and tibial plateau.
– Degenerative grade 1 degeneration in the posterior horn of the male, lateral bone fragment retinacular inserjioda avulsion fracture of the separate bone fragment and inserjioda heterogeneous signal increase.
-Tibiofemoral joint space width and joint relation is of course.
-Tibial and femoral articular cartilage thicknesses and cartilage signal intensities are natural.
-Lateral meniscus morphology and signal intensities are natural.
The anterior cruciate, the posterior cruciate ligaments, the medial and lateral collateral ligaments,
Signal intensities are subject.
– Formal fossa occurrences are natural.
-Quadriceps and patellar tendons are subject to trace, contour and signal intensities.

I wrote Voltaren cream, painkiller pills and bandages. This time I use flexo gel, cataflam and wool knee prints.

My medications are about to end, but I still do not see any effect what I need to do is to be helpful.

Answer: MR is sometimes mistaken. Examination findings are very important. After examination, anterior cruciate ligament rupture or patella (knee cap) dislocations can be demonstrated

Question regarding Meniscus Grade 1 and Grade 2 Treatment

Question: I went to the doctor with his belly button, of course. He made a few moves and did not say anything.

I have pain from the bottom of my knees. I have pain, numbness and burning in the back of my lids, my thighs and my feet.

I gave right and left mr and we had blood test (normal blood tests)
I wanted to ask you a little before I showed up. I do not write the normal part of the MR command.
Right knee mr result;
In the 1-tibia femoral joint, minimal effusion is observed in the patella femoral joint.
In the anterior and posterior horns of the medial meniscus, intense increase of interameniscal signal is observed in favor of grade 2 degeneration.
A grade 1 degeneration is observed in the lateral meniscus posterior horn.

Anterior cruciate thick- ness, and signal sprain pattern and partial rupture.
Left knee mr end;
1-tibia femoral joint shows effusion in the patellafemoral joint.
There is grade 2 degeneration in medial meniscus anterior and posterior horns
Grade 1 degeneration is observed in the anterior and posterior horns of the 3-lateral meniscus

Answer: Grade 1 and 2 degenerations are small, non-tearable changes. I think your situation will improve with a good exercise program. Get well soon.

Question: What is paramenischeal cyst? Stage 2 degeneration in the posterior neck of the medial meniscus and lateral meniscus and rupture of three oblique views were observed.

A paramenischeal cyst of 7 mm in diameter was observed in the lateral meniscus.

I had a meniscus operation. My husband, these are the mr. I am currently 20 days in operation but I am a referee, and I will start the race in 25 days
Is it possible for me to get physical therapy or not? Tskler hocam

Answer: This question can best be answered by our colleague who has surgery. Generally speaking; Enough time, if the meniscus surgery is done, the spore can be started.

However, if an operation has been performed for parameniscal cyst, the sport allowed by the procedure can be delayed by your doctor.

Question: I entered mr because I dropped it on 05.07.2012. The doctor recommended ice and bandage and rest, I applied them to my age 15.

I entered control mr on 06.08.2012 and I am writing you the comparison below

Edema defined in the lateral condyle of the femur and intense effusion seen in the joint space is regrese in appearance.

Deformation in the posterolateral part of the capsule is regulated. There is slight regression in the size of the baker’s cyst (45 mm extension and the largest apical capillary cyst measuring 16 mm)

The medial meniscus posterior hornda is an additional finding of mild intrameniscal degenerative signal increase.
I play in a basketball club today when I ask my doctor, you can play basketball in 2 weeks. Do you feel better in 1 month?

Thank you very much for your reply.

Answer: I agree with what your doctor said. You’re likely to play. Do force exercises, pain limit.

Medial meniscus questions and meniscus treatment
MEDICAL MENISCUS BREYS
Medial meniscus questions

Question:  If you answer will be a liability satisfied. My mother was 47 years old and suffered from left knee.

Last week when we went to the holiday, the pain increased more there. Could it be the effect of nemin and sea?

Yesterday we went to orthopedic, x-rays were taken, the doctor told me that meniscus was torn .. today the results will be out in 10 days ..

Do you want to ask this doctor meniscus is dangerous to rupture what will result?

Is the only solution in meniscus rupture surgery, and is this meniscus operation easy?

Answer: Stabil meniscus tears (not painful, just do not lock) can be treated with muscle strengthening, meniscus exercises.

If there is not enough reduction in the pain in the follow-up, the operation decision can be made later.
Grade 1 degeneration in the posterior aspect of the medial meniscus

Question: The left knee arthroplasty performed 2 months ago revealed grade 1 degeneration in the posterior medial meniscus, ACL rupture. Because my age is 17, the doctor said he could not do the surgery.

He exercised but did not reduce my pain. Can I use knee braces for meniscus?

Answer: MR can sometimes be tripped (depending on the comment error or the shooting quality).

If you really have cross ligaments, you should have anterior cruciate ligament surgery without delay. Because your age is 17, your surgery is even more important to me.

Question: Hi, my husband. I am playing amateur football. I applied to the doctor because of the pain and numbness in my neck. Mr result:

-Device degenerative signal changes are observed in the posterior horn of the medial meniscus.
-The formula liquid is minimally increased.

What do you suggest I do, when can I play football again? Thank you, respectful

Answer: Mr ‘I can be considered normal, nothing important. In this case, clinical findings for pain are very important.

You need to follow the advice of the examining doctor.

Question: About Grade 2 degeneration

It is about 2 sen in the left sequence, especially in cold periods, there is tingling, cold and light burning.

Last week I went to a private hospital doctor and I requested an MR. Afterwards, the doctor said there was meniscal tear and said that I had to undergo surgery.

I went to a second doctor to make sure that he did not have an operating condition for now, looking at the MR result.

Because there is no complaint other than my complaints that I wrote in the serial. Why can not you evaluate my results as my husband?

Thank you.

– Horizantal high-signal lesion is observed in both menstruas (grade II degeneration)

– Minimal fluid increase is observed in the equation range.

-Not: The other results in the test are normal.

I wish you a good day again.
Best regards.

Answer: MR findings have no place in my decisions. Clinical findings are more important. If you do not complain, what do you say to the MR?

Achilles Tendon Exercises and Pictures

Achilles tendon exercises to be done after Achilles tendon surgery, you should plan and discuss with your doctor. A physical therapy program should be applied according to the condition of your leg and foot.

There are options such as stair exercises, stretching exercises, exercises that can be done on the seats. Achilles Tendon  exercise that can be done with the help of a tera band. You need to be very careful when doing the Achilles tendon exercises. Because you can tear the Achilles tendon again.

Towel stretch, standing calf stretch, standing soleus strech, step up ,plantar fascia stretch, heel raises, static and balanca exercises picturef for the achilles tendon exercises .

Easier exercises should be done in the first days after surgery. For example; Towel exercises, step up exercices, heel raises.

Achilles Tendon Rehab Exercises

1- Ankle stretching:
Turn your face in a wall and twist your two legs so that your injured foot will be at the back as it is. Without lifting your heels, sit on the wall until you feel tension in the achilles tendon region (behind your heel). Wait 30 seconds after you feel the strain and repeat it 2 times.

2- BLEEDING STRENGTH

Achilles tendonitis exercises

Turn your face in a wall and bring your sturdy leg to the position as if it were your bent, wounded leg. Slowly feel the tension on your calf muscles before you sit on the back of your foot. Wait 30 seconds and repeat 2 times when you feel tension.

Sore Achilles Tendon Exercises

3- Lifting Two Foot

Achilles tendonitis exercises

Straighten your legs without stretching too far. Then press your fingertips to lift your ball from the floor and stand in this position for about 1 second and slowly press your heels again. Repeat this exercise 20 times.

4- SINGLE FOOT LIFTING

Achilles tendonitis exercises

Put an upright chair upside down and hold it firmly on the chair and twist your firm foot like you did on your left. Then lift the ball of your injured foot and wait for one second at the tip of your finger. Then repeat the same exercise 10 times by pressing the ball of your wounded foot on the floor.

Achilles tendonitis exercises are mainly these. Achilles tendonitis exercises should be repeated 3 times a day morning and evening. Your physiotherapist will give you more detailed information about the exercises. Achilles tendonitis exercises should not be released shortly after the sensation of pain has passed. Continuing for a few more weeks is important for not repeating the injury.

Achilles Tendon rupture Treatment :

When is the Achilles tendon surgery necessary?

Achilles tendon surgery has different techniques. These techniques can help alleviate pain and improve bone alignment. Your orthopedic doctor may offer the following treatment options about the type of surgery:

Fusion of one or more bones in the artery or foot and ankle
Cutting and reshaping of osteotomy or bone for correct alignment
-Excision or removal of bone and bony prominence
-Skinovectomy or tendon covering covering cleaning
-Tendon transfers or tendon extensions.

When the achilles tendon rupture , You feel a pain with tearing or rupture of the Achilles tendon . The sound of the break on the back of the wrist can be heard remotely. It is believed that the Achilles tendon has received a back-to-back impact. During the break of the Achilles tendon, there is a loud noise and pain.

After Achilles Tendon Surgery:

The patient’s foot is held constant for up to 1 month for recovery after the Achilles tendon surgery. Then brace attached to the foot. The patient begins to walk with the brace. After the operation, after 3 to 4 hours a day, exercises are performed and after 2 months, the patient may become sick. After 2 nd month of physical therapy exercises, the Achilles tendon is strengthened. To reduce the risk of scarring, we need to exercise and be careful not to be fed.

Achilles tendon pain :

Some questions about achilles tendon rupture: 

Question 1: Hello, I have had two Achilles tendon surgery, the second one was 2.5 months, I started walking after the Achilles tendon surgery, but I can not rise to the foot, and when I try to rise to the tip of my finger, I get pain on my ball. Because of this, I feel pain in my paw while walking. I also have swelling on the outside of my wrist.

Are these paints normal? Is aching like this because the Achilles tendon is not fully recovered?
Answer 1: I think I need more time. Remember that physical therapy exercises should be done regularly during the achilles tendon healing process.

Achilles tendon treatment exercises 

Question 2: I had an Achilles tendon operation 6 years ago. Now my foot is having a hard time. I get a lot of pain when I walk or run. What advice would you recommend as an exercise or medication?

Answer 2: You should do regular force exercises. Flexibility movements are important for tendon health. Make regular and balanced nutrition, pay attention to the selection of shoes.

Question 3: I had an achilles tendon surgery. Though 10 days passed, the swelling did not go down. Now the skin closed. The hematoma formed in the wound area. When I hang my leg downwards, blood collects in that area. I keep painting my feet and I keep it up and I apply ice. However, there was no improvement.

Answer 3: Things you normally talk about. Your pain will decrease in 10 days. Therefore Continue with your doctor’s recommendations.