The study was particularly interesting because a series of MRI scans were also performed and these showed that no deterioration in the arthritis occurred in the knees injected.

COMMENT:

This is a very interesting and illuminating research paper.  We are using PRP injections as a joint preserving treatment in selected patients with knee arthritis and are monitoring our results carefully.

Partial and Total Knee joint replacements are very successful procedures, giving affected patients a “new lease of life”. We offer all types of replacement to our patients and we carefully select the best type for each patient individually based on various factors.

The KineSpring device is showing great promise in selected patients with arthritis limited to the inner side of the joint.    It can help to delay or avoid the need for partial knee replacement.

Also known as “housemaids knee” this is a condition affecting the small soft tissue bursa that lies over the front of the patella.  It becomes inflamed and painful.  This can occur due to repeated kneeling activities or sometimes due to a single blow to the front of the knee, for example after a fall onto the front of the knee.  It usually responds to rest, icing and anti-inflammatory medication.  If not, physiotherapy or a steroid injection may be required.

Sometimes the patella tendon (linking the lower border of the patella to the front of the shin bone) becomes painful.  This is usually an overuse type injury, but various factors may make it more likely to occur. The diagnosis of the condition is usually relatively straightforward, and an ultrasound scan is often used to confirm the typical appearances.  Treatment options include dealing with any underlying causative factors, physiotherapy, low energy shock-wave therapy, platelet-rich plasma (PRP) injections and rarely surgery.

Advise security officers about your implant. 

Let the security officer know that you have a replacement and where it is located. The security officer should offer you a private screening consisting of a hand held detector sweep and a pat-down inspection. You will not need to show your surgical scar or remove any clothing, but feel free to ask to be screened in a private area.

Carry a joint replacement ID card

These cards identify the holder of the card as a joint replacement patient. They are not essential, but can be helpful.  They confirm that the implant may activate metal-detectors.   At Specialist Hip & Knee Surgery we have now introduced the “Joint Replacement Passport” to help identify our patients as having an implant in place.  All new hip and knee replacement clients will be issued with a card, and we are also sending cards to our past clients.

Please find here some further general  information from the TSA that might also be of some help.

Pacemakers, Defibrillators, Other Implanted Medical Devices, & Metal Implants

Source: TSA website

• If you have implanted medical device, that you would like to remain private and confidential, ask the Security Officer to please be discreet when assisting you through the screening process.
• It is recommended (but not required) that individuals with a pacemaker carry a Pacemaker Identification Card (ID) when going through airport security. Show the Security Officer your pacemaker ID, if you have one, and ask the Security Officer to conduct a pat-down inspection rather than having you walk-through the metal detector or be handwanded
• It is recommended (but not required) that you advise the Security Officer that you have an implanted pacemaker, other implanted medical device, or metal implant and where that implant is located
• Security Officer will offer you a private screening once it becomes known that you have a metal implant or implanted medical device
• If your Doctor has indicated that you should not go through the metal detector or be handwanded because it could affect the functionality of your device or the magnetic calibration of your device, or if you are concerned, ask the Security Officer for a pat-down inspection instead.
• Security Officers will need to resolve all alarms associated with metal implants. Most alarms will be able to be resolved during a pat-down, therefore clothing will not be required to be removed or lifted as part of the inspection process.

Painful plica rubbing on medial femoral condyle

Trimming a thick plica with a radiofrequency probe

 

 

 

 

 

 

 

 

 

 

 

 

 

This condition can sometimes be difficult to diagnose when it is confused with a meniscal tear and when an MRI scan shows no such tear.  Often a painful plica can be felt when the knee is examined in the clinic. 

Trimming the knee plica arthroscopically (through key-hole surgery) can cure this condition.

The most commonly injured ligaments are the anterior cruciate ligament (ACL) and medial collateral ligament (MCL).   

The ACL is typically injured by a twisting mechanism, often non-contact during football.  Patients often hear a “pop” and the knee usually swells quickly after the injury. 

The MCL is usually injured by a contact blow to the outer side of the knee.  MCL injuries typically heal without surgery but sometimes the knee needs to be fitted with a brace.  ACL ruptures will not heal and in many cases an ACL reconstruction is required.  We perform arthroscopic (“key-hole”) ACL reconstruction usually using a hamstring graft.  We also perform revision (re-do) ACL reconstruction in those patients who re injure and tear their ACL reconstructions or who have been referred to us with poorly functioning ACL grafts.

Reconstructed ACL using hamstring graft