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Loose Bodies/Spurs

Loose bodies are fragments of cartilage or bone that freely float inside the knee joint space.  They can be the result of an injury or from generalized wear and tear over time.  Depending on the severity of the condition, there can be one or many loose bodies inside the joint.  They can be stable (they don’t move about inside the joint) or unstable (they float through the inside of the joint) which can cause pain or loss of motion. 

Bone spurs are bony overgrowths that occur around the joint (i.e., at the end of the thigh bone or top of the shin bone) and are in response to abnormal stresses placed across that area.  These are most commonly seen in patients with degenerative joint disease (DJD or arthritis).

Symptoms

Bone spurs in the knee can often make it painful to extend and bend your leg.  The bony growths can get in the way of bones and tendons that keep your knee operating smoothly.

Diagnosis

These injuries can occur due to a traumatic incident or a fall or previous injury dynamic.  Our knee specialists bring a compassionate and caring approach to every condition and injury assessment.  During your assessment they will perform a thorough evaluation and examination to determine the extent of your injuries, including a complete review of your medical history.

Our specialists may also utilized diagnostic tools such as an MRI, X-ray or CT scan to confirm the extent of your condition.

Treatment

Like any injury, the goal of treating a loose body is to enable the patient to return to their day-to-day activities. The surgery to treat a loose body can be performed arthroscopically.

Surgery

Typically, our knee surgeons will schedule surgical management of the loose bodies if they fail to resolve during conservative treatment programs.  When the loose bodies are unstable or cause decreased function and pain, they can be surgically removed.  Your HOA knee surgeon can elect to remove these fragments by utilizing minimally invasive surgery such as arthroscopic surgery.  During this procedure the HOA knee surgeon identifies the fragments through a small camera and removes them utilizing specialized instruments.  Additional measures to smooth out rough edges of the cartilage may also be included.  If you have several loose bodies and arthritis, these conditions are usually the result of severe degeneration of the knee and are usually addressed during a total knee replacement surgery.

Knee Ligament Injuries

There are four ligament categories related to knee ligament injuries:

Anterior Crucial Ligament (ACL) Injury

The ACL (anterior cruciate ligament) is the main support structure of the knee joint.  The ACL is the most commonly injured ligament in the knee. Injuries to the ACL are typically caused my traumatic events such as collisions in athletics, accidents or severe falls. Patients with ACL injuries often complain of a “pop” sound from inside the joint, immediate, intense pain and a feeling of the knee giving out. Due to anatomy strength, size and hormonal factors, females are at increased risk for ACL injuries.

Lateral Collateral Ligament (LCL) Injury

The lateral collateral ligament (LCL) is one of the four knee ligaments. It spans the distance from the end of the femur (thigh bone) to the top of the fibula (thin, outer, lower leg bone) and is on the outside of the knee. The lateral collateral ligament resists widening of the outside of the joint.  It is injured from a direct force from the side of the knee, causing moderate to severe knee pain which often leads to knee surgery. It is much less frequently injured than the medial collateral ligament (MCL) but commonly occurs with other ligament injuries to the knee.

Medial Collateral Ligament (MCL) Injury

The medial collateral ligament (MCL) is one of four ligaments that are critical to the stability of the knee joint. A ligament is made of tough fibrous material and functions to control excessive motion by limiting joint mobility. The MCL spans the distance from the end of the femur (thigh bone) to the top of the tibia (shin bone) and is on the inside of the knee joint. The medial collateral ligament resists widening of the inside of the joint, or prevents "opening-up" of the knee.

Posterior Cruciate Ligament (PCL) Injury

The PCL has been described as one of the main stabilizers of the knee.  It is broader and stronger than the ACL.  It connects the femur (thigh bone) to the tibia (shin bone).  PCL injury commonly occurs in sports such as football, soccer, basketball, and skiing.  A forceful hyperextention of the knee or a direct blow just below the knee cap will disrupt the PCL.  For example, the football player who is tackled with a direct hit to the knee could hyperextend the limb and rupture the PCL.  The basketball player who lands on the court directly on a bent knee could tear his/her PCL.  

Symptoms

Most patients are able to walk on their injured knee. However, with an acute injury, the knee will likely become swollen and stiff. Symptoms of degenerative tears include chronic pain, stiffness and intermittent swelling. Many meniscus tears cause mechanical symptoms, or catching and locking of the knee.

Diagnosis

These injuries can occur due to a traumatic incident or chronic and degenerative activity.  Our knee specialists bring a compassionate and caring approach to every condition and injury assessment.  During your assessment they will perform a thorough evaluation and examination to determine the extent of your injuries, including a complete review of your medical history.

Our specialists may also utilized diagnostic tools such as an MRI, X-ray or CT scan to confirm the extent of your condition.
 

Treatment

Your Hinsdale Orthopaedics knee specialist may recommend an arthroscopic technique which is commonly used to repair or replace torn ligaments of the knee. Arthroscopic knee surgery incorporates the use of small (< 1 cm) incisions (portals) around the joint, and the use of a specialized camera (arthroscope) among other specified arthroscopic surgical instruments. The goal of arthroscopic surgery is to repair and restore the joint to optimal strength, while maintaining range of motion. Due to the minimally invasive nature of the arthroscopic technique, trauma to surrounding muscles, ligaments, tendons, nerves and blood vessels is significantly reduced. Ligament surgery involves the removal of damaged ligament fragments and replacement of the ligament with either the patient’s own soft tissue or tissue from a cadaver; known as an autograft or an allograft respectively. Ligament surgery may either be performed as an outpatient, or inpatient procedure with an overnight hospital stay.


 

Knee Fractures

Fractures involving the knee can be subcategorized in more specific terminology as Supracondylar Femur Fractures, Patella Fractures, and Tibial Plateau Fracture.

Supracondylar Femur Fracture

A supracondylar femur fracture is an injury to the femur just above the knee joint. These fractures often involve the cartilage surface of the knee joint. Patients who sustain a supracondylar femur fracture are often at high risk of developing knee arthritis later in life.  Supracondylar femur fractures are more common in patients with severe osteoporosis and in patients who have previously undergone total knee replacement surgery. In these groups of patients, the bone just above the knee joint may be weaker than in normal patients, and therefore more prone to fracture.

Symptoms

A knee fracture typically causes pain, tenderness, bruising, swelling and some deformity of the knee joint.   You may experience tenderness of the knee bone (and inability to move the knee area.  You will experience some weakness of the leg area around the injury and possible leg numbness below the knee area.

Diagnosis

These injuries can occur due to a traumatic incident or a fall or previous injury dynamic.  Our knee specialists bring a compassionate and caring approach to every condition and injury assessment.  During your assessment they will perform a thorough evaluation and examination to determine the extent of your injuries, including a complete review of your medical history.

Our specialists may also utilized diagnostic tools such as an MRI, X-ray or CT scan to confirm the extent of your condition.

Treatment

Treatment for Supracondylar Femur Fractures often involves surgery with a plate and screws to hold the fracture fragments in proper alignment while the bone heals.  After surgery, patients will typically not be allowed to bear weight on the affected leg for at least six to eight weeks.

Patella Fracture

The patella is a bone that makes up the kneecap. It is located in front of the knee joint (where the thighbone and shinbone meet). It allows people to extend their knee and is crucial in leg movement. Patella fractures are most common in people between 20 and 50 years old. The fracture usually results from a fall onto the kneecap. It can also occur when the quadriceps muscle is contracting but the knee joint is bending. 

Symptoms

A knee fracture typically causes pain, tenderness, bruising, swelling and some deformity of the knee joint.   You may experience tenderness of the knee and inability to move the knee area.  You will experience some weakness of the leg area around the injury and possible leg numbness below the knee area.

Diagnosis

These injuries can occur due to a traumatic incident or a fall. Our knee specialists bring a compassionate and caring approach to every condition and injury assessment.  During your assessment they will perform a thorough evaluation and examination to determine the extent of your injuries, including a complete review of your medical history.

Our specialists may also utilized diagnostic tools such as an MRI, X-ray or CT scan to confirm the extent of your condition.
 

Treatment

After taking an x-ray of the knee, an HOA surgeon typically performs a straight leg raise on his patients with this condition. The patient lies flat on a bed. With the leg straight, the patient then raises the foot and holds it in the air. If this can be done, then non-operative treatment may be possible. This treatment usually entails a long leg cast or a knee immobilizer.

For those patients who need surgery, our surgeons typically makes an incision on the front of the knee joint to repair the fractured ends using wires, screws and pins. The knee must usually be in a brace for several weeks. The patient can begin to move the knee about two weeks after the surgery, depending on the strength that the surgeon was able to restore in the knee during the procedure.
 

Tibial Plateau Fracture

The tibial plateau is located at the top of the shin bone, below the knee joint. Tibial plateau fractures often result from motor vehicle accidents, falls, and sports injuries. Symptoms include pain, swelling, bruising, stiffness, and inability to bear weight on the side of the injured knee. There are two types of tibial plateau fractures: displaced and non-displaced. A non-displaced fracture occurs when there is a crack in the bone, yet all the bones remain in place. A displaced fracture leaves the bone broken into two or more pieces and is more severe.

Symptoms

A knee fracture typically causes pain, tenderness, bruising, swelling and some deformity of the knee joint.   You may experience tenderness of the knee bone (patella, femur or tibia) and inability to move the knee area.  You will experience some weakness of the leg area around the injury and possible leg numbness below the knee area.

Diagnosis

These injuries can occur due to a traumatic incident or a fall. Our knee specialists bring a compassionate and caring approach to every condition and injury assessment.  During your assessment they will perform a thorough evaluation and examination to determine the extent of your injuries, including a complete review of your medical history.

Our specialists may also utilized diagnostic tools such as an MRI, X-ray or CT scan to confirm the extent of your condition.
 

Treatment

Non-displaced fractures can be treated without surgery, as long as the patient doesn’t put much pressure on the leg for a period of several months. A displaced fracture requires surgery in order to stabilize the knee joint and line up the bones beneath it. A surgeon will usually use plates and screws to restore stability within the leg.

 

Iliotibial Band Syndrome

Iliotibial band inflammation is an overuse syndrome that occurs often in long-distance runners, bicyclists, and other athletes who repeatedly squat. Iliotibial band syndrome may be the result of a combination of issues from poor training habits and poor flexibility to muscle and other mechanical imbalances in the body.

Anatomy issues may include differences in the lengths of the legs (a leg-length discrepancy), an abnormal tilt to the pelvis, or bowed legs (genu varum). These situations can cause the iliotibial band to become excessively tight, leading to excess friction when the band crosses back and forth across the knee area during activity.

Runners can develop iliotibial band syndrome symptoms should they make mistakes in their training. Roads are canted or banked with the center of the road higher than the outside edge to allow for water runoff. If a runner always runs on the same side of the road, it produces the same effect on the body as having a leg-length discrepancy.

When running hills, one leg is always downhill compared to the other, and the pelvis has to tilt to accommodate the activity. Running too many hills can also cause inflammation of the IT band.

Bicyclists may develop IT band inflammation should they have improper posture on their bike and "toe in" when they pedal. This can cause the same effect as bowed legs, increasing the angle of the IT band as it crosses the knee, increasing the risk of inflammation.

Other activities with increased knee flexion can cause symptoms and include rowing and weight lifting, especially with excessive squatting.
 

Symptoms

Symptoms of iliotibial band syndrome includes pain on the outer side of the knee, sensation of stinging or needle-like pricks in the knee area or a snapping or popping sound of the knee.
 

Diagnosis

One of our highly-trained knee specialists will perform a thorough evaluation and examination to determine the extent of your condition, including a complete review of your medical history.

Our specialists may also utilized diagnostic tools such as an MRI, X-ray or CT scan to confirm the extent of your condition.
 

Treatment

Iliotibial band syndrome is an overuse injury that causes inflammation. Initial treatment includes rest, ice, compression, and elevation (RICE).  Your HOA knee surgeon may choose to prescribe anti-inflammatory medications or physical therapy to decrease the inflammation of the IT band.  In rare cases when conservative treatment plans fail, arthroscopic intervention may be necessary to cut away the inflammation found around the iliotibial band area.


 

Cartilage Injuries

Injury to the knee can cause damage to the articular lining cartilage in the knee joint, or sometimes to both the cartilage and the bone.  If the injury is restricted to the cartilage, it will not show up in a plain X-ray; it may be noted on an MRI. An arthroscopy (using a special instrument to look inside the joint) can thoroughly identify it.

Detached Cartilage of Bone in the Knee Joint

If a piece of cartilage or bone has become detached in the knee and the injury is not treated immediately, the loose part can 'swim around' in the joint. This means that it may occasionally get stuck, causing pain and a feeling that the knee is locked. The knee may also click and swell up. Such a condition is called a loose body in the knee.  As cartilage does not show up on an X-ray, the loose body will only be visible if it consists of bone.

Symptoms

Symptoms may include swelling and pain when bending the knee.

Diagnosis

These injuries can occur due to a traumatic incident or chronic and degenerative activity.  Our knee specialists bring a compassionate and caring approach to every condition and injury assessment.  During your assessment they will perform a thorough evaluation and examination to determine the extent of your injuries, including a complete review of your medical history.

Our specialists may also utilized diagnostic tools such as an MRI, X-ray or CT scan to confirm the extent of your condition.

Treatment

In some cases arthroscopy can be used to 'smooth' the cartilage. Although new cartilage cannot grow to take its place, scar tissue appears.

If the injury is fairly recent, it may be possible to put the piece back in place. More commonly, the loose body may be removed by arthroscopy.
 

 

Bursitis of the Knee

Knee bursitis is inflammation of a bursa located near your knee joint. A bursa is a small fluid-filled, pad-like sac that reduces friction and cushions pressure points between your bones and the tendons and muscles near your joints.

Each of your knees has 11 bursae. While any of these bursae can become inflamed, knee bursitis most commonly occurs over the kneecap or on the inner side of your knee below the joint.

Symptoms

Symptoms of knee bursitis is pain and limited mobility.

Diagnosis

One of our highly-trained knee specialists will perform a thorough evaluation and examination to determine the extent of your condition, including a complete review of your medical history.

Our specialists may also utilized diagnostic tools such as an MRI, X-ray or CT scan to confirm the extent of your condition.
 

Treatment

Our knee specialists may recommend non-surgical treatments, which may include pain relievers, antibiotics and anti-inflammatory drugs.  Your Hinsdale Orthopaedic knee surgeon may also aspirate a burse to reduce excess fluid by inserting a needle directly into the affected bursa and drawing fluid into a syringe during a routine office visit.  If your bursitis persists, your surgeon may elect to recommend surgical removal of the inflamed bursa.

Anterior Crucial Ligament (ACL) Injury

The ACL (anterior cruciate ligament) is one of the main support structures of the knee joint.  The ACL is the most commonly injured ligament in the knee. Injuries to the ACL are typically caused my traumatic events such as collisions in athletics, accidents or severe falls. Patients with ACL injuries often complain of a “pop” sound from inside the joint, immediate, intense pain and a feeling of the knee giving out. Due to strength, size and hormonal factors, females are at increased risk for ACL injuries.

Symptoms

Most patients are able to walk on their injured knee. However, with an acute injury, the knee will likely become swollen and stiff. Symptoms of degenerative tears include chronic pain, stiffness, and intermittent swelling. Many meniscus tears cause mechanical symptoms, or catching and locking of the knee.

Diagnosis

These injuries can occur due to a traumatic incident or chronic and degenerative change.  Our knee specialists bring a compassionate and caring approach to every condition and injury assessment.  During your assessment they will perform a thorough evaluation and examination to determine the extent of your injuries, including a complete review of your medical history.

Our specialists may also utilize diagnostic tools such as an MRI, X-ray or CT scan to confirm the extent of your condition.
 

Treatment

Your Hinsdale Orthopaedics knee specialists may recommend an arthroscopic technique, which is commonly used to repair or replace torn ligaments of the knee. Arthroscopic knee surgery incorporates the use of small (< 1 cm) incisions (portals) around the joint, and the use of a specialized camera (arthroscope) among other specified arthroscopic surgical instruments. The goal of arthroscopic surgery is to repair and restore the joint to optimal strength, while maintaining range of motion. Due to the minimally invasive nature of the arthroscopic technique, trauma to surrounding muscles, ligaments, tendons, nerves and blood vessels is significantly reduced. Ligament surgery involves the removal of damaged ligament fragments and replacement of the ligament with either the patient’s own soft tissue or tissue from a cadaver; known as an autograft or an allograft respectively. Ligament surgery may either be performed as an outpatient, or inpatient procedure with an overnight hospital stay.

Osteoarthritis/Degenerative Joint Disease

Osteoarthritis or Degenerative Joint Disease, commonly known as wear and tear arthritis, is a condition in which the natural cushioning between joints -- cartilage -- wears away. When this happens, the bones of the joints rub more closely against one another with less of the shock-absorbing benefits of cartilage.   The most frequent reason for osteoarthritis or DJD is genetic, since the durability of each individual’s cartilage is based on genetic profile.  

Symptoms

Symptoms of osteoarthritis or DJD of the knee may include pain that increases when you are active, swelling, feeling of warmth in the joint, stiffness in the knee, decreased mobility of the knee and creaking, crackly sounds heard when the knee moves.

Diagnosis

One of our highly-trained knee specialists will perform a thorough evaluation and examination to determine the extent of your condition, including a complete review of your medical history.

Our specialists may also utilized diagnostic tools such as an MRI, X-ray or CT scan to confirm the extent of your condition.
 

Treatment

Our knee specialists may recommend non-surgical treatments which may include weight modification, pain relievers and anti-inflammatory drugs, injection of corticosteroids or hyaluronic acid into the knee or non-weight bearing stabilizer.  Surgical treatment typically includes arthroscopic surgery, possible osteotomy, or joint replacement surgery.

Work-related Injuries/Work Conditioning

In our eyes, the injured worker is the same as the injured athlete, only the playing field is different. Hinsdale Orthopaedics’ successful work conditioning/hardening program uses a sports performance based methodology to safely return injured workers back to their workplace.

With a focus on the use of free weights, specialized machines, and functional activity designed to simulate the work environment in which the patient is striving to return, this truly unique program is designed to increase strength, endurance, and cardiovascular function.

Upon completion of the program, patients often tell us they are in the best physical shape of their lives - and, we have the studies to prove it. The Hinsdale Orthopaedics’ return-to-work conditioning program has earned international recognition for its results.

Functional Capacity Evaluations

After a work injury, don't put yourself at risk of hurting yourself again. HOA can help determine if you are physically ready to go back to work. A Functional Capacity Evaluation (FCE) is a scientifically developed objective process to measure a worker's physical capabilities and tolerances, also known as a worker's physical demand level (PDL).

HOA’s Physical Therapy's standardized protocols determine the level of participation and activity that is right for the patient following rehabilitation, thus providing the highest probability for return to work without re-injury.


Reliability & Validity

Hinsdale Orthopaedics’ certified functional evaluators administer FCEs with evaluation tools and methods that are peer-reviewed, validity based and legally defensible in the field of occupational rehabilitation. All testing is performed with standardized protocols that are specific to each case in question. Each FCE will provide information on reliability of physical effort, reliability of pain reports/behaviors and safe levels of functional capacity.


Honesty & Objectivity

HOA Physical Therapy provides testing results that are trustworthy. HOA provides these services with the goal to provide fair, accurate, concise, objective data and information in each specific Workers' Compensation case.
Communication

HOA Physical Therapy's certified functional evaluators produce FCEs that are clear, concise, timely and specific to provide case closure for the referral sources and the Workers' Compensation client.


Convenience

HOA Physical Therapy uses mobile equipment, which allows companies and their employees the convenience of HOA professionals performing on-site evaluations when needed.
 

Post-surgical Physical Therapy

Our goal during your post-surgical rehabilitation is to return you to your prior level of physical function. This includes successful return to your work, recreational activities, and competitive sports.

Our therapists provide one-on-one treatment sessions to closely monitor your progress and will advance you according to your response, as well as your physician’s recommendations. We maintain regular communication with your Hinsdale Orthopaedics’ surgeon to ensure your progress matches the rate of tissue healing so that your recovery is optimal.
Your participation in your rehabilitation is critical. On your first post-surgical visit, your therapist will work with you to establish your goals for therapy. Your therapist will review any post-surgical precautions you may have. You will also be prescribed a home exercise program so that you can continue your progress outside of therapy. 

Commonly treated orthopedic procedures include, but are not limited to:

  • Rotator cuff repairs
  • Total joint replacements (shoulder, hip, knee)
  • Anterior cruciate ligament (ACL) reconstruction
  • Arthroscopic knee surgeries (such as meniscectomies, meniscal repairs)
  • Arthroscopic hip surgeries (such as labral repairs)
  • Achilles tendon repairs
  • Nerve releases (such as cubital tunnel, radial tunnel, carpal tunnel, tarsal tunnel)
  • Neck and back surgery (such as fusions, laminectomy, decompression)
  • Surgical fixation of fractures of the arms and legs

We strongly recommend you schedule your first post-operative visit before you have surgery in order to ensure you are seen in a timely manner. You should ask your Hinsdale Orthopaedics’ specialist/surgeon how soon after surgery you should begin physical therapy.

Our surgeons and on-site physical therapists work closely to ensure your post-operative success, providing a seamless continuum of care to achieve optimum results.

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