Conservative Treatment for Knee Surgery

Knee surgeries, including a total knee replacement, are a growing field in orthopedics that is designed to alleviate the pain associated with arthritis, trauma, and other degenerative issues. Many older adults are typically the target population for much of these procedures and while knee surgery tends to be a popular choice among this group, surgery may not always be the best option available.

What is the Purpose of Knee Surgery And Replacement?

Millions of adults worldwide are faced with the decision each year to have some sort of knee surgery. The most common reasons to have a knee surgery are to replace a knee joint that is causing severe limitation and pain. While most adults who go through knee surgery likely are to experience improved range of motion and a reduction of pain, many actually have little to no improvements at all, thus leaving the surgery not succeed.

Is Surgery Needed to Fix a Knee Problem?

The common knowledge is that when something in the knee is not working the way that it should be that surgery is needed. While for some adults this is true, there is some evidence to suggest that surgery may not be for everyone. Older adults with knee problems who undergo a replacement surgery may notice some of the side effects of such a procedure, such as blood clots as well as pain following surgery. Among the younger population, as with middle-age and younger adults, surgery may not always lead to the best outcomes, when compared to arthroscopy and anterior cruciate ligament repair surgery. Among the younger group, surgery was just as effective as some holistic approaches, which leads practitioners to question if surgery is the best option.

What is the Role of Exercise in Knee Surgeries?

While most knee surgeries are recommended as a way to alleviate pain and to improve quality of life, there is some promise for exercise therapy as a way to treat the condition. Middle-aged adults recently were examined with arthroscopic knee surgery and compared to exercise therapy. It appears that arthroscopy provided the same benefits as those who exercised, but the difference is that those who performed exercise has more muscle mass as a result of the program. Similar results have been found among younger adults with anterior cruciate ligament (ACL) injuries. It seems there may not be any added benefit to an ACL repair surgery than with exercise therapy, thus suggesting that exercise could be a holistic approach to healing.

Is Exercise Therapy for Everyone?

While exercise therapy has shown great promise when it comes to knee surgeries, everything needs to come down to your specific condition and how much you are willing to experience. If time is something you want to preserve then surgery may be an option, but there are risks and the effectiveness is not always better. In contrast, if time is of no concern then exercise therapy could be the conservative treatment option of choice.

Find a Physical Therapist for Conservative Treatment for Knee Problems

If you currently suffer from a degenerative knee condition or your doctor has recommended knee surgery, it is important to seek the professional advice of a physical therapist to see how exercise therapy can affect your treatment program. A physical therapist can detail a specific program that is geared towards strengthening the muscles around the knee joint, while helping to decrease pain. If surgery is not high on your priority list, exercise therapy may be a holistic modality that can help you from going under the knife.

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In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)

image

Complete tear of rectus femoris
with large hematoma (blood)

image

Separation of muscle ends due to tear elicited
on dynamic sonography examination

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