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If an individual experiences an injury during exercise, sports participation, or any physical activity, the severity of the injury will determine whether they are advised by a sports medicine specialist to consult an orthopedic surgeon for treatment. Surgery is typically considered a last resort for amateur athletes and is more commonly seen among professional athletes. It may be recommended if the injury is severe or if persistent symptoms persist despite prior non-surgical treatments.

Sports surgery aims to repair damaged soft tissue, realign bones and joints. However, not all injuries require surgical intervention. A sports medicine doctor can address various injuries sustained during physical activity, including sprained ankles, hip bursitis, fractures, knee and shoulder injuries, tendonitis, low back pain, pulled muscles, concussion, and cartilage injuries.

The most common sports injuries are strains and sprains, which occur when ligaments are stretched beyond their limits, resulting in tears. It is important to seek appropriate medical evaluation and treatment for sports-related injuries to promote proper healing and prevent further complications.

Sports Medicine

Arthroscopic Surgeries

Arthroscopic surgeries are the procedures performed on sedentary individuals or professional players to address joint conditions in the hip, knee, shoulder, and ankle. These surgeries include anterior cruciate ligament (ACL) reconstruction, meniscus repair or replacement, various cartilage procedures such as autologous chondrocyte implantation and scaffolds, repair of rotator cuff tears, treatment of labral tears, management of Bankart lesions causing shoulder instability, and addressing talus osteochondral defects in the ankle.

 

The recovery process following an operation for a sports injury varies depending on the severity of the injury and the individual's specific case. In most cases, a significant period of rest is necessary after surgery to allow the affected joint, muscle, or soft tissue to heal properly. Physiotherapy plays a crucial role in the recovery process as it focuses on rebuilding strength and improving the range of motion around the injured area. Additionally, physiotherapy helps condition the injury, making it more resilient to potential future complications. The duration and intensity of the rehabilitation program will be tailored to the specific injury and the individual's progress. It is important to follow the guidance of healthcare professionals and adhere to the prescribed rehabilitation plan to ensure a successful recovery and minimize the risk of reinjury.

An ACL injury refers to a tear or sprain of the anterior cruciate ligament, which is a strong tissue band that connects the thigh bone to the shinbone. These injuries often occur during sports activities that involve sudden stops, changes in direction, and jumping or landing movements, such as soccer, basketball, football, and downhill skiing. Typically, individuals may hear a pop sound or feel a sensation when the injury happens. Symptoms of an ACL injury include knee swelling, instability, and intense pain that makes it difficult to bear weight.

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The treatment for an ACL injury depends on its severity. Mild to moderate cases may be managed with rest and rehabilitation exercises aimed at restoring strength and stability to the knee joint. However, in more severe cases, surgery may be recommended to replace the torn ligament, followed by a comprehensive rehabilitation program. Implementing a proper training program can also help reduce the risk of sustaining an ACL injury. It is important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan for an ACL injury.

Anterior Cruciate Ligament (ACL) Reconstruction

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Meniscus Replacement

Meniscus replacement, also known as meniscal allograft transplantation (MAT), is a surgical procedure performed to replace a damaged or torn meniscus in the knee. The meniscus is a C-shaped cartilage structure that acts as a cushion in the knee joint, protecting the bones during movement. In this procedure, a healthy meniscus is obtained from a cadaver or deceased donor (allograft) and used to replace the damaged meniscus. 

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Meniscal replacement surgery aims to alleviate knee pain, improve knee function, and prevent the early onset of osteoarthritis. The recovery period typically lasts around one to two months. However, to ensure proper healing, individuals may need to avoid strenuous sports and certain physical activities for up to a year following the surgery. It is important to follow the post-operative instructions provided by the healthcare team to support successful recovery and optimize the outcomes of meniscal replacement surgery.

Articular cartilage serves as a firm and smooth covering found on the ends of bones, specifically at the points where they meet to form a joint like the knee. The building blocks of articular cartilage are chondrocytes, Unlike other types of tissue, articular cartilage has limited self-repair abilities. Consequently, injuries to this cartilage can result in increasing joint pain, reduced range of motion, and even the development of degenerative conditions like osteoarthritis, which involves the gradual deterioration of the articular cartilage.

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Autologous Chondrocyte Implantation (ACI) is a procedure that involves the collection of articular cartilage cells (chondrocytes) from the patient's own body. These cells are then multiplied in a laboratory setting to increase their numbers before being re-implanted into the damaged area of the knee using a specialized surgical technique. This process allows for the growth of new and durable cartilage, promoting cartilage repair and potentially improving joint function. The re-implantation typically takes place after approximately four weeks of cell multiplication.

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Synthetic scaffold repair is a surgery involving the use of acellular artificial plugs or patches to restore damaged areas of articular cartilage. Although this procedure is commonly performed on the knee, it can also be used to treat the ankle and shoulder. In this procedure, synthetic plugs and patches made from man-made materials are employed as a scaffold or framework for cartilage growth. These plugs and patches are composed of substances that mimic the natural structural components of articular cartilage. Once inserted into the patient's knee, cells migrate to the damaged area and begin repairing the cartilage by integrating with the plug or patch. The migrating cells collaborate with the implanted scaffold to restore the damaged cartilage region.

Cartilage Procedures

Rotator Cuff Tears

The rotator cuff refers to a collection of muscles and tendons that encompass the shoulder joint, providing stability and ensuring that the upper arm bone remains securely in the shallow socket of the shoulder. When the rotator cuff sustains an injury, it can result in a persistent, dull ache in the shoulder that tends to worsen during nighttime. These injuries typically occur due to gradual degeneration and wearing down of the tendon tissue over time. Activities involving repetitive overhead motions or prolonged periods of heavy lifting can cause irritation or damage to the tendon. Additionally, the rotator cuff can also be harmed in a single traumatic incident, such as a fall or accident. If left untreated, rotator cuff issues can lead to permanent loss of motion or weakness in the shoulder joint.

A labral tear involves damage to the ring of cartilage, known as the labrum, that encircles the outer rim of the hip joint socket. The labrum serves the purpose of cushioning the hip joint and acting as a seal or gasket to keep the ball of the thighbone securely positioned within the hip socket. Individuals participating in sports like ice hockey, soccer, football, golf, and ballet are at a higher risk of developing hip labral tears. Structural issues of the hip, such as dysplasia or a shallow socket, can accelerate wear and tear on the joint and contribute to a labral tear. Additionally, conditions like femoroacetabular impingement (FAI), which involves extra bone in the hip, can lead to pinching of the labrum and eventual tearing. Repetitive motions in activities like long-distance running or sudden twisting and pivoting motions in sports like golf or softball can also lead to joint wear and tear and result in a hip labral tear. It's important to note that a hip labral tear increases the likelihood of developing osteoarthritis in the affected joint.

Labral Tears

Bankart Lesions

​A Bankart lesion occurs when the shoulder joint gets dislocated towards the front, causing damage to the labrum (a ring of cartilage). This happens when the upper arm bone is pressed against the labrum, resulting in the labrum tearing away from the socket of the shoulder joint. Sometimes, there may also be a small fracture in the edge of the socket. Bankart lesions can sometimes heal on their own without surgery, especially if they are not severe. However, in cases where surgery is needed, it involves stitching the torn labrum back to its original place using special anchors.

An osteochondral lesion of the talus (OLT) refers to a problem with the cartilage and bone on the top of the talus bone in your ankle joint. It can also be called osteochondritis dissecans (OCD) of the talus or a talar osteochondral lesion (OCL). This condition is often caused by a severe ankle sprain or ongoing issues with ankle instability.

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When you have an OLT, there can be damage in two specific areas of the talus bone: the inside and top part or the outside and top part. If your OLT is severe or doesn't get better with non-surgical treatments, surgery may be recommended. There are different surgical options for treating OLTs.

 

The most common procedure is Arthroscopic debridement and microfracture which involves using a small camera (arthroscope) to clean out the damaged area and make tiny fractures in the bone to stimulate new cartilage growth. It has a good success rate for smaller OLTs.

 

Osteochondral Autograft Transfer (OATs Procedure) is done if the previous treatment doesn't work or if you have a larger OLT. It involves taking healthy cartilage and bone from another part of your body (usually the knee) and placing it in the damaged area of your talus. However, there is a risk of knee problems after this surgery, and it takes longer to recover compared to the first procedure.

 

In Osteochondral Allograft Transfer, a piece of bone and cartilage from a deceased donor is used to replace the damaged area in your talus. This avoids the need to take tissue from your own body. However, there is a chance that the graft may collapse as it gets a new blood supply.

 

Lastly, Autologous Chondrocyte Transplantation (ACI) involves taking healthy cartilage cells from your own body, growing them in a lab, and then placing them back into the damaged area of your talus. Unfortunately, this approach hasn't been very successful for ankle cases yet, so it's not widely available.

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It's important to discuss your specific situation with our doctor to determine which surgical option, if any, is best for you. They will consider the size and severity of your OLT and other factors to make the most appropriate recommendation for your condition.

Talus Osteochondral Defects

What you need to do before surgery

  • To prepare for your surgery, it's important to discontinue all unnecessary medications and support pills, such as aspirin, hormonal drugs, vitamins, and birth control, at least two weeks prior to your scheduled surgery. Additionally, you should avoid substances that may increase bleeding. If you are receiving ongoing treatment for heart conditions, hypertension, thyroid disorders, or diabetes, please inform us of your situation.

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  • The healthier you are before surgery, the faster your recovery time will be. It's crucial to avoid smoking and alcohol for at least three days before your surgery and consume mainly fruits and vegetables to promote speedy recovery.

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  • On the day of surgery, please remove any jewelry, hearing aids, contact lenses, makeup, and other accessories that may be on your body. Comfortable clothing is recommended for the day of surgery.

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  • Depending on the procedure you have chosen, it will be performed under either local anesthesia with sedation or general anesthesia. You will be required to fast for up to eight hours prior to your surgery.

What you need to do after surgery

  • From the moment you arrive at the airport, we will be with you every step of the way, providing guidance and support. Our team will ensure that you receive excellent care, assist you with communication, monitor your recovery, and oversee your after-surgery medication.

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  • It's normal to experience soreness and discomfort after surgery. We recommend that you get plenty of rest to help alleviate any discomfort.

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  • It's important to attend all of your scheduled check-ups and cleanings, as well as complete any medication given to you after surgery.

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  • To promote a speedy recovery and achieve optimal results, it's crucial to avoid smoking and alcohol consumption for at least four weeks following your surgery.

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