Knee & Ankle
Injuries to the ACL are typically the result of sports related activity, either from impact or severe cutting movements. Joshua Dines, MD has treated many patients for this injury, from high-level athletes to weekend sports enthusiasts. His comprehensive approach to ACL tears has helped many people in New York City and on Long Island.
ACL tears have a surgical and rehabilitative component. Dr. Dines has long emphasized to his patients that the surgical reconstruction, when indicated, is critical. However, equally as important is the patient’s own follow up in rehabilitation. A resumption of activity and what level of activity the patient achieves is directly related to the diligence and patience the patient commits to the rehabilitation process.
The Anterior Cruciate Ligament is one of the four ligaments in the knee. Injuries to this critical ligament frequently, but not always, require surgical reconstruction. A partial ACL tear occurs when a trauma to the knee results in part of the ligament tearing.
Tears to the ACL can occur from either non-contact athletic activity, such as changing direction, pivoting or landing after a jump, or through sudden impact to the knee. Untreated ACL tears result in decreased stability and control in the knee and can lead to damage of the meniscus, articular cartilage or other ligaments.
In more severe ACL tears, the ligament needs to be rebuilt, not simply repaired. Surgical repair of the ACL results in successful return to sport in the majority of cases. Surgery involves taking a tendon graft from elsewhere in the body (patella tendon, hamstring tendon) and fixing the graft in the location of the normal ACL. Modern arthroscopic techniques, which involve fiber optic technology, allow for small incisions and instruments to be utilized. Athletes typically return back to sports 6-9 months after surgery.
The knee is comprised of the thighbone (femur), shinbone (tibia), and kneecap (patella). In between these bones, articular cartilage and the menisci cushion the joint and absorb shock. Four ligaments hold the bones together and maintain stability during movement. Damage to the knee from overuse or trauma can make daily activities such as walking, climbing stairs, or even resting very difficult and painful. Knee arthroscopy is a surgical option for patient who suffer from a painful and debilitating knee condition that does not respond to conservative treatment. Dr. Joshua Dines uses knee arthroscopy to perform procedures such as:
- Repair or removal of torn meniscus
- Anterior cruciate ligament (ACL) Reconstruction
- Removal of painful loose cartilage and bone fragments (loose bodies)
Knee arthroscopy is a minimally invasive surgery, in which the surgeon uses a tiny camera (arthroscope) to examine, diagnose, or repair tissues inside or surrounding the knee. The arthroscope displays live video on a television that allows the surgeon to use small instruments in the joint. The surgeon uses one or several small incisions (usually 1cm or smaller) to insert the arthroscope and other surgical instruments into the knee. Most patients undergoing knee arthroscopy are given regional anesthesia. Patients are discharged from the hospital on the same day of surgery. Your surgeon will recommend either a physical therapy or home exercise program to regain strength and function in your knee over the next several weeks.