There are many sports-related injuries in lower legs which cause pain, stiffness, instability or other problems in athletes of all ages. We always take care to diagnose and treat them properly.
Repeating same movement or motion can lead to overuse syndrome in your body, which is highly seen in daily clinical situations. This is basically treated in conservative treatment, self-care with stretching and icing, and we provide a program to prevent the recurrence.
If the symptoms not relieving, or injured due to a trauma, we suggest a surgical option. We have a basic treatment strategy to reconstruct as a normal structure and restore normal function. We hope that patients can return to sports or active life.
ACL is an important structure in the knee which connects the femur and the tibia, and it resists anterior tibial translation and rotational loads. ACL injury is a common injury among athletes and it needs to be surgically treated due to its poor healing potential. If left untreated, it leads to develop osteoarthritis earlier in life. Thus, we perform an anatomical reconstruction with autologous tendon graft (bone-patellar tendon-bone (BTB), hamstring tendon, or quadriceps tendon) to restore normal ACL function. After the operation, the patient enters a staged rehabilitation program to recover range of motion, strength and stability. It usually takes 7 to 9 months to return to participating in sports, depending on the recovery of strength/performance and the level of competition.
Meniscus has an important function in load distribution/transmission and stability of the knee. We have two menisci in the knee: medial and lateral meniscus. The meniscus is often injured when the knee deeply bended or twisted, or concomitant with ACL injury. The meniscus can also hardly heal spontaneously because the blood supply is limited in the outer 1/3 area. There are many types of tear: longitudinal, radial, flap, horizontal and complex tear. And healing capacity is different in each tear type. ‘Save the Meniscus’ is a global slogan, and we basically treat any meniscus injury with repair. After the operation, we start a staged rehabilitation and it usually takes more than 6 months to return to sports activity. However, degenerative tear, which is often seen in elderly patient and is happened on gradual onset, is much harder to repair. Thus, in case of degenerative tear, conservative treatment is firstly applied, and if the pain cannot be relieved in several months, we perform osteotomy which can reduce affected compartment load. Osteotomy can preserve patient’s joint and low impact sports can be allowed after 6 months.
Cartilage covers the surface of the bone of joints, acts as a shock absorber and provides a smooth, lubricated surface for articulation. It can be damaged as a result of a sports injury or gradual wear. Same as the meniscus, cartilage has limited regenerative potential. Thus, for focal cartilage injury, we perform surgical treatments: drilling/microfracture, autogenous osteochondral graft transfer, autologous chondrocyte implantation, and other regenerative therapy (clinical research can be applied if the patient matches its indication). After the surgery, it usually takes 6 months to about 1 year to return to sports. If the cartilage continues to wear, it progresses in osteoarthritis (as shown below).
Osteoarthritis (OA) is the most common painful knee disorder, known as degenerative joint disease. Aging is one of the causes of OA, but younger people may also have the condition early as a result of knee injury (mentioned above). Spontaneous osteonecrosis of the knee has recently been termed subchondral insufficiency fracture of the knee, and this is often due to meniscus dysfunction (degenerative meniscus root tear). Conservative treatment including restricting load of the affected joint or sometimes intra-articular injection can be firstly applied, but if pain cannot be relieved, osteotomy (cutting a bone and realign the joint) is good indication for these diseases (e.g. medial opening wedge high tibial osteotomy for medial compartment). After the operation, pain due to osteotomy may continue for several months, but patient’s joint can be preserved. This procedure is performed if the patient is active and younger than 70 years old to delay the need for total knee replacement.