Rahul Deshmukh

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Rahul Deshmukh
Orthopedic Hand Surgery
Heekin Orthopedic Specialists
10475 Centurion Parkway Ste. 220

I have been told I am “missing cartilage” in my knee...what does this mean?

There are two forms of cartilage in the knee; the two meniscal cartilage discs http://i.ixnp.com/images/v3.61.1/t.gif or cushions, and the articular cartilage http://i.ixnp.com/images/v3.61.1/t.gif on the ends of the bones. Cartilage defects http://i.ixnp.com/images/v3.61.1/t.gif on the end of the bones could be the result of a traumatic injury, Osteonecrosis http://i.ixnp.com/images/v3.61.1/t.gif, Osteochondritis Dessicans, http://i.ixnp.com/images/v3.61.1/t.gif or simply the early stages of Osteoarthritis.  When a surgeon says you are "missing cartilage" in your knee, more often than not, he or she is referring to the articular cartilage http://i.ixnp.com/images/v3.61.1/t.gif on the end of your bone.

Do all ACL tears require surgery?

No. Many ACL tears can be treated non-operatively. Many factors go into the decision-making process. Some patients have ACL tears and no instability symptoms. Others are profoundly symptomatic, even with simple stair climbing, turning, or twisting.

We do not know why some people are more symptomatic than others -- which is why surgery is not the right answer for everybody. Typically a reconstruction is necessary if you plan to return to competitive activities involving cutting, pivoting, twisting, and rapid side-to-side movements.  Fortunately, surgery for ACL reconstruction has improved dramatically, allowing the operation to be done as an outpatient, require much less down-time, and a much less invasive process known as the “all-inside” technique.

Are Injections such as Synvisc or Hyalgan helpful with muscle tears as well or just osteoarthritis?

Viscosupplementation injections such as Synvisc or Hyalgan are designed to provide more lubrication for an arthritic joint.  It’s similar to having an oil change in your knee—things run a bit smoother, but the fluid eventually thins out again and the parts can still wear out.  Overall, these are very effective, especially in milder cases of arthritis, and can provide extended relief.  Combined with weight loss and exercise, these injections can significantly help reduce symptoms of arthritis. Muscle tears are not treated with these injections.  Rather, they are managed with rest, physical therapy, and very rarely surgery.

Rahul Deshmukh
Rahul Deshmukh

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