Wednesday, 14 of November of 2018

Tag » Knee Pain

Update on PRP & Other Injections



If you have chronic tendonitis in your elbow, knee pain from osteoarthritis, or bursitis in your hip, cortisone injections are an effective treatment that can reduce inflammation and discomfort. Now PRP or platelet-rich plasma is another type of injection that is gaining popularity as a way to reduce pain and disability prior to considering surgery.

The December Journal of the American Association of Orthopedic Surgeons and the November 14 issue of New Yorker magazine both featured the latest information about PRP. Here’s what the publications had to say about this high-tech, advanced treatment that Dr. Kagan has been offering for some time.

In the New Yorker article, Chris Waddell, a star athlete who is a paraplegic and the most decorated male skier in Paralympic history, talks about the major improvement PRP had on his shoulder injuries – a torn rotator cuff in one shoulder and a torn biceps tendon in the other shoulder. He says the successful treatment helped him regain his shoulder strength and decreased his pain almost 100 percent. But most importantly, it helped him avoid surgery.

How safe and effective is PRP? There are many opinions on PRP’s ability to accelerate healing and enhance tissue recovery. Whether you may benefit is a decision best made in a one-on-one consultation with a physician who is experienced in using the technique. PRP takes the patient’s own blood and separates the red and white blood cells from the platelets. Platelets have both clotting and growth factors, which are vital for healing. To treat the injury, a concentrated mix of platelets is injected into the joint, ligament or tendon.

In the AAOS journal articles, Dr. Scott Rodeo of Weill Medical College of Cornell University and Dr. Freddie Fu of the University of Pittsburgh School of Medicine express some caution. They suggest that PRP is a promising treatment option that may offer symptomatic relief in tendonitis and osteoarthritis, but recommend additional scientific research before it can be considered a proven therapy. The doctors recommended PRP as a “second line of defense” when other nonsurgical options have not been effective.

For more information about PRP and other treatment options for orthopedic-related injuries, go to, or call the office at 239-936-6778 to schedule a consultation.

Do Your Knees Ache? Here’’s What You Need To Know



shutterstock_137018378If your knee pain makes you limp when you walk or you dread going up and down stairs, you might be one of the millions of people with osteoarthritic knees. In fact, the Arthritis Foundation says the knee is one of the most common spots for osteoarthritis to develop. But you don’t have to let knee pain limit your enjoyment of life. According to the Centers for Disease Control, “many people with OA are not being proactive because of the misconception that arthritis is an inevitable part of aging and that the aches and pains are simply something you must learn to live with.

Here are 4 things you need to know about this chronic condition:

1. What is osteoarthritis? It’s a medical condition that damages the cartilage, bones, fluid and lining of the joint. Cartilage covers the ends of the bones in the knee joint. Without this protective cushion, the bones can rub against each other, causing friction and pain. Over time, fragments of bone or cartilage may break lose and float around. Spurs may develop on the end of the bones and the joint lining may become inflamed. All of this leads to swelling, tenderness, stiffness and pain.

2. What causes it? According to the Arthritis Foundation, osteoarthritis is no longer thought of as simply a “mechanical process” where the joint wears out due to age. Instead, the current view is that osteoarthritis has multiple risk factors, including a predisposition based on family history; being overweight, which can put pressure on the knee joint; traumatic injury or accident; chronic overuse and stress to the joint.

3. Is there a cure? At the present time, there isn’t a cure for osteoarthritis, but there are number of treatment options, both surgical and nonsurgical. Exercise, over the counter medications and topical creams can help early stage disease. Injections and prescription drugs may help more advance conditions. But chronic pain and disability is best relieved through joint replacement surgery.

4. How is it diagnosed? The doctor will conduct a physical exam, which includes inspecting your knee for swelling, warmth or tenderness, and evaluating how far you can extend your leg without discomfort. X-rays can identify a narrowing of spaces in the joint and other evidence of joint disease. It can also rule out other conditions, such as bone fracture. If needed, more advanced imaging techniques, such as CT scan, ultrasound or MRI may be considered.

If OA knee pain is affecting you quality of life, call us today at 239-036-6778 to schedule a consultation. For more general information on osteoarthritis, go to

Meniscus Tears of the Knee




Meniscus Tear 1Meniscus tears of the knee are a common orthopedic injury for people of any age. In younger adults, it’s often related to sports. A sudden twisting, turning or forceful squatting can cause a tear. Even the repetitive pounding the knee takes during jogging can increase the risk for this type of injury.

In older adults, a meniscus tear is usually related to degenerative disease. As the cartilage thins out and weakens, it can rip. Something as simple as stepping off the curb the wrong way or twisting when getting up from a chair can tear the tissue. Without treatment, a piece of meniscus could come loose and drift into the joint, causing pain and swelling and making it difficult to bend and move the knee.

Years ago, treating a meniscus tear required a two-to-three inch incision to repair the tissue and a two or three day hospital stay. Today, the procedure of choice is minimally invasive arthroscopic surgery, in which a small endoscopic tube is inserted through a half-inch incision. Patients go home the same day. Recovery is quick and pain is minimal.

What does the treatment involve? Surgeons can remove fragments of torn tissue, trim and smooth rough edges and use sutures to stitch the torn pieces back together.  The type of treatment best for your situation will depend on the size, location and type of tear.

How do you know if you have a meniscus tear?  Symptoms include a dull ache, swelling, tenderness, sensations such as locking, popping or catching, as well as difficulty bearing weight on the knee and limited range of motion.

Seek advice from an experienced orthopedic surgeon if you have lingering knee pain and problems walking. For more information about meniscus tears or other common orthopedic conditions, go to

Total Knee Replacement vs. Partial Knee Replacement or Resurfacing – What’s the Difference?

If pain and stiffness in your knees is starting to make getting around increasingly difficult, the first step is to consult with an orthopedic surgeon. After tests confirm a diagnosis of osteoarthritis, the next step is to discuss your options with the doctor.

You might be surprised to learn that thanks to advances in technology, there are new options that are available as an alternative to total knee replacement. Younger patients and those with less advanced disease may be good candidates for an innovative technique called partial knee replacement or partial knee resurfacing.

According to the American Academy of Orthopedic Surgeons, “most patients report that a partial knee replacement feels more natural and that the knee may bend better” than with a total knee replacement.

Whether you qualify as a candidate for a partial knee will depend primarily on the extent of damage from osteoarthritis.

Anatomy of the Knee

The knee has three compartments – an inside or medial compartment; an outside or lateral compartment; and a front or patellar (the kneecap) compartment. In some patients, damage from osteoarthritis may affect only one or two compartments of the knee, rather than all three. And for these patients, a partial knee replacement may be a good choice.

A partial knee is a minimally invasive procedure that replaces only one or two compartments of the knee, leaving the cartilage, ligaments and bone in other areas of the knee that are healthy intact. Most of the time, it is the medial and patellar, rather than the lateral compartments that are replaced or resurfaced.

During the procedure, the surgeon removes the damaged cartilage, as well as some bone from the tibia and femur, (the upper and lower leg bones). Then the ends of the bones are reshaped to accept the new implant. 

In contrast, a total knee replacement removes damaged tissue from all three compartments of the knee — replacing the entire joint with artificial implants.

Advantages & Disadvantages

There are many advantages to partial knee replacement or resurfacing, including:

  • Smaller incisions
  • Less trauma to the body
  • Reduced blood loss
  • Shorter hospitalization
  • Faster recovery time
  • Less need for physical therapy
  • Gentle exercises at home and walking restore mobility

What are the disadvantages? The biggest concern is the potential for cartilage in the remaining compartments to deteriorate at some point in the future, which would then require additional surgery.

To find out whether you might be a candidate for partial knee replacement, call Dr. Kagan at 239-936-6778 or go to For a more detail explanation on how the procedure is performed, go to

Unicompartmental Knee Resurfacing

 If knee pain keeps you on the sidelines and prevents you from enjoying golf, running, tennis or even walking the dog, it may be time to consider surgery. Depending on the severity of your condition, you may have more than one option to treat the pain and disability. 

Unicompartmental Knee Resurfacing is a less invasive alternative to total knee replacement. Instead of replacing the entire knee joint, this procedure treats only the potion of the femur and the tibia that have been damaged by arthritis, conserving the rest of the knee. Other advantages include less blood loss and faster recovery.

The procedure is done arthroscopically using a small endoscopic tube with a video camera attached that transmits images in real-time to a monitor, allowing the physician to clearly see inside the knee joint.

The first step is to remove the arthritic portions of the end of the femur, along with damaged meniscus. The femur is the thighbone or upper bone in the leg. The meniscus is the smooth covering of cartilage that protects the end of both the femur and tibia.

Next, the surgeon resurfaces the end of the femur and applies a special type of bone cement, pressing the new femoral implant into place. The surgeon then applies cement to the end of the tibia (the thigh bone) and the new tibial implant is pressed into place. Finally, a third implant is inserted between the femoral and tibial implants and the knee is tested to make sure that the patient can extend and flex the knee with good range of motion.

 If you have knee pain that doesn’t respond to nonsurgical therapy, ask whether you may be a candidate for unicompartmental knee resurfacing. To view a patient education video and brochure about the procedure, go to

Acute or Chronic Knee Pain? You Might Benefit From Arthroscopic Knee Surgery

If your physician suggests scoping your knee to look for an answer to acute or chronic knee pain, what can you expect? Arthroscopy is a minimally invasive technique in which a tiny tube, called an arthroscope, is inserted into the knee joint. The arthroscope is connected to a video camera, which sends high-resolution images of the knee to a TV monitor, making it possible for the physician to see the interior structures and diagnose the problem, while also repairing or removing damaged tissue.

The American Orthopaedic Society for Sports Medicine reports some 4 million people around the world undergo knee arthroscopy each year due to sports or work injuries, arthritis, or simple aging of the joints. The most common reasons for the procedure include removing or repairing torn cartilage (meniscus tears); reconstructing a torn ligament (ACL tear); trimming torn articular cartilage; removing loose chips of bone or cartilage; and removing inflamed synovial tissue.

Compared with surgical techniques of the past, arthroscopy has a quick recovery time, with less pain and less trauma to the body. Since arthroscopic surgery is done on an outpatient basis, patients go home the same day. Most people can return to light activity and a desk job within one week, but it may take several weeks to get back to sports, depending on the severity of the procedure.

For more information or to schedule a consultation, please call 239-936-6778 or visit

Warning: Illegal string offset 'status_txt' in /home/content/53/6203553/html/Kaganorthoblog/wp-content/plugins/share-and-follow/share-and-follow.php on line 1938

Warning: Illegal string offset 'status_txt' in /home/content/53/6203553/html/Kaganorthoblog/wp-content/plugins/share-and-follow/share-and-follow.php on line 1938

Warning: Illegal string offset 'status_txt' in /home/content/53/6203553/html/Kaganorthoblog/wp-content/plugins/share-and-follow/share-and-follow.php on line 1938