Wednesday, 14 of November of 2018

Tag » Knee Surgery

National Men’s Health Week




This Sunday, June 16, Dr. Kagan and staff will join families across the country in celebrating Father’s Day and thanking Dads – or other significant men in our lives, such as grandparents, step-fathers, uncles, teachersand mentors – for all they have done and continue to do for us.

This week, June 10-16, is also National Men’s Health Week and a perfect time to remind men to adopt healthier lifestyle habits, including eating healthy, exercising more, maintaining appropriate weight, not smoking and making sure they have an annual check-up with their physician.

Early detection is the key to preventing many illnesses and even has a role to play in greater awareness about orthopedic-related issues that affect men. As boomers push the boundaries for active, healthy aging, men of all ages are enjoying exercising, staying fit and participating in sports. This is a very positive trend, but at the same time, can put men at risk for sports-related overuse injuries that strain ligaments and tendons and stress joints and damage cartilage. Remind Dad to go easy on the joints and not ignore acute or chronic pain and tenderness.

Shoulder, hip and knee arthroscopic surgery are among the top 10 successful procedures in the U.S. every year. These procedures can be life-changing in reversing mobility and improving quality of life.

For more information about bone and joint health, visit

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

New Medical Study Finds Vitamin D Doesn’t Help Arthritic Knees

Taking vitamin D supplements does not stop the progression of osteoarthritis in the knees, according to a new medical study published this week in the Journal of American Medical Association.

Because of vitamin D’s importance to bone health, it was thought that it might alleviate the pain of osteoarthritis and reduce damage to the cartilage. But results of a two-year study showed this was not the case. Physicians at Boston’s Tufts Medical Center directed the randomized, placebo-controlled trail that evaluated 146 people with advanced osteoarthritis of the knee.

However, there are a number of nonsurgical treatment options, including hyaluronic injections, prolotherapy treatment and platelet rich plasma (PRP) that can help reduce discomfort and improve quality of life for people with chronic knee pain until joint replacement surgery becomes necessary. To learn about these options, go to

Nonsurgical Treatment for Joint Pain

Surgery is not always the immediate solution to stiffness, pain and limited range of motion due to joint pain in your knee or hip. Before suggesting the most appropriate treatment plan for your condition, the doctor will take into consideration many factors, including the extent of damage to the joint and whether it was caused by a degenerative condition like osteoarthritis or injury due to an accident, sports or other factors. In many cases, the first step is a series of nonsurgical therapies. These may include one or more of the following.


Exercise can help manage joint pain and increase flexibility by strengthening the muscles that support the joint. Aerobic exercise that increases your heart rate, such as tennis, brisk walking, dancing, climbing stairs and swimming can improve circulation and help keep your weight at a good level, which decreases the stress on the joints of the knee and hips. Some patients may benefit from physical therapy sessions.


RICE, which stands for rest, ice, compression and elevation is always helpful for temporary management of joint pain. Heat therapy increases blood circulation and aids in stretching. Cold therapy with cold packs, ointments and sprays can reduce pain.


Over-the-counter analgesics, anti-inflammatory medications, non-steroidal anti-inflammatory drugs (NSAID) and pain relievers give temporary relief and can reduce swelling and tenderness. Prescription NSAID medications, such as Celebrex, may also be helpful. In addition, oral supplements like glucosamine and chondroitin sulfate can reduce swelling and discomfort.
Cortisone Injections

Cortisone injections are powerful anti-inflammatory agents that provide quick and effective temporary pain relief. However, cortisone can be given only a few times a year because of its effect on muscles and bone.

Joint Fluid Supplements

Hyaluronic acid is one type of joint fluid supplement that can act as a lubricant or “joint grease.” The supplements don’t cure the problem but will provide temporary relief from discomfort.

Supportive Devices

For patients with chronic knee pain, the American Academy of Orthopedic Surgeons recommends using a knee brace, cane, or wearing energy-absorbing shoes or inserts can provide some relief from pain by providing support to the joint.

For more information about treating joint pain, go to

Going Home From The Hospital After Knee Surgery

If you or a family member will be having knee surgery, you might be wondering what to expect when you return home from the hospital. How much discomfort will you be in? Will you be able to get by without help or will you need someone to assist you? How soon will you get back to your regular activities?

Here is an overview of what you can expect for the first few days and weeks after your knee surgery.

1. You will definitely need someone to assist you at home – preferably a spouse or another family member who can stay with you around the clock for a while until you feel strong enough to manage on your own. Because you will not be able to drive a car for about six weeks, you will also need to rely on someone to take you back and forth to doctor appointments, to the grocery store or other errands.

2. Exercise is vital to recovery. Short walks are good and will strengthen the muscles in the upper and lower leg, while helping stabilize the knee joint. You will also be prescribed specific exercises to improve the range of motion and flexibility in your knee. A physical therapy may come to the house or you may go for therapy at the doctor’s office or outpatient center. Expect to use crutches or a walker at first to help you get around. And be sure to rest frequently and not overdo it at first.

3. Medication will be prescribed for pain control. It’s much easier to prevent the pain that to “chase it.” Take pain medication about 30 minutes before physical therapy. Ice packs and elevating the leg will help reduce swelling and discomfort. A footstool can be handy for elevating your leg.

4. For a few weeks, If you can avoid, sitting in chairs that are low to the ground, chairs without arms or overstuffed furniture. It will be difficult to pull yourself up and out of this type of furniture.

5. Expect to use crutches or a walker to help you get around at first. The doctor will let you know how soon you can put weight on the leg and knee that underwent the procedure. Always lead with your non-operated leg and knee first.

6. Don’t leave preparations to the last minute – get your home ready a week or so before surgery. Have the laundry done, the house cleaned, food shopping done and meals frozen and ready for when you need them.

7. Remove throw rugs and eliminate clutter, including moving furniture if necessary, to avoid tripping or falling when you get home.

8. Some final tips for when you do get home:

• Don’t attempt to carry anything. Attach a bag or basket to your walker to make it easier to carry small items. Slide items along the counter rather than picking them up and carrying them.
• To make showering easier, use a hand-held shower hose and be sure to place a non-skid rubber mat on the bottom of the shower stall or bathtub.
• Use liquid soap so you won’t have to worry about bending over to pick up a bar of soap if you drop it.
• Avoid climbing stairs. If you do have to use stairs, make sure there is a handrail to help you.
• Expect full recovery to take approximately six to eight weeks.

For more information, visit

When Is Knee Replacement Surgery The Right Decision?

If you have chronic knee pain caused by osteoarthritis, eventually, the progressive, degenerative nature of the disease may mean that surgery is the best solution to relieve pain and improve your quality of life. Surgery reshapes the damaged portion of bone caused by the wearing away of cartilage and replaces the joint with an artificial implant.

Even though knee replacement is a very common and successful surgery, making the decision to undergo this procedure is a very big step. How do you know when the time is right to make this important decision?

Many people think of knee replacement surgery as the last resort –that their knee pain must be bad enough to severely compromise their lifestyle before they agree to an operation. But today, most medical experts agree that there is no reason to live with chronic pain. When conservative treatment fails to help, it’s time to consider more permanent measures.

According to the American Academy of Orthopedic Surgery, there are several important signs that you may be a good candidate for knee replacement surgery:

You have tried a variety of conservative, nonsurgical treatments, such as exercise, anti-inflammation and pain-relief medication, hot and cold therapy, and injections. However, these methods have failed to control the pain and improve your condition.

Knee pain wakes you up at night or prevents you from falling asleep.

You find that knee pain makes it nearly impossible to participate in recreational activities that you enjoy – golf, tennis, dancing, walking, shopping.

Knee pain makes performing every day activities, from getting out of bed or a chair to climbing the stairs or standing for very long, even to cook meals, painful and challenging.

Learning more about knee replacement surgery can help you make a better decision about whether it’s for you. Find out how it’s performed and what to expect at

What is Knee Arthroscopy Surgery?

The trend in surgery today is toward a minimally invasive approach that is less traumatic to the body. This is especially true for knee surgery, where it’s possible to repair damage to ligaments, tendons, cartilage and bone without the need for large, open incisions, an overnight hospital stay and a very lengthy recovery period.

Minimally invasive procedures are possible thanks to improvements in technology, such as the development of tiny fiber-optic scopes that can be inserted into the body through incisions or “portals” only three to four millimeters in diameter.

While the incision is small, the surgeon’s ability to perform the procedure isn’t compromised by a tiny view. Instead, a small lens, light source and video camera on the end of the scope sends images of the knee joint to a large monitor in the operating room, which gives the surgeon a “big picture” and a clear view of the operating field.

Additional incisions are made to allow the surgeon to insert small surgical instruments into the knee joint. These tiny instruments are used to repair damage to the knee caused by an accident, sports or other situations or to reduce pain and disability caused by degenerative conditions like osteoarthritis.

The American Academy of Orthopedic Surgeons reports five common reasons why patients undergoing knee arthroscopy:

1. Remove or repair a torn meniscus
2. Reconstruct a torn ACL, anterior cruciate ligament
3. Trim torn pieces of articular cartilage
4. Remove loose fragments of bone or cartilage
5. Remove inflamed synovial tissue

For more information about the kinds of conditions that benefit from arthroscopic knee surgery, go to

Recovery From Knee Surgery

Once you’ve made the decision to have knee replacement surgery, you may wonder what the recovery period will be like.

During the first few days in the hospital, a physical therapist will come to your room to help you begin a gentle exercise regimen. Don’t be surprised when you’re asked to get up and out of bed the day after surgery. The objective is to stretch and strengthen the knee muscles and improve your range of motion as quickly as possible.

The therapist will guide you in putting weight on the knee and walking down the hall with the aid of a walker. You will also exercise your knee using a continuous passive motion machine, a piece of equipment that will automatically move the knee while you lie in bed. Pain medication will be prescribed to help with any discomfort you feel as the knee heals.

Once you leave the hospital, you will continue to use a walker and then a cane as your knee heals. Physical therapy will be an important part of your recovery. You will receive exercises to do at home, but may also have a physical therapist come to your home or you can go to an outpatient center.

If you live alone, talk with your doctor about the benefits of going to a rehab facility for a short time versus having someone come to the house to help you. For the first few weeks after your surgery you will need help with basic tasks including cooking, bathing, doing laundry, driving and grocery shopping. You can expect it to take about four to six weeks to resume all your normal day-to-day activities.

If you decide to go home, a little advance planning is helpful. If your bedroom is on the second floor, set up a temporary bedroom on the first floor so you can avoid over-stressing the knee by walking up and down stairs.

Check your home for items that may cause you to trip and fall. Remove throw rugs, eliminate clutter in hallways or doorways and rearrange furniture if necessary. Installing a handrail or grab bar in the bathroom is another good idea. Make sure basic items that you’ll need every day are easily accessible.

For more information knee replacement surgery or other orthopedic-related conditions, go to

What Does Minimally Invasive Surgery Mean?

Minimally invasive surgery is a newer technique that orthopedic surgeons use to diagnose and treat a wide variety of orthopedic-related conditions that can affect the knees, hips, shoulder, ankles and elbows.

Also called arthroscopic surgery and sometimes “keyhole” surgery, minimally invasive surgery has become the preferred choice and standard of care whenever possible due to the many benefits it offers to both the surgeon and the patient, including:

• Small incision size
• Less damage to the tissue
• Less blood loss
• Reduced post-operative pain
• Faster recovery
• Smaller scars
• The potential to go home the same day as the surgery

In contrast with traditional surgery, in which a large incision is used to open the body, with minimally invasive techniques, only tiny incisions – often described as “keyhole” size are required. This shift toward less invasive methods of diagnosing and treating injury and illness represents a major improvement in patient care.

What are some of the orthopedic-related procedures that can be performed with minimally invasive techniques? Removal of bone chips and spurs, damaged cartilage, and inflamed synovial fluid. Repairing ligament tears, bone fractures and tears to the meniscus and ACL. Treatment of shoulder dislocation, instability and rotator cuff tears. Even joint replacement surgery is often performed using minimally invasive techniques.

If you would like to learn more about minimally invasive orthopedic surgery, go to or call 239-936-6778.

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

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