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14/Nov/2014

From shoulder pain to knee pain: this new technique for using stem cells to help patients cope with knee pain is garnering attention even before the results are in. The procedure is something of a hybrid, combining hyaluronic acid (HA) with concentrated stem cells to promote healing and “seed” the creation of new cartilage:

Patients who undergo the Abicus operation have the cartilage cut and tidied and undergo microfracture, but their cartilage tissue is then coated with a substance made up of bone marrow cells, platelet gel and hyaluronic acid.

During the 30-minute procedure, the bone marrow sample is spun in a centrifuge in the operating theatre to give a concentrated amount of the patient’s own stem cells.

These cells are then mixed with the gel and acid to create a “glue” substance which is placed over the cartilage defect and allowed to set.

If clinical trials show a clear benefit, it will represent yet another advance in our treatment of knee pain, and a new avenue forward for orthopedic knee surgeons who are always on the lookout for the latest innovations in patient care.

If you have chronic knee pain and want to avoid a more invasive knee replacement procedure, I urge you to contact my San Diego knee surgery offices today.


30/Sep/2014

ACL injuries or Knee ligament injuries are seen commonly by the best orthopedists in town, as these injuries often times occur in aggressive or elite level San Diego athletes that yearn to return to play.

acl-injury-sports

Anterior Cruciate Ligament (ACL) injuries or simply ACL injuries happen to hundreds of thousands of people every year.  ACL  injuries usually end play and can be extraordinarily painful. Although debilitating, they are treatable. You just have to make sure you know how severe your injury is and what you can do to treat the problem.bruised-knee-contusion

ACL injuries are actually quite common among people who participate in high action cutting sports, such as:

  • Soccer
  • Football
  • Basketball
  • Lacrosse

Levels of Severity with ACL Injuries

There are three categories of injuries based on what kind of damage has been done to the ACL:

  1. Grade 1 ACL injuries: This is the easiest ACL injury to heal. A grade one ACL injury is the result of the ligament stretching slightly. It does not cause the knee joint to become unstable.
  2. Grade 2 ACL injuries: This grade of injury is in the middle, and the least common of all knee injuries. A grade two type of injury happens when the ligament stretches to the point where it is unstable. It is more commonly known as a partial tear.
  3. Grade 3 ACL injuries: This ACL injury is the most severe. A grade three injury is labeled when the ligament is completely torn in half. This can cause the knee to become extremely unstable. Severe knee pain and an almost impossible time walking are common symptoms.

acl-tear-grades

At the end of the day, the grade doesn’t really matter.  To an orthopedist this injury boils down to those athletes that are able to compensate (ie, their knee is functionally stable) and those that can’t (ie, their knee is functionally unstable). Having a functionally stable knee means that that athlete is able to return to his/her level of customary play in cutting sports without the knee giving out.  Generally speaking, one third of athletes will be able to return to play despite their injury with little to no intervention; one third of athletes will be able to return to play after engaging in directed physical therapy without surgery; one third will require surgery in order to return to play due to continued knee instability despite physical therapy.

Treatments for ACL injuries

Non-Severe ACL Injuries

If you only have a mild injury, you can, usually, use physical therapy to treat your injuries. Your physical therapist will have you go through a series of exercises and motions to help you regain full control of your knee again. It can take some time to heal completely, depending on the injury type.

Since this is so common with sports athletes, there are specialists who work specifically with athletes. The goal is to help them get back into their sport of choice as quickly as possible.

Severe ACL Injuries (ie, unstable knee)

One third of the athletes will require surgery to regain a stable knee, despite having engaged in physical therapy.  With a physical examination and an MRI scan, a well-trained sports medicine surgeon can anticipate the need for treatment of various concomitant injuries: cartilage damage, meniscus tears, etc.  severe-acl-tear

ACL reconstruction can be done in a variety of ways.  First decision to be made is whether a patient chooses to use their own tissue or donor tissue to reconstruct the ligament.  If a patient chooses their own tissue, the options are bone-patellar tendon-bone, or hamstring tendon, or quadriceps tendon.  Although some surgeons may argue that one type of tissue is superior to the other, many studies have looked at this and there is little to no clinical difference.

If you have been told that you have an ACL tear or are concerned about a knee injury, contact our award winning sports medicine doctors at San Diego Orthopedic Surgery Clinic.

 


26/Sep/2014

ACL injuries or Knee ligament injuries are seen commonly by the best orthopedists in town, as these injuries often times occur in aggressive or elite level San Diego athletes that yearn to return to play.

acl-injuries-nfl

Anterior Cruciate Ligament or ACL injuries happen to hundreds of thousands of people every year. This knee ligament injury usually ends play and can be extraordinarily painful. Although debilitating, they are treatable. You just have to make sure you know how severe your injury is and what you can do to treat the problem.

ACL injuries are actually quite common among people who participate in high action cutting sports, such as:

  • Soccer
  • Football
  • Basketball
  • Lacrosse

Levels of Severity with ACL Injuries

There are three categories of injuries based on what kind of damage has been done to the ACL:

  1. Grade 1: This is the easiest ACL injury to heal. A grade one ACL injury is the result of the ligament stretching slightly. It does not cause the knee joint to become unstable.
  2. Grade 2: This grade of injury is in the middle, and the least common of all knee injuries. A grade two type of injury happens when the ligament stretches to the point where it is unstable. It is more commonly known as a partial tear.
  3. Grade 3: This ACL injury is the most severe. A grade three injury is labeled when the ligament is completely torn in half. This can cause the knee to become extremely unstable. Severe knee pain and an almost impossible time walking are common symptoms.

At the end of the day, the grade doesn’t really matter.  To an orthopedist this injury boils down to those athletes that are able to compensate (ie, their knee is functionally stable) and those that can’t (ie, their knee is functionally unstable). Having a functionally stable knee means that that athlete is able to return to his/her level of customary play in cutting sports without the knee giving out.  Generally speaking, one third of athletes will be able to return to play despite their injury with little to no intervention; one third of athletes will be able to return to play after engaging in directed physical therapy; one third will require surgery in order to return to play due to continued knee instability.

Treatments for ACL injuries

Non-Severe ACL Injuries

If you only have a mild injury, you can, usually, use physical therapy to treat your injuries. Your physical therapist will have you go through a series of exercises and motions to help you regain full control of your knee again. It can take some time to heal completely, depending on the injury type.

Since this is so common with sports athletes, there are specialists who work specifically with athletes. The goal is to help them get back into their sport of choice as quickly as possible.

acl-injury

Severe ACL Injuries (ie, unstable knee)

One third of the athletes will require surgery to regain a stable knee, despite having engaged in physical therapy.  With a physical examination and an MRI scan, a well-trained sports medicine surgeon can anticipate the need for treatment of various concomitant injuries: cartilage damage, meniscus tears, etc.

ACL reconstruction can be done in a variety of ways.  First decision to be made is whether a patient chooses to use their own tissue or donor tissue to reconstruct the ligament.  If a patient chooses their own tissue, the options are bone-patellar tendon-bone, or hamstring tendon, or quadriceps tendon.  Although some surgeons may argue that one type of tissue is superior to the other, many studies have looked at this and there is little to no clinical difference.

If you have been told that you have an ACL tear or are concerned about a knee injury, contact our award winning sports medicine doctors at San Diego Orthopedic Surgery Clinic.


19/Sep/2014

Obesity is intricately linked with multiple medical problems, knee pain, and hip pain. With more than 74% of its population considered overweight or obese, the United States is the ninth-most corpulent nation on Earth, according to the World Health Organization.

A recent study by the Centers for Disease Control and Prevention suggested that the problem is getting worse. The researchers wrote that “the waists of men, women, blacks, whites and Mexican-Americans all grew significantly from 1999 to 2012.”

The average man’s waistline expanded from 38.9 inches to 39.7 inches, while the typical woman’s measurement grew from 36.3 inches to 37.8 inches, according to the study (published in the Journal of the American Medical Association).

USA Today reported that researchers detected an increase in “abdominal obesity” in 43 percent of men and 64 percent of women. In 1999, the statistics were 37 percent of men and 55 percent of women.

The study involved 32,816 adults, including African-American women in their 30s, Mexican-American women older than 70, Mexican-American men in their 20s, African-American men in their 30s and white women in their 40s.

The Washington Post noted that “obesity calculated from body mass index, which measures body fat based on height and weight, (has) remained relatively stable.” However, BMI does not measure the distribution of weight. Patients with normal BMIs can have large waistlines, which leave them more vulnerable to cardiovascular disease.

Patients with abdominal obesity also are more likely to experience hip pain or knee pain. They have an elevated risk of osteoarthritis developing in their hips and knees, which sometimes requires joint replacement.

In a story by The Associated Press, Dr. William Dietz (an obesity expert formerly with the CDC) said: “Even though the obesity rate may be stable, fat distribution may be changing. The seemingly contradictory trends are puzzling. It could be that Americans are exercising less and getting flabby. But because fat weighs less than muscle, they are not necessarily getting heavier.”

To prevent abdominal obesity, it is necessary to adopt a healthy diet and engage in regular exercise. The body stores carbohydrates as fat, often in the lower part of the torso. Reducing carb intake is key to staying in shape.

A balanced diet consists primarily of vegetables, fruits, whole grains and lean protein. These foods contain few calories, but provide the vitamins, minerals and fiber essential to fitness. Spinach and other green, leafy veggies are the best because they deliver nutrients while burning fat.

Studies have linked sedentary behaviors, like spending too much time sitting, with a number of illnesses and diseases. Couch potatoes also are more susceptible to hip or knee osteoarthritis, which causes pain and limits mobility.

The solution is to stay active and adopt a regimen of daily exercise. Effective workouts can be as simple as walking or running in place, or on a treadmill, while watching television.

Other popular options include walking or running outside, swimming in a pool, and playing sports like tennis or golf. Cardio exercises, those that sustain an elevated heart rate for 20 minutes, burn the most fat.  If you need help addressing your knee pain or need help developing a proper exercise regimen, contact our renowned sports medicine team at San Diego Orthopedic Surgery today.

 


10/Sep/2014

Knee pain as a result of a meniscus tear is extraordinarily common in both the young teenage Carlsbad soccer player as well as the mature La Jolla tennis player.  The tear can occur from a twisting or pivoting mechanism.  This is commonly seen on the football field.

Quarterbacks, running backs, and wide receivers tend to get all the attention from fans and NFL analysts. One of the most underrated positions in all of sports could very well be NFL’s long-snapper. The position of long-snapper is important enough that most NFL teams use a roster spot specifically for a designated long-snapper. Unfortunately for the Steeler’s, long-snapper Greg Warren suffered a torn meniscus in practice two weeks ago. Warren has played every regular season game for the last four years for the Steelers but he is likely to have that consecutive game streak come to an end at the beginning of this season.Greg-warren-meniscus-tear

The meniscus is a wedge of cartilage that acts as a shock absorber and stabilizer between the thighbone (femur), shinbone (tibia), and kneecap (patella). A meniscus tear can result in reduced cushioning between the femur, tibia, and kneecap, as well as reduced stability. The result of a meniscus tear is an intense amount of knee pain, stiffness, swelling, decreased range of motion, and instability. Without treatment, there is a good chance that a piece of the meniscus can come loose. This often results in a slipping, locking or popping of the knee. Meniscus tear often occurs as a result of a twisting or pivoting motion in non-contact situations. They can also be caused by direct contact, as with a tackle to the knee. In the case of Greg Warren, the meniscus tear injury was sustained without direct contact.

meniscus-tear

Meniscus Tear Diagnosis:

The process of diagnosing a meniscus tear begins with a visit to a physician.  The doctor will most likely be the McMurray test, which involves bending, then straightening, and then rotating the knee. If there is a click then it is considered a positive McMurray test and if there is no click it is a negative McMurray test. A positive test would mean that there might be a meniscus tear.

After the McMurray test the doctor may order a battery of imaging tests to check for a meniscus tear and other associated knee injuries. An X-ray would be used to determine if there is a different cause of the symptoms. Rather, an MRI would reveal damage or tear to soft tissue such as a meniscus.meniscal-tear-injury

Meniscus Tear Treatment:

Treatment of a meniscus tear can involve either surgical or non-surgical treatment. Non-surgical treatment involves rest, ice, compression, elevation along with medication to relieve pain and swelling. Surgical treatment may be a meniscectomy or a meniscus repair. In a meniscectomy, the orthopedic surgeon trims away the damaged meniscal tissue. Meniscal repair involves the suturing torn meniscus pieces back together.

Rehabilitation is dependent on the severity of the injury and can require about two weeks for injuries that do not require surgery. Three to four weeks of rehabilitation is required for meniscectomy surgeries. Three to four months of rehabilitation is required for a meniscus repair. In the case of Greg Warren, he likely underwent a meniscectomy as he is scheduled to return to the field about a month after the injury. A little math shows that Greg Warren will be snapping again by week three of the 2014-2015 NFL season, which is great news for Greg Warren and the Steelers.meniscus-tear-view

If you have been told that you need an arthroscopy for a meniscus tear or would like a second opinion, call to schedule an appointment with our award winning sports medicine doctors at Orthopedic Surgery San Diego Clinic.

 

 


09/Sep/2014

Knee and Hip pain is 70% more common in patients with elevated BMI (body mass index).  In preparation to undergo a hip replacement or knee replacement for joint pain, it is imperative to shed any extra weight you may have.  Despite our active lifestyles in San Diego, sometimes it becomes necessary to utilize a diet. Here in America, it seems like most people are always on one type of weight loss diet or another. Comparing which diet helps you lose the most weight is a common topic of conversation these days. But, the answer remains unclear, as each diet has its benefits as well as disadvantages, based on the dieters’ needs. And, when it comes to overweight and obese adults, those needs tend to vary. Oftentimes, the need to eliminate pain is the biggest issue.

How Obesity or Being Overweight Affects Knee and Hip Pain

One thing is clear, though, the heavier you are, the more weight your hips and knees have to carry around all day and night. So, if you’re obese, or very heavy for your body frame, your weight is probably the cause of much of your body pain. If you’ve been having Knee and Hip pain that simply will not go away, your weight is adding to your orthopedic problems. And, even if your orthopedic surgeon recommends knee replacement or hip replacement surgery, the pain still won’t go away for good without your help. You’ll still need to lose a substantial amount of weight in order to improve the outcome of the surgical procedures. If not, eventually, your weight will simply wear down your new hips and knees, causing them to be in pain again in the near future.

JAMA Study on Popular Weight Loss Diets

The Journal of the American Medical Association (JAMA) published an abstract paper in regards to popular diets. Its objective was to determine the outcomes of various popular weight loss diets. In this particular study, overweight adults with body mass indexes above 25 were randomly assigned to a specific popular weight loss diet. They all had to report their body mass indexes and weight at 3-month, 6-month and 12-month follow ups. The study which included 7,286 individual participants.

Results of the JAMA Popular Weight Loss Diets Study

Low Carb Diets Results

The highest weight loss amounts related to low-carbs diets:

  • 8.73 kg at 6-month follow up
  • 7.25 kg at 12-month follow up

Low Fat Diets Results

The highest weight loss amounts related to low-fat diets:

  • 7.99 kg at 6-month follow up
  • 7.27 kg at 12-month follow up

Results for Individual Diets

When it comes to the results for individual weight loss diets, the differences were minimal. Here are some examples:

  • At 6-month follow up, the Atkins Diet showed greater weight loss of 1.71 kg than the Zone Diet
  • Between the 6-month and 12-month follow up periods, the Atkins Diet combined with behavior support had a greater weight loss of 3.23 kg than the Zone Diet.

Weight Loss and Knee and Hip Pain

In other words, both low-carb and low-fat diets can help you achieve your goal of weight loss. The specific named diet doesn’t really seem to matter as long as you cut down on carbs and fat intake. So, what’s the bottom line for overweight and obese adults suffering from knee pain and/or hip pain? Your weight can be a major factor when it comes to sustaining relief from your hip and knee pain. When you combine maintaining a healthy weight with hip replacement or knee replacement surgeries, your long-term outcome is so much more successful.  Much lower risk of infection, blood clots, residual pain, and much longer lasting implant!! If you have been told that you would benefit from hip or knee replacement due to ongoing pain, call our award winning physicians at Orthopedic Surgery San Diego for an appointment.


09/Sep/2014

ACL tear can happen to proathletes or the teenage competitive soccer player scrimmaging in a Carlsbad park on a sunny  San Diego Sunday afternoon.Isaiah-Pead-acl-tear

Arguably the most volatile position in the NFL is the running back. Injuries, everyday wear and tear, and age can shorten the career of a running back. For Isaiah Pead, the end could be near. He was a top five running back in the 2012 NFL draft. He has been off and on injured, had some off-the-field issues, and has been overall underwhelming when he is available to play. Unfortunately for Pead, his career outlook just got even bleaker as he has suffered a season ending injury during a preseason kickoff return. Pead was running down field full speed when his feet got tangled and he went down. The result: an ACL Tear.  This knee ligament injury will stop you in your tracks.  Most athletes report hearing and feeling a pop and then they go down.acl-tear-san-diego

The ACL or anterior cruciate ligament connects the front of the shinbone (tibia) to the middle of the kneecap (patella). The main purpose of the ACL is to provide rotational stability and to prevent the shinbone from getting too far ahead of the thighbone (femur).

Sometimes ACL tear can occur as a result of direct contact with the knee, but more times than not, an ACL tear is a non-contact injury such as in the case of Isaiah Pead. The cause of this non-contact injury is often due to rapid direction changes, sudden stops and decelerations, as well as incorrect landing and pivoting. The symptoms of a ACL Tear include knee pain, knee swelling, knee discomfort, knee tenderness, and decreased range of motion in the knee.

If a knee injury has occurred, an orthopedic physician will compare the structures of your injured and your non-injured knee and in most cases this is sufficient enough to diagnose ligament tears. However, the doctor will sometimes schedule an x-ray and an MRI in order to dismiss potential confounding problems, to validate the diagnosis, and to determine the degree of the injury.

Treatment for an ACL tear is dependent upon the severity of the injury. Grade I sprains involves overly stretched but still in tact. Grade I sprains typically require keeping the weight off the affected leg. Once the swelling has subsided, a physical therapy regimen will be prescribed. These exercises are meant to strengthen the leg muscles that support the ACL. Grade II sprains involves the ACL being stretched to the point that it has become loose. Grade II sprains are a little trickier to handle because they may or may not require surgery depending on lifestyle of the patient. The non-surgical approach is similar to that of grade I sprain but generally this is a longer process since these sprains are more severe. The surgical approach involves the rebuilding of the ligament via a tissue graft followed by rest and physical therapy. Grade III sprains occur when the ligament has been completely split into two pieces. In grade III sprains, surgery is required to rebuild the ligament. The recovery time for ACL surgery is often six to nine months. The prognosis for surgical recovery is positive and many athletes are able to return to their respective sport at near pre-injury form.ACL-Tear-Grades

As for Isaiah Pead, there is a very good chance he will make a full recovery, but considering his career thus far, it is doubtful he will ever become the player we once thought he could be. Then again, sometimes a player needs to hit rock bottom before they can really begin to understand what it takes to make it, maybe this, will be his wakeup call.

If you have been told you have an ACL tear or are suffering from knee pain, contact our top sports medicine specialists at Orthopedic Surgery San Diego to obtain a consult and be treated they way you deserve!

 

 


31/Aug/2014

Many of our Carlsbad and North County San Diego competitive soccer players sustain ACL tear every year.  Even though, sports medicine specialists take measures to prevent such devastating knee injuries, a twisting injury to the knee suffered by the Arizona Cardinals’ Darnell Dockett is just the latest ACL tear to sideline a professional athlete.acl-tear

ESPN reported that Dockett, a defensive tackle, damaged the knee when his foot caught in the turf during training camp in Tempe, Ariz. Following an examination, doctors scheduled Dockett for surgery. Just a few days earlier, Rams quarterback Sam Bradford sustained an ACL tear  as a result of a hard hit by a defensive lineman. Both players are out for the season.  The risk of sustaining such knee injuries and other ligament tears are somewhat preventable with proper core strengthening.  acl-tear-knee-injury

ACL is short for anterior cruciate ligament, connective tissue that extends from beneath the femur (thigh bone) to the top of the tibia (the large bone in the lower leg). The smallest of the four main ligaments in the knee, it stabilizes the knee for rotational movements. The ACL enables a person to make fast “cuts” while running. It is rarely stressed during activities like jogging that do not involve sudden stops, twists or turns.

ACL tear and sprains were once referred to as “trick knees.” They occur frequently in football, basketball, soccer and tennis because of the pressure and repetitive stress that athletes put on their knees. Most of the 250,000 to 300,000 ACL tear injuries reported in the United States each year involve people who play sports. The odds of an athlete spraining or tearing an ACL reportedly is about 1,000 to 1.

ACL Tear Types:

A Grade 1 ACL tear features a ligament that has been stretched too far. It does not usually prevent normal use of the knee. A Grade 2 sprain results from the ligament being stretched to the point that it is loose. This condition also is called a partial tear. The most serious ACL tear injury, a Grade 3 sprain, is a complete tear, in which the ligament is severed and the knee becomes unstable.acl-tear-grades

The ways that Dockett and Bradford hurt their knees were typical. ACL tears result from changing direction too quickly or stopping suddenly, landing wrong on the knee after jumping, and the blunt-force trauma of a blow to the joint or a collision. When an ACL tear occurs, the person might hear a popping sound in the knee. The joint gives out and quickly becomes inflamed. This causes a great deal of pain, as well as loss of mobility and range of motion.

While a mild sprain sometimes heals without surgery, an ACL tear must be repaired for a patient to regain full use of the knee. It is not possible to merely stitch back together the two pieces of a severed ligament. Orthopedic surgeons reconstruct ACLs by grafting tissue from the patellar tendon (with attaches the kneecap to the shine bone), the hamstring tendons (in the back of the thigh) or the quadriceps tendon (which runs from the kneecap to the thigh). Tissues from cadavers also are used.

The arthroscopic procedure requires only small incisions in the skin. Surgeons insert miniature instruments, which they manipulate to graft the tissues. Patients experience less pain, and recover more quickly, than they would if more invasive surgery were needed. Sometimes, ACL injuries happen in conjunction with damage to other ligaments or cartilage. That can necessitate more extensive surgical procedures.  You don’t have to live with the knee pain and instability.  Contact our Orthopedic Surgery San Diego Sports Medicine specialists to help you regain your mobility and be the best athlete you can be.

 


23/Aug/2014

Total knee arthroplasty (TKA) and unicompartmental knee arthroplasty (UKA) have always been considered inpatient surgical procedures. Questions have been asked whether, due to recent advances such as minimally invasive techniques and improved operative anaesthesia protocols, these surgeries can be successfully performed on an outpatient basis.

A study was presented to the American Academy of Orthopedic Surgery which focused on the feasibility of outpatient Total Knee Arthroplasty and unicompartmental knee arthroplasty (UKA)  surgery. It was agreed that only certain patients would be suitable for this surgery and that only those who met the criteria be considered for same-day discharge.

However, even if a patient was considered to be an ideal candidate for surgery on an outpatient basis, there is still a danger of complications which could require readmission to hospital.

What sort of criteria would a patient have to meet?

  • Orthopedic assessment. This will include the physical history and the reason for the surgical intervention. Patients might have to be motivated for Total knee arthroplasty (TKA) or unicompartmental knee arthroplasty (UKA)  outpatient treatment, and the home situation would also need to be evaluated.
  • Preoperative medical clearance. A thorough medical clearance reduces post-operative risks and visits to the ER. In addition the medical team selected has to be a team which is absolutely familiar with outpatient procedures.
  • Preoperative patient education. Information about what to expect during the procedure, how to manage pain and move about after the operation helps to reduce fear and anxiety.
  • The patient’s vital signs, such as blood pressure, heart rate, respiratory rate and temperature need to be stable before being considered for home discharge.

This study also demonstrates that for selected patients who meet all the criteria, outpatient Total knee arthroplasty (TKA) and UKA is safe with very few short-term complications or hospital readmissions.

Are there still concerns about outpatient TKA and UKA?

Although new protocols have been designed for outpatient knee surgery, concerns still exist for potential complications. A different study concluded that people who had outpatient surgery often returned to the ER for pain related issues, most without readmission to hospital being necessary. Unfortunately though, a small number of these cases suffered complications which required readmission to hospital.

It was also noted that patients who spent one or two nights in hospital had more or less the same readmission rates as those who had same day procedures.

No recommendations either way for outpatient TKA and UKA.

Outpatient surgery does have cost saving potential, but the possibility of readmission to hospital or the ER could quickly negate this.

There is actually no guarantee that even the most suitable of selected patients, who meet every single criteria perfectly, will have a complication-free outpatient surgical procedure.

The study included the fact that the smallest error on the part of the team performing an outpatient TKA or UKA operation could result in the patient having to spend at least one night in hospital.

At this stage it would be fair to conclude that the jury is still out concerning the feasibility and success of outpatient TKA and UKA. A big part of the decision whether to undergo the procedure depends on the eligibility of the patient, and the advice of the surgeon concerned.


18/Aug/2014

Avoid Knee pain and injury by optimizing your training technique.  Jogging or running is a popular exercise and often recommended for cardiovascular health. Sprinting, the big brother of those two, is usually a bout of running at maximum pace and speed. Sprinting has proven to be more beneficial than jogging/running, with respect to body composition and lean mass. Next time there’s a sprinting event on TV, check out the bodies of the sprinters and compare them with the average runner.  It is clear that sprinters tend to be more lean.

Like with any other sport, there are exercise regimens meant for beginners and then there are those for the elite. This article will show you a variety of “workouts” to help you create some variety in your cardiovascular routines.

Protocol 1: an eight second sprint, 12 second rest, repeated for 20 minutes.

According to the Journal of Obesity, this type of exercise usually referred to as interval training, was found to lower insulin resistance, reduce fat and improve lean body mass. (1)

It is no surprise that I would recommend you initiate your interval training with a more modest goal of maybe 5 or 10 minutes. 20 minutes might be a little difficult to achieve for the novice. Keep working towards that goal and once you can hit that 20 minute mark easily, you should start aiming for more.

Protocol 2: Tabata training (4 minutes total)

This training program targets those Type A executives out there that “don’t have time to exercise”.   This routine is short and focused.  It is for those who want to get maximum efficiency from a short workout. This type of training will ramp up your metabolism; improve cardiovascular health, and insulin sensitivity.

This protocol, meant for intermediate level sprinters is very simple: a 20 second intense activity followed by 10 seconds of rest. Keeping this up for 4 minutes is not as easy as it seems, you need to be mentally prepared for the physical effort that’s required. The benefits from this type of exercise will be definitely worth it though.

Protocol 3: The famous Wingate protocol

This is extremely beneficial for fat loss, improved athletic endurance, and overall cardiovascular health. The Wingate protocol is also directed towards intermediate level sprinters; it helps to get you back in shape quickly after a set-back or exercise hiatus. The resulting benefits of this routine are lean muscle mass.  It is a good and steady calorie burner.  It consists of a 30 second maximum interval; this routine is completed 4 to 6 times in a timeframe of choice (the shorter, the better). (2)

Protocol 4:  

Pyramid training starts with low intensity then slowly surges the intensity to maximum level and gradually returns back to the initial warm up intensity. This gradual advancement requires a strong endurance capability. This type of training can induce maximal oxygen intake and improve stamina and work capacity significantly.pyramid-training

Protocol 5: Long intervals with 1:1 ratio

To increase your endurance, this should be your exercise of choice. Like it’s name implies, you will be doing long intervals (85% of your maximum strength for 2-3 minutes) followed by a similar period of rest.

Great for weight loss and overall well-being.

 

References:

1) http://www.hindawi.com/journals/jobe/2011/868305/abs/

2) http://www.nature.com/ijo/journal/vaop/ncurrent/full/0803781a.html


© 2023 Dr. Robert Afra – San Diego Orthopedic Surgery Shoulder – Knee – Elbow