Knee Repair

The knee is one of the largest and most complex joints in the body. The knee joins the thigh bone (femur) to the shin bone (tibia). The smaller bone that runs alongside the tibia (fibula) and the kneecap (patella) are the other bones that make the knee joint.

Tendons connect the knee bones to the leg muscles that move the knee joint. Ligaments join the knee bones and provide stability to the knee:

• The anterior cruciate ligament prevents the femur from sliding backward on the tibia (or the tibia sliding forward on the femur).
• The posterior cruciate ligament prevents the femur from sliding forward on the tibia (or the tibia from sliding backward on the femur).
• The medial and lateral collateral ligaments prevent the femur from sliding side to side.

Two C-shaped pieces of cartilage called the medial and lateral menisci act as shock absorbers between the femur and tibia.

Numerous bursae, or fluid-filled sacs, help the knee move smoothly.

Conditions We Treat:

• Chondromalacia patella (also called patellofemoral syndrome): Irritation of the cartilage on the underside of the kneecap (patella), causing knee pain. This is a common cause of knee pain in young people.
• Knee osteoarthritis: Osteoarthritis is the most common form of arthritis, and often affects the knees. Caused by aging and wear and tear of cartilage, osteoarthritis symptoms may include knee pain, stiffness, and swelling.
• Knee effusion: Fluid build-up inside the knee, usually from inflammation. Any form of arthritis or injury may cause a knee effusion.
• Meniscal tear: Damage to a meniscus, the cartilage that cushions the knee, often occurs with twisting the knee. Large tears may cause the knee to lock.
• ACL (anterior cruciate ligament) strain or tear: The ACL is responsible for a large part of the knee’s stability. An ACL tear often leads to the knee “giving out,” and may require surgical repair.
• PCL (posterior cruciate ligament) strain or tear: PCL tears can cause pain, swelling, and knee instability. These injuries are less common than ACL tears, and physical therapy (rather than surgery) is usually the best option.
• MCL (medial collateral ligament) strain or tear: This injury may cause pain and possible instability to the inner side of the knee.
• Patellar subluxation: The kneecap slides abnormally or dislocates along the thigh bone during activity. Knee pain around the kneecap results.
• Patellar tendonitis: Inflammation of the tendon connecting the kneecap (patella) to the shin bone. This occurs mostly in athletes from repeated jumping.
• Knee bursitis: Pain, swelling, and warmth in any of the bursae of the knee. Bursitis often occurs from overuse or injury.
• Baker’s cyst: Collection of fluid in the back of the knee. Baker’s cysts usually develop from a persistent effusion as in conditions such as arthritis.
• Rheumatoid arthritis: An autoimmune condition that can cause arthritis in any joint, including the knees. If untreated, rheumatoid arthritis can cause permanent joint damage.
• Gout: A form of arthritis caused by buildup of uric acid crystals in a joint. The knees may be affected, causing episodes of severe pain and swelling.
• Pseudogout: A form of arthritis similar to gout, caused by calcium pyrophosphate crystals depositing in the knee or other joints.
• Septic arthritis: Bacterial infection inside the knee can cause inflammation, pain, swelling, and difficulty moving the knee. Although uncommon, septic arthritis is a serious condition that usually gets worse quickly without treatment.

Foot and Ankle

The foot is made up of 26 bones, 33 joints, 107 ligaments, 19 muscles, and numerous tendons. Complex biomechanics keep all these parts in the right position and moving together. Given these intricacies, it is not surprising that most people will experience some problem with their feet at some time in their lives. Foot pain can be detrimental to continuing an active, healthy lifestyle. At Klamath Orthopedic, we focus on the diagnosis and treatment of conditions that affect the foot and ankle, promoting long-term health.

Conditions

• Ankle pain
• Ankle sprain
• Ankle arthritis
• Bunions
• Congenital ankle and foot deformities
• Diabetic limb
• Drop Foot
• Flat feet & high arch feet
• Fractures
• Gout
• Hammertoes
• Heel pain
• Infections (Bacterial, Fungal, Viral)
• Ingrown nails
• Nerve problems & neuromas
• Skin Conditions
• Sports injuries
• Tendonitis
• Tendon tears
• Tumors
• Achilles Tendon Rupture
• Ankle Fractures (Broken Ankle)
• Calcaneus (Heel Bone) Fractures
• Dislocations
• Jones Fracture (5th metatarsal base)
• Lisfranc (Midfoot) Injury
• Pilon Fractures of the Ankle
• Stress Fractures of the Foot and Ankle
• Talus Fractures Toe and Forefoot Fractures
• Turf Toe

Surgeries

All of our physicians are board certified by the American Board of Foot and Ankle Surgery. Our clinic offers specialized care in all aspects of foot and ankle surgery including reconstructive surgery for common and complex deformities, arthritis, trauma surgery, and arthroscopic (minimally invasive) surgery.

Surgical treatments

• Total Ankle Replacement
• Ankle ligament reconstruction for chronic ankle sprain
• Flatfoot reconstructions & realignments
• Bunion, hallux rigidus and forefoot reconstruction
• Surgery for foot and ankle fractures
• Ankle fusion or ankle replacement for arthritis
• Diagnostic ankle arthroscopy
• Arthroscopic ankle cartilage repair
• Lateral ankle ligament reconstruction
• Surgery for foot deformities

Nonsurgical treatments

• Exercise
• Injections
• Medication
• Orthotics
• Physical therapy
• Splinting

Ankle

1. Talocrural Joint: This is a hinge joint formed by the distal ends of the fibula and tibula that enclose the upper surface of the talus. It allows for both dorsiflexion (decreasing the angle between the foot and the shin) and plantarflexion (increasing the angle).
2. Inferior tibiofibular Joint: This is strong joint between the lower surfaces of the tibia and fibula. This is supported by the inferior tibiofibular ligament.
3. Subtalar Joint: This joint comprises of the articulating surfaces of the talus and the calcaneus. It provides shock absorption and the movements of inversion and eversion (inward and outward ankle movements respectively) occur here.

Ligaments of the ankle joint

The ligaments of the ankle joint are comprised mainly of the collateral ligaments, both medial (inner) and lateral (outer). These are extremely important in the stability of the ankle itself:

1. Lateral Collateral Ligament:

The lateral collateral ligament prevents excessive inversion. It is considerably weaker than the larger medial ligament and thus sprains to the lateral ligament are much more common. It is made up of 3 individual bands:

1. Anterior talofibular ligament (AFTL): passes from the fibula to the front of the talus bone.
2. Calcaneofibular ligament (CFL)– connects the calcaneus and the fibula
3. Posterior talofibular Ligament (PTFL)– passes from the back of the fibula to the rear surface of the calcaneus.
4. Medial Collateral Ligament:

The medial ligament also known as the deltoid ligament is considerably thicker than the lateral ligament and spreads out in a fan shape to cover the distal (bottom) end of the tibia and the inner surfaces of the talus, navicular, and calcaneus.