Why Is Fiber Good For You?

Fiber can decrease mortality, arthritis, diabetes and heart disease. Find out why HERE

Does An ACL Tear Result In Arthritis

Studies have demonstrated a risk of arthritis following an ACL tear with or without a subsequent ACL reconstruction. We have found in the MARS (Multi-Center ACL Revision Study) cohort that 90% have a meniscus tear or arthritis. ~ 70% have both. HERE are some details regarding the risk.

Arthritic Joint Pain: The Facts

Separate the fact from fiction regarding arthritic joint pain HERE

MOON-MARS Revision ACL Graft Study Presented Toronto AOSSM Meeting

A combined MOON (Multi-Center Orthopaedic Outcomes Network)- MARS (Multi-Center ACL Revision Study) looked at patellofemoral (kneecap) cartilage changes after allograft or autograft primary ACL reconstruction as identified at the time of revision ACL reconstruction. This study presented by Robert Magnussen of Ohio St. at the Toronto AOSSM (American Orthopaedic Society for Sports Medicine) meeting in July. 134 patients had undergone MOON primary ACL reconstruction followed by MARS revision ACL reconstruction. Progression was identified as progression of one grade worse or a 25% increase in size of the lesion. 31 (23%) had worsening progression of arthritis. Results showed allografts had a 15.5 times higher risk of progression. Odds also increased 10% with each unit increase of BMI. Age, sex, activity level, meniscus status, injury mechanism had no impact. The association between graft choice and damage was surprising. Previously it was thought maybe a patellar tendon (BTB) autograft might be at more riskk. Allografts with more laxity may place more pressure on cartilage, but we cannot be sure. Further work will be necessary to sort this out.

Cartilage Replacement in the Knee

Articular cartilage covers the ends of bones in joints throughout the body. Normal cartilage is smooth allowing easy gliding of the joint. When cartilage is injured, the smooth surface can become rough. Cartilage is unable to heal or replace itself. Occasionally the cartilage injury is severe and there is complete loss of cartilage resulting in exposed bone. Sometimes called OATS or Mosaicplasty osteochondral grafting is a method of treating cartilage injuries that expose underlying bone. Osteochondral grafts

replace both the articular cartilage on the surface and the underlying bone. The tissue can come from other parts (typically knee) of the patient’s body (called osteochondral autograft) or from a tissue donor (osteochondral allograft). These techniques are commonly used in the knee but can be used in other joints.

The injured area of cartilage is identified and a core of the injured cartilage and the underlying bone is removed in a method similar to coring an apple. A replacement core made up of cartilage and bone from another site in the knee (autograft) or a tissue donor knee (allograft) is then made to fit into the hole. The replacement core is gently tapped into place until it lines up with the surrounding tissue. It acts as a pressfit. No screws or other devices are typically needed to hold the replacement core in place since it fits tightly. Frequently it can be performed all arthroscopically.

Patients can usually start to bear weight within 4-6 weeks of surgery. Activity is gradually increased with return to sport typically occurring after 6-9 months.

Patients often recover very well from both of these procedures. One advantage of these techniques is the ability to replace both cartilage and bone with similar tissue. There are limitations to the amount of tissue that can be taken from within a patient’s own knee so larger areas of cartilage loss may not be best for this approach. A potential concern with the use of donor tissue is the very low risk of disease transmission (like a blood transfusion). Although these techniques are new to have data on how well patients recover in the long term, it has been seen that these patients frequently do very well.

Is Running Bad for Your Knees?

Frequently, running gets a bad reputation for damaging joints. I have always told patients it is somewhat controversial, but that running on a normal non-arthritic joint is probably safe. If you have developed arthritis then I believe you should at a minimum cross train with less impact cardio activities such as elliptical, walking, stairmaster, cycling or swimming. If you continue to run on a damaged joint I believe it may accelerate the wear and tear and subsequent arthritis.  A recently published study seems to support the fact that running may not be harmful and actually may be helpful for normal joints. read the details HERE