Chiamami +39 389 45 95 133
- Meniscal lesions
- Ligament injury
- Cartilage lesions
- Prosthetic Surgery
Knee meniscus injuries
The knee is the largest joint in the body and also one of the most complex. Meniscal tears are among the most common knee injuries. Athletes, especially those who play contact sports like football, are more at risk for meniscal tears. However, anyone at any age can break a meniscus even with a trivial trauma or a repeated microtrauma. The two menisci (medial and lateral) complete the joint and serve as “shock absorbers” between the femur and the tibia. And when they break they cause pain, swelling and limitation of movement. The meniscus can tear in different ways and injuries are known and classified based on their appearance and the area where the injury occurs. I also perform meniscus repair when injuries allow it.
I solve the problem with a small operation called arthroscopy and is performed on an outpatient or day surgery basis. If neglected, meniscal injuries can worsen or cause joint blockage of the knee and this can lead to a more demanding operation.
Ligament injuries
They can be of the anterior or posterior cruciate and collateral ligaments. More rarely, the ligaments of the patella are affected.
The most frequent injury in athletes is that of the anterior cruciate which can occur due to a tackle but also after a hyperextension trauma or a sudden change in movement. It is also possible to treat injuries of the posterior cruciate ligament, collateral ligaments and patellar ligaments for which surgery is less frequent.
In some cases, when the ACL ruptures, patients report hearing a “pop” sound. The injury is usually associated with pain and the knee becomes very swollen and hot with inability to walk.
In my clinical practice I almost always opt, in agreement with the patient, for surgical intervention.
My primary experience with ligament reconstructions occurred at the Fowler Kennedy sports medicine Unit in 2006-2007 and since then I have customized the technique to reduce post-operative pain and return athletes to the field stronger than before injury.
In advanced age sports patients, or in cases of revision or multiligament, in addition to the usual techniques with the gracilis and semitendinosus tendons or with the patellar tendon, I have the synthetic ligament available which allows physiotherapy and recovery time to be minimized.
Cartilage damage to the knee
I treat small cartilaginous lesions with arthroscopy, i.e. a day surgery operation where, through two point incisions on the knee, joint cleaning can be performed, the “microfracture” technique or grafts of synthetic cartilaginous tissue enriched with blood-derived cells.
The unicompartmental knee prosthesis
Patients with osteoarthritis that is limited to only one part of the knee may be candidates for the Unicompartmental Knee Replacement (also called “partial” knee replacement). In my practice, careful clinical evaluation is required as this mini prosthesis represents approximately 10 percent of knee replacement surgery. It can be used in young patients but also finds excellent application in those over eighty as the surgical access is small, there is little pain and little need for physiotherapy and recovery after surgery is very fast. I have medial, lateral and patellofemoral partial prostheses available.
The total knee prosthesis
When conservative treatments and physical therapy are not effective, if your knee is severely damaged by osteoarthritis or previous trauma, it may be difficult to perform simple activities, such as walking or climbing stairs, and it may be difficult to sleep. In this case it is recommended and sometimes necessary to undergo total knee replacement in which all three compartments are replaced. With accurate and robotic surgery techniques, without placing drainage and without metal sutures and thanks to fast postoperative recovery techniques, on the afternoon of the operation you can get up and walk and return home on the fourth postoperative day. It is a very frequent surgery for me and very successful and satisfying for patients. In recent years, the indications have also expanded to include obese patients and younger people. I am always asked how long the prosthesis will last, which depends on the weight, correct positioning and use of it. For a normal life in a normal weight person the duration can be lifelong.
With the increase in the number of prosthetic operations and the age of the population, I am increasingly asked to remove and reposition a new prosthesis which I carry out in the facilities where I work which also provide intensive care.
