Platelet Rich Plasma (PRP)

Platelet Rich Plasma (PRP) therapy holds Great Promise to heal the Soft Tissue, Chronic Tendon Injury, Knee Osteoarthritis, Sports Injury, Acute Ligament and Muscle Injury. Get your PRP done with us today. Call us at +65 97731458 to schedule for an appointment

During the past several years, much has been written about a preparation called platelet-rich plasma (PRP) and its potential effectiveness in the treatment of injuries.

Many famous athletes Tiger Woods, tennis star Rafael Nadal, and several others have received PRP for various problems, such as sprained knees and chronic tendon injuries. These types of conditions have typically been treated with medications, physical therapy, or even surgery. Some athletes have credited PRP with their being able to return more quickly to competition.

Platelet Rich Plasma

What is Platelet Rich Plasma (PRP)?

Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries.

PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets and, thereby, the concentration of growth factors can be 5 to 10 times greater (or richer) than usual.

To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood.

How does Platelet Rich Plasma (PRP) works?

Although it is not exactly clear how PRP works, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process.

To speed healing, the injury site is treated with the PRP preparation. This can be done in one of two ways:

  • PRP can be carefully injected into the injured area. For example, in Achilles tendonitis, a condition commonly seen in runners and tennis players, the heel cord can become swollen, inflamed, and painful. A mixture of PRP and local anesthetic can be injected directly into this inflamed tissue. Afterwards, the pain at the area of injection may actually increase for the first week or two, and it may be several weeks before the patient feels a beneficial effect.
  • PRP may also be used to improve healing after surgery for some injuries. For example, an athlete with a completely torn heel cord may require surgery to repair the tendon. Healing of the torn tendon can possibly be improved by treating the injured area with PRP during surgery. This is done by preparing the PRP in a special way that allows it to actually be stitched into torn tissues.

What conditions are treated with Platelet Rich Plasma (PRP)?

Research studies are currently being conducted to evaluate the effectiveness of PRP treatment. At this time, the results of these studies are inconclusive because the effectiveness of PRP therapy can vary. Factors that can influence the effectiveness of PRP treatment include:

  • The area of the body being treated
  • The overall health of the patient
  • Whether the injury is acute (such as from a fall) or chronic (an injury developing over time)

– Chronic Tendon Injuries

According to the research studies currently reported, PRP is most effective in the treatment of chronic tendon injuries, especially tennis elbow, a very common injury of the tendons on the outside of the elbow.

The use of PRP for other chronic tendon injuries such as chronic Achilles tendonitis or inflammation of the patellar tendon at the knee (jumper’s knee) is promising. However, it is difficult to say at this time that PRP therapy is any more effective than traditional treatment of these problems.

– Acute Ligament and Muscle Injuries
Much of the publicity PRP therapy has received has been about the treatment of acute sports injuries, such as ligament and muscle injuries. PRP has been used to treat professional athletes with common sports injuries like pulled hamstring muscles in the thigh and knee sprains. There is no definitive scientific evidence, however, that PRP therapy actually improves the healing process in these types of injuries.

– Surgery
More recently, PRP has been used during certain types of surgery to help tissues heal. It was first thought to be beneficial in shoulder surgery to repair torn rotator cuff tendons. However, the results so far show little or no benefit when PRP is used in these types of surgical procedures.Surgery to repair torn knee ligaments, especially the anterior cruciate ligament (ACL) is another area where PRP has been applied. At this time, there appears to be little or no benefit from using PRP in this instance.
– Knee Arthritis
Some initial research is being done to evaluate the effectiveness of PRP in the treatment of the arthritic knee. It is still too soon to determine if this form of treatment will be any more effective than current treatment methods.
– Fractures
PRP has been used in a very limited way to speed the healing of broken bones. So far, it has shown no significant benefit.Treatment with platelet-rich plasma holds great promise. Currently, however, the research studies to back up the claims in the media are lacking. Although PRP does appear to be effective in the treatment of chronic tendon injuries about the elbow, the medical community needs more scientific evidence before it can determine whether PRP therapy is truly effective in other conditions.Even though the success of PRP therapy is still questionable, the risks associated with it are minimal: There may be increased pain at the injection site, but the incidence of other problems — infection, tissue damage, nerve injuries — appears to be no different from that associated with cortisone injections.

If you are considering treatment with PRP, be sure to check your eligibility with your health insurance carrier. Few insurance plans, including workers’ compensation plans, provide even partial reimbursement.

Platelet Rich Plasma (PRP) therapy holds Great Promise to heal the Soft Tissue, Chronic Tendon Injury, Knee Osteoarthritis, Sports Injury, Acute Ligament and Muscle Injury. Get your PRP done with us today. Call us at +65 97731458 to schedule for an appointment

Gouty Arthritis

Managed your Gout Attack today. Effective and Fast Relief Treatment by Orthopaedic Specialist. Call us +65 97731458 to schedule for an appointment.

Gout is a rheumatoid form of arthritis that causes the inflammation, joint pain and swelling especially in the toe, knee and ankle, also reducing their mobility. Gout usually appears in midlife and primarily in males. It can be hereditary or the secondary to some other disease process.

What are the causes of Gout?
Gout is mainly caused by the clustering of uric acid crystals in the arteries, obstructing normal blood flow and causing inflammation. Uric acid is a residual product that is excreted from the body through urine during synthesis of purine – a substance that presents in fat meats, fish, some dairy products and vegetables. The level of uric acid can be found and measured in the blood.

What are the first signs of gout attacks?
In most cases, the first gout signs appear at the level of the big toe. The skin around the affected regions turns yellow, appears to be stretched and bruised. The regions affected by gout become very sensitive. It even causes the sufferers can’t tolerate clothing or shoes. Gout attacks in the region of the big toe are referred to as podagra and they involve inflammation, swelling, pain and a sensation of burning. Podagra can also occur due to acquired injuries or intense physical effort that involves the lower limbs.

Apart from the region of the toes, recurrent attacks also involve pain and inflammation of the knees, elbows, shoulders, wrists and fingers. Most types of gout attacks can generate low to moderate fever and sweating.

And when gout becomes chronic, the damage to the joint is deforming and crippling. Chronic gout attacks are usually long-lasting and they occur in multiple regions of the body.

What are the main symptoms of Gout?
The main symptoms of gout are severe pain and swelling in joints. It’s the crystallized and lodged of uric acid in the joints that cause joint pain. The joint gets hot, swollen and tender. In most cases, the pain attacks seem to amplify at night causing sleeping difficulty to many patients. How long can gout pain remain? The pain may remain anywhere from a few minutes to a few hours and in some cases, even days. As the disease progresses, the duration of gout attacks can exceed 7-10 days.

Other common gout symptoms include fever, discomfort, sourness, malaise, tachycardia, elevations in skin temperature, itching sensations, body aches, water retention, inflammation and intense pain of the affected area – gout in the knee cause joint pain in the knee whereas gout in the finger or toe cause pain in finger or toe. The skin in the affected regions often looks stretched. Gouty arthritis may also cause back pain since it affects the joints.

There are few therapies available for treating gout.  Fortunately gout attacks subside within a period of a week or so and gout attacks are less frequent.  There may be period ranging from months to even years between two gout attacks.

Managed your Gout Attack today. Effective and Fast Relief Treatment by Orthopaedic Specialist. Call us +65 97731458 to schedule for an appointment.

Osgood Schalatter Disease

Are you suffering from Osgood Schalatter Disease? Get fast relief treatment from Experienced Knee Sports Specialist. Call us +65 97731458 to schedule for an appointment.

Definition of Osgood Schalatter Disease

Osgood Schlatter disease is a disorder of the lower front of the knee where the large tendon under the kneecap (patellar tendon) attaches to the bone of the leg below. The condition is characterized by localized pain and tenderness in this area. Osgood-Schlatter disease is predominantly seen in young adolescent boys. It is felt that stress on the bone from the tendon tugging it during activities leads to Osgood-Schlatter disease.

What are symptoms of Osgood Schlatter disease?
Osgood Schlatter disease is felt to be due in part to recurrent pulling tension on the kneecap tendon by the bulky muscles of the front of the thigh. The irritation of this pulling can cause local pain, inflammation, swelling, and calcification of the tendon that is visible with an x-ray test.

How is Osgood Schlatter disease diagnosed?
Osgood Schlatter disease can be diagnosed clinically based on the typical symptoms and physical examination findings. X-ray testing is sometime performed in order to document the status of the calcification at the insertion of kneecap (patellar) tendon. Sometimes a tiny piece of the bone of the tibia actually is pulled away by the inflamed tendon.

What are the treatment for Osgood Schalatter disease?
Patients with Osgood Schlatter disease can be helped by anti inflammation and pain-relieving medications, ice, and rest. Osgood-Schlatter disease typically goes away over time (months to years after the normal bone growth stops). Some adults who have had Osgood-Schlatter disease are left with “knobby” appearance to the front of the knee.

Are you suffering from Osgood Schalatter Disease? Get fast relief treatment from Experienced Knee Sports Specialist. Call us +65 97731458 to schedule for an appointment.

Shin Splints

Get professional Opinion and Treatment about your Shin Splint today. Effective and fast relief treatment by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Shin splints are injuries to the front of the outer leg. While the exact injury is not known, shin splints seem to result from inflammation due to injury of the tendon (posterior peroneal tendon) and adjacent tissues in the front of the outer leg.

Shin splints are a member of a group of injuries called “overuse injuries.” Shin splints occur most commonly in runners or aggressive walkers.

What are Shin splints symptoms?
Shin splints cause pain in the front of the outer leg below the knee. The pain of shin splints is characteristically located on the outer edge of the mid region of the leg next to the shinbone (tibia). An area of discomfort measuring 4-6 inches (10-15 cm) in length is frequently present. Pain is often noted at the early portion of the workout, then lessens, only to reappear near the end of the training session. Shin splint discomfort is often described as dull at first. However, with continuing trauma, the pain can become so extreme as to cause the athlete to stop workouts altogether.

What causes Shin Splints?
A primary culprit causing shin splints is a sudden increase in distance or intensity of a workout schedule. This increase in muscle work can be associated with inflammation of the lower leg muscles, those muscles used in lifting the foot (the motion during which the foot pivots toward the tibia). Such a situation can be aggravated by a tendency to pronate the foot (roll it excessively inward onto the arch).

Similarly, a tight Achilles tendon or weak ankle muscles are also often implicated in the development of shin splints.

How are Shin Splints diagnosed?
The diagnosis of shin splints is usually made during examination. It depends upon a careful review of the patient’s history and a focused physical exam (on the examination of the shins and legs where local tenderness is noted).

Specialized (and costly) tests (for example, bone scans) are generally only necessary if the diagnosis is unclear. Radiology tests, such as X-rays, bone scan, or MRI scan, can be helpful in this setting to detect stress fracture of the tibia bone.

What is the treatment of shin splints?
Previously, two different treatment management strategies were used: total rest or a “run through it” approach. The total rest was often an unacceptable option to the athlete. The run through it approach was even worse. It often led to worsening of the injury and of the symptoms.

Currently, a multifaceted approach of “relative rest” is successfully utilized to restore the athlete to a pain-free level of competition.

Get professional Opinion and Treatment about your Shin Splint today. Effective and fast relief treatment by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Osteochondritis Dissecans

Are you suffering from Osteochondritis Dissecans? Get Effective, Non Surgery Treatment  from Experienced Knee Specialist. Call us +65 97731458 to schedule for an appointment.

Osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of the bone beneath it, comes loose from the end of a bone.

Caused by reduced blood flow to the end of a bone, osteochondritis dissecans occurs most often in young men, particularly after an injury to a joint. The knee is most commonly affected, although osteochondritis dissecans can occur in other joints, including your elbow, shoulder, hip and ankle.

If the loosened piece of cartilage and bone stays put, lying close to where it detached, you may have few or no symptoms of osteochondritis dissecans, and the fracture can often heal by itself. Surgical repair may be necessary if the fragment gets jammed between the moving parts of your joint.

What are the symptoms of Osteochondritis Dissecans?
Signs and symptoms of osteochondritis dissecans may include:

  • Pain. The most common symptom of osteochondritis dissecans, pain may be triggered by physical activity — walking up stairs, climbing a hill or playing sports.
  • Joint popping or locking. Your joint may pop or get stuck in one position if a loose fragment gets caught between the bones during movement.
  • Joint weakness. You may feel that your joint is “giving way” or weakening.
  • Decreased range of motion. You may be unable to straighten your leg or arm completely.
  • Swelling and tenderness. The skin around your joint may become swollen and tender.

What are the causes of Osteochondritis Dissecans?
Osteochondritis dissecans appears to be caused by a reduction of blood flow to the end of the affected bone. This may occur from repetitive trauma of small, multiple episodes of minor unrecognized injury that damage the end of the affected bone. There may also be a genetic component involved, making some people more inclined to develop the disorder.

Are you suffering from Osteochondritis Dissecans? Get Effective, Non Surgery Treatment  from Experienced Knee Specialist. Call us +65 97731458 to schedule for an appointment.

Plica Syndrome

Get professional Opinion and Treatment about your Plica Syndrome. Effective Treatment, Non Surgery by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Definition of Plica Syndrome:

Often called “synovial plica syndrome,” this is a condition that is the result of a remnant of fetal tissue in the knee. The synovial plica are membranes that separate the knee into compartments during fetal development. These plica normally diminish in size during the second trimester of fetal development. In adults, they exist as sleeves of tissue called “synovial folds,” or plica. In some individuals, the synovial plica is more prominent and prone to irritation.

What is Plica Syndrome of the Knee?
The plica on the inner side of the knee, called the “medial plica,” is the synovial tissue most prone to irritation and injury. When the knee is bent, the plica is exposed to direct injury, and it may also be injured in overuse syndromes. When the plica becomes irritated and inflamed, the condition called “plica syndrome” results.

How is Plica Syndrome diagnosed?
Diagnosis is made by physical examination or at the time of arthroscopic surgery. Plica syndrome has similar characteristics to meniscal tears and patellar tendonitis, and these may be confused. A MRI may be done, but it is often not terribly helpful in the diagnosis of plica syndrome.

What is the treatment for Plica Syndrome?
Symptomatic plica syndrome is best treated by resting the knee joint and anti-inflammatory medications. These measures are usually sufficient to allow the inflammation to settle down. Occasionally, an injection of cortisone in to the knee will be helpful.

If these measures do not alleviate the symptoms, then surgical removal of the plica may be necessary. This surgical procedure is performed using an arthroscope, or a small camera, that is inserted into the knee along with instruments to remove the inflamed tissue. The arthroscopic plica resection has good results assuming the plica is the cause of the symptoms. Often a plica is seen on arthroscopic examination. Unless symptoms are consistent with plica syndrome and the plica looks inflamed and irritated, the plica is usually left alone. Plica resection during arthroscopy is only performed if the plica is thought to be the cause of symptoms.

Get professional Opinion and Treatment about your Plica Syndrome. Effective Treatment, Non Surgery by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Knee Bursitis

Get professional Opinion and Treatment about your Knee Bursitis. Minimal Invasive to treat your Knee Bursitis by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Definition of Bursitis:

A bursa is a closed fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. Bursae is plural for bursa. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees. When a bursa becomes inflamed, the condition is known as bursitis. Most commonly, bursitis is caused by local soft tissue trauma or strain injury, and there is no infection (aseptic bursitis). On rare occasions, the bursa can become infected with bacteria. This condition is called septic bursitis.

What is knee bursitis?
The knee joint is surrounded by three major bursae. At the tip of the knee, over the kneecap bone, is the prepatellar bursa. This bursa can become inflamed (prepatellar bursitis) from direct trauma to the front of the knee. This commonly occurs when maintaining a prolonged kneeling position. It has been referred to as “housemaid’s knee,” “roofer’s knee,” and “carpet layer’s knee,” based on the patient’s associated occupational histories. It can lead to varying degrees of swelling, warmth, tenderness, and redness in the overlying area of the knee. As compared with knee joint inflammation (arthritis), it is usually only mildly painful. It is usually associated with significant pain when kneeling and can cause stiffness and pain with walking. Also, in contrast to problems within the knee joint, the range of motion of the knee is frequently preserved.

Prepatellar bursitis can occur when the bursa fills with blood from injury. It can also be seen in rheumatoid arthritis and can occur from deposits of crystals, as seen in patients with gouty arthritis and pseudogout. The prepatellar bursa can also become infected with bacteria (septic bursitis). When this happens, fever may be present. This type of infection usually occurs from breaks in the overlying skin or puncture wounds. The bacteria involved in septic bursitis of the knee are usually those that normally cover the skin, called staphylococcus. Rarely, a chronically inflamed bursa can become infected by bacteria traveling through the blood.

How is prepatellar bursitis of the knee treated?

The treatment of any bursitis depends on whether or not it involves infection. Aseptic prepatellar bursitis can be treated with ice compresses, rest, and antiinflammatory and pain medications. Occasionally, it requires aspiration of the bursa fluid. This procedure involves removal of the fluid with a needle and syringe under sterile conditions and can be performed in the doctor’s office. Sometimes the fluid is sent to the laboratory for further analysis. Noninfectious knee bursitis can also be treated with an injection of cortisone medication into the swollen bursa. This is sometimes done at the same time as the aspiration procedure.

Septic bursitis requires even further evaluation and treatment. The bursal fluid can be examined in the laboratory to identify the microbes causing the infection. It requires antibiotic therapy, often intravenously. Repeated aspiration of the inflamed fluid may be required. Surgical drainage and removal of the infected bursa sac (bursectomy) may also be necessary.

What about the other knee bursae?

A second bursa of the knee is located just under the kneecap beneath the large tendon that attaches the muscles in front of the thigh and the kneecap to the prominent bone in front of the lower leg. This bursa is called the infrapatellar bursa, and when inflamed, the condition is called infrapatellar bursitis. It is commonly seen with inflammation of the adjacent tendon as a result of a jumping injury, hence the name “jumper’s knee.” This condition is generally treated with ice, rest, and oral anti-inflammatory and/or pain medicines.

A third bursa of the knee is called the “anserine bursa.” It is located on the lower inner side of the knee. This bursa most commonly becomes inflamed in middle-aged women. This condition is referred to as anserine bursitis. Anserine bursitis is particularly common in those who are obese. These patients can notice pain in the inner knee while climbing or descending stairs. Anserine bursitis is generally treated with ice, rest, and oral anti-inflammatory and/or pain medicines, although cortisone injections are also given.

Get professional Opinion and Treatment about your Knee Bursitis. Minimal Invasive to treat your Knee Bursitis by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Baker’s Cyst

Get professional Opinion and Treatment about the lump at the back of you knee. Effective Treatment, Non Surgery by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Baker cyst is swelling caused by fluid from the knee joint protruding to the back of the knee. The back of the knee is also referred to as the popliteal area of the knee. A Baker cyst is sometimes called a popliteal cyst. When an excess of knee joint fluid is compressed by the body weight between the bones of the knee joint, it can become trapped and separate from the joint to form the fluid-filled sac of a Baker cyst. The name of the cyst is in memory of the physician who originally described the condition, the British surgeon William Morrant Baker (1839-1896).

What causes a Baker Cyst?

Baker cysts are not uncommon and can be caused by virtually any cause of joint swelling (arthritis). The excess joint fluid (synovial fluid) bulges to the back of the knee to form the Baker cyst. The most common type of arthritis associated with Baker cysts is osteoarthritis, also called degenerative arthritis. Baker cysts can occur in children with juvenile arthritis of the knee. Baker cysts also can result from cartilage tears (such as a torn meniscus), rheumatoid arthritis, and other knee problems.

A Baker cyst may cause no symptoms or be associated with knee pain and/or tightness behind the knee, especially when the knee is extended or fully flexed. Baker cysts are usually visible as a bulge behind the knee that is particularly noticeable on standing and when compared to the opposite uninvolved knee. They are generally soft and minimally tender.

What are symptoms of a Baker Cyst?
Baker cysts can become complicated by protrusion of fluid down the leg between the muscles of the calf (dissection). The cyst can rupture, leaking fluid down the inner leg to sometimes cause the appearance of a painless bruise on the inner ankle. Baker cyst dissection and rupture are frequently associated with swelling of the leg and can mimic phlebitis of the leg. A ruptured Baker cyst typically causes rapid-onset swelling of the leg.

How is a Baker Cyst diagnosed?
Baker cysts can be diagnosed by the doctor’s examination and confirmed by radiological testing (either ultrasound, injection of contrast dye into the knee followed by imaging, called an arthrogram, or MRI scan) if necessary.

How is a Baker Cyst treated?
Baker cysts often resolve with removal of excess knee fluid in conjunction with cortisone injection. Medications are sometimes given to relieve pain and inflammation.

When cartilage tears or other internal knee problems are associated, surgery can be the best treatment option. During a surgical operation, the surgeon can remove the swollen tissue (synovium) that leads to the cyst formation. This is most commonly done with arthroscopic surgery.

Get professional Opinion and Treatment about the lump at the back of you knee. Effective Treatment, Non Surgery by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Kneecap Dislocation

Get professional Opinion and Treatment about your Kneecap Dislocation. Minimal Invasive to treat your Kneecap Injury by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Definition of Kneecap Dislocation:

Kneecap dislocation occurs when the triangle-shaped bone covering the knee (patella) moves or slides out of place. The problem usually occurs toward the outside of the leg.

What are the causes of Kneecap Dislocation?
Kneecap (patella) dislocation is often seen in women. It usually occurs after a sudden change in direction when your leg is planted. This puts your kneecap under stress.

Dislocation may also occur as a direct result of injury. When the kneecap is dislocated, it can slip sideways and around to the outside of the knee.

What are the symptoms of knee dislocation?

  • Knee appears to be deformed
  • Knee is bent and cannot straighten
  • Kneecap (patella) dislocates to the outside of the knee
  • Knee pain and tenderness
  • Knee swelling
  • “Sloppy” kneecap — you can move the kneecap too much from right to left (hypermobile patella)

The first few times this occurs, you will feel pain and be unable to walk. However, if dislocations continue to occur and are untreated, you may feel less pain and have less immediate disability. This is not a reason to avoid treatment. Kneecap dislocation damages your knee joint.

What are the first aids for Kneecap Dislocation?
If you can, straighten out the knee. If it is stuck and painful to move, stabilize (splint) the knee and get medical attention.

Your health care provider will examine the knee, which could confirm that the kneecap is dislocated.

A knee x-ray and, sometimes, MRIs should be done to make sure that the dislocation did not cause a bone to break or cartilage to be damaged. If tests show that you have no such damage, your knee will be placed into an immobilizer or cast to prevent you from moving it for several weeks (usually about 3 weeks).

After this time, physical therapy can help build back your muscle strength and improve the knee’s range of motion.

If the knee remains unstable, you may need surgery to stabilize the kneecap. This may be done using arthroscopic or open surgery.

Get professional Opinion and Treatment about your Kneecap Dislocation. Minimal Invasive to treat your Kneecap Injury by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Chondromalacia Patella

Get professional Opinion and Treatment about your Chondromalacia Patella. Effective treatment, Non Surgery by Experienced Knee Sports Specialist. Call us +65 97731458 to schedule for an appointment.

Chondromalacia Patella is a common cause of kneecap pain or anterior knee pain. Often called “Runner’s Knee,” this condition often affects young, otherwise healthy athletes.

Chondromalacia is due to an irritation of the undersurface of the kneecap. The undersurface of the kneecap, or patella, is covered with a layer of smooth cartilage. This cartilage normally glides effortlessly across the knee during bending of the joint. However, in some individuals, the kneecap tends to rub against one side of the knee joint, and the cartilage surface become irritated, and knee pain is the result.

What happens to the cartilage with chondromalacia?
Chondromalacia is due to changes of the deepest layers of cartilage, causing blistering of the surface cartilage. The pattern of cartilage damage seen with chondromalacia is distinct from the degeneration seen in arthritis, and the damage from chondromalacia is thought to be capable of repair, unlike that seen with arthritis.

Who gets chondromalacia?
Chondromalacia is interesting in that it often strikes young, otherwise healthy, athletic individuals. Women are more commonly affected with chondromalacia. Exactly why this is the case is unknown, but it is thought to have to do with anatomical differences between men and women, in which women experience increased lateral forces on the patella.

Get professional Opinion and Treatment about your Chondromalacia Patella. Effective treatment, Non Surgery by Experienced Knee Sports Specialist. Call us +65 97731458 to schedule for an appointment.

Patella Tendonitis

Get professional Opinion and Treatment about you Knee Patella Tendonitis. Effective treatment, Non Surgery by Experienced Knee Sports Specialist. Call us +65 97731458 to schedule for an appointment.

Patellar tendinitis is a common overuse injury. It occurs when repeated stress is placed on the patellar tendon. The stress results in tiny tears in the tendon, which the body attempts to repair. However when the tears in the tendon increase faster than what the body can recover, it causes the inflammation in the tendon to worsen.

HOW IS PATELLAR / QUADRICEPS TENDINITIS DIAGNOSED?

Physical examination by applying pressure to different parts of the knee determines exactly where the pain is. Pain associated with patellar tendinitis usually concentrates on the front part of the knee, just below the kneecap. Ultrasound is also used to reveal the location of tears in the patellar tendon. However MRI can reveal more subtle changes in the patellar tendon.

WHAT ARE THE CAUSES?

Repeated jumping is the most common cause of patellar tendinitis. Sudden increases in the intensity of physical activity or increases in frequency of activity also add stress to the tendon. Additionally, being overweight or obese increases the stress on the patellar tendon which in turn increases the risk of patellar tendinitis.

WHAT ARE THE TREATMENTS?

Treatment includes resting which means to avoid running and jumping, massaging the patellar tendon which encourages tendon healing and strengthening the tendon by strengthening exercises which involve lowering weight slowly after raising it, such as a seated knee extension exercise.

Get professional Opinion and Treatment about you Knee Patella Tendonitis. Effective treatment, non surgery by Experienced Knee Sports Specialist. Call us +65 97731458 to schedule for an appointment.

Meniscus Injury (Meniscal Tear)

Get professional Opinion and Treatment about your Knee Meniscal Injury. Minimal Invasive to treat your Meniscus Injury by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

What is knee pain due to Meniscus Injury?

The meniscus is a small “c” shaped cartilage that acts as a cushion in the knee joint. They sit between the femur and the tibia bone, one on the outside and one on the inside of the knee. A meniscus tear occurs when the cartilage tear and are injured usually during movements that forcefully rotate the knee while weight bearing.

What is a Meniscus Tear?
A meniscus tear occurs when these pieces of cartilage tear and are injured usually during movements that forcefully rotate the knee while bearing weight. A partial or total tear of a meniscus sometimes occurs if an athlete quickly twists or rotates the upper leg while the foot is firmly planted. This often occurs in field sports such as soccer and football.

How is Meniscus Tear diagnosed?

A meniscus tear is diagnosed by taking a complete history and performs a physical exam. Pain, pops, or clicks during this test may suggest a meniscus tear. An MRI may also be done to see the extent of the tear.

What are the treatments for Meniscus Tear?

Treatment varies depending upon the extent and location of the meniscus tear. The treatment options are available from oral medications,  injection, physiotherapy, platelet rich plasma therapy and surgical intervention.

Surgical Repair for a Meniscus Tear

A large meniscus tear that causes symptoms or mechanical problems with the function of the knee joint may require arthroscopic surgery for repair. In this procedure, a small camera is inserted into the joint through a small incision, while surgical instruments are inserted into the joint through a second, small incision. With the camera, the surgeon can see the entire joint and remove and repair the torn pieces of meniscus. The goal is to save as much of the original, normal meniscus cartilage as possible.

During meniscus repair surgery the torn section of meniscus is either removed (a partial meniscectomy) or the torn edges are joined back together with suture or tacks.

Common Ask Question:
Can Meniscus Tear heal on its own?

Ans: it all depends on where the tear is located and how large. If the tear is on the outer rim or edge of the meniscus there is a blood supply and it can heal. If it is in the middle or inner edge the chances of it healing are much less. As for the surgery the latest studies indicate that you should not have the procedure done unless the knee is locking. The reason for this is in the anatomy. The meniscus sits on top of cartilage. The meniscus deepens the joint and helps control the movement of the femur on the tibia. If you take away this piece of meniscus you expose the underlying cartilage to stresses that it would not normally have. This will cause the cartilage to deteriorate which in turn causes a condition of bone on bone. This will lead to the early or premature need for a total knee replacement. What you should be doing is strengthening the entire leg from the hip to the foot. The stronger the muscles are the less likely you are to have problems. So work on this aspect. If you are having locking of the knee or the inability to fully use the range of motion then you should be looking at a surgical answer to this problem. In either case the stronger that you make the leg the easier the recovery.

Get professional Opinion and Treatment about your Knee Meniscal Injury. Minimal Invasive to treat your Meniscus Injury by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Knee Ligament Injuries

Get professional Opinion and Treatment about your Knee Ligament Injury. Minimal Invasive to treat your Ligament Injury by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Ligament injuries in the knee – such as an Anterior Cruciate Ligament (ACL) — are dreaded by professional and amateur athletes alike. They can be painful and debilitating. They can even permanently change your lifestyle.

But there’s good news. While an ACL injury or other ligament damage once ended the career of many an athlete, treatment is much more successful now.

So what’s behind these feared injuries? Ligaments are tough bands of tissue that connect the bones in your body. Two important ligaments in the knee, the ACL and Posterior Cruciate Ligament (PCL),  connect the thigh bone with the bones of the lower leg. But too much stress on these ligaments can cause them to stretch too far or even snap.

ACL injury and other ligament injuries can be caused by:

  • Twisting your knee with the planted.
  • Getting hit on the knee.
  • Extending the knee too far.
  • Jumping and landing on a flexed knee.
  • Stopping suddenly when running.
  • Suddenly shifting weight from one leg to the other.

These injuries are common in soccer players, football players, basketball players, skiers, gymnasts, and other athletes.

There are four ligaments in the knee that are prone to injury.

  • The Anterior Cruciate ligament (ACL) is one of the two major ligaments in the knee. It connects the thigh bone to the shin bone. ACL injuries are a common cause of disability in the knee.
  • The posterior cruciate ligament (PCL) is the second major ligament in the knee connecting the thigh bone to the shin bone.
  • The lateral collateral ligament (LCL) connects the thigh bone to the fibula, the smaller bone of the lower leg.
  • The medial collateral ligament (MCL) also connects the thigh bone to the shin bone.

Anterior Cruciate Ligament (ACL) Injury

One of the most common knee injuries is an anterior cruciate ligament sprain or tear.

Athletes who participate in high demand sports like soccer, football, and basketball are more likely to injure their anterior cruciate ligaments.

If you have injured your anterior cruciate ligament, you may require surgery to regain full function of your knee. This will depend on several factors, such as the severity of your injury and your activity level.

About half of all injuries to the anterior cruciate ligament occur along with damage to other structures in the knee, such as articular cartilage, meniscus, or other ligaments.

Injured ligaments are considered “sprains” and are graded on a severity scale.

Grade 1 Sprains. The ligament is mildly damaged in a Grade 1 Sprain. It has been slightly stretched, but is still able to help keep the knee joint stable.

Grade 2 Sprains. A Grade 2 Sprain stretches the ligament to the point where it becomes loose. This is often referred to as a partial tear of the ligament.

Grade 3 Sprains. This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable.

Partial tears of the anterior cruciate ligament are rare; most ACL injuries are complete or near complete tears.

Causes of ACL Injuries?

The anterior cruciate ligament can be injured in several ways:

  • Changing direction rapidly
  • Stopping suddenly
  • Slowing down while running
  • Landing from a jump incorrectly
  • Direct contact or collision, such as a football tackle

Several studies have shown that female athletes have a higher incidence of ACL injury than male athletes in certain sports. It has been proposed that this is due to differences in physical conditioning, muscular strength, and neuromuscular control. Other suggested causes include differences in pelvis and lower extremity (leg) alignment, increased looseness in ligaments, and the effects of estrogen on ligament properties.

Symptoms of ACL Injuries?

When you injure your anterior cruciate ligament, you might hear a “popping” noise and you may feel your knee give out from under you. Other typical symptoms include:

  • Pain with swelling. Within 24 hours, your knee will swell. If ignored, the swelling and pain may resolve on its own. However, if you attempt to return to sports, your knee will probably be unstable and you risk causing further damage to the cushioning cartilage (meniscus) of your knee.
  • Loss of full range of motion
  • Tenderness along the joint line
  • Discomfort while walking

Examination of ACL Injuries

  • Physical Examination and Patient History
    During your first visit, our doctor will talk to you about your symptoms and medical history.During the physical examination, our doctor will check all the structures of your injured knee, and compare them to your non-injured knee. Most ligament injuries can be diagnosed with a thorough physical examination of the knee.
  • Imaging Test – Other tests which may help our doctor confirm your diagnosis include:X-rays. Although they will not show any injury to your anterior cruciate ligament, x-rays can show whether the injury is associated with a broken bone.
  • Magnetic resonance imaging (MRI) scan. This study creates better images of soft tissues like the anterior cruciate ligament. However, an MRI is usually not required to make the diagnosis of a torn ACL.

Treatment of ACL Injuries

Treatment for an ACL tear will vary depending upon the patient’s individual needs. For example, the young athlete involved in agility sports will most likely require surgery to safely return to sports. The less active, usually older, individual may be able to return to a quieter lifestyle without surgery.

Nonsurgical Treatment
A torn ACL will not heal without surgery. But nonsurgical treatment may be effective for patients who are elderly or have a very low activity level. If the overall stability of the knee is intact, your doctor may recommend simple, nonsurgical options.

  • Bracing. Our doctor may recommend a brace to protect your knee from instability. To further protect your knee, you may be given crutches to keep you from putting weight on your leg.
  • Physical therapy. As the swelling goes down, a careful rehabilitation program is started. Specific exercises will restore function to your knee and strengthen the leg muscles that support it.

Surgical Treatment
Rebuilding the ligament: Most ACL tears cannot be sutured (stitched) back together. To surgically repair the ACL and restore knee stability, the ligament must be reconstructed. Our doctor will replace your torn ligament with a tissue graft. This graft acts as a scaffolding for a new ligament to grow on.

Grafts can be obtained from several sources. Often they are taken from the patellar tendon, which runs between the kneecap and the shinbone. Hamstring tendons at the back of the thigh are a common source of grafts. Sometimes a quadriceps tendon, which runs from the kneecap into the thigh, is used. Finally, cadaver graft (allograft) can be used.

There are advantages and disadvantages to all graft sources. You should discuss graft choices with your own orthopaedic surgeon to help determine which is best for you.

Because the regrowth takes time, it may be six months or more before an athlete can return to sports after surgery.

Procedure: Surgery to rebuild an anterior cruciate ligament is done with an arthroscope using small incisions. Arthroscopic surgery is less invasive. The benefits of less invasive techniques include less pain from surgery, less time spent in the hospital, and quicker recovery times.

Unless ACL reconstruction is treatment for a combined ligament injury, it is usually not done right away. This delay gives the inflammation a chance to resolve, and allows a return of motion before surgery. Performing an ACL reconstruction too early greatly increases the risk of arthrofibrosis, or scar forming in the joint, which would risk a loss of knee motion.

Get professional Opinion and Treatment about your Knee Ligament Injury. Minimal Invasive to treat your Ligament Injury by Experienced Knee Sports Surgeon. Call us +65 97731458 to schedule for an appointment.

Knee Osteoarthritis

Treat your Knee Osteoarthritis today. Discuss with our Knee Specialist for the Diagnosis, Treatment and Prognosis of your Knee Pain. Effective and Non-Surgery treatment. Call us +65 97731458 to schedule for an appointment.

Knee pain is a common problem in Asia, especially in individuals above the age of 40. The most common cause of knee pain is degenerative osteoarthritis. Women are more prone to the disease. It is characterized by mild to debilitating pain. The treatment ranges from physiotherapy, medication, injection and surgery. Once the condition is diagnosed, it is important to choose the treatment according to the individual’s age, and the severity of the symptoms.

Knee osteoarthritis

 

Symptom of Osteoarthritis:

The symptoms of osteoarthritis are mainly pain, swelling, and stiffening of the knee. Osteoarthritis develops slowly, but may present with sudden attacks of knee pain.

Diagnose Osteoarthritis:

An individual must be diagnosed by a doctor. After a physical examination and full detailing symptoms, the physician may also recommend X-rays to confirm presence of the disease. X-rays are very helpful in the diagnosis and may be the only special test required in the majority of cases.

Prevention Osteoarthritis:

You can take steps to help prevent osteoarthritis. If you already have arthritis, these same steps may keep it from getting worse.

Stay at a healthy weight or lose weight if you need to. Extra weight puts a lot of stress on the large, weight-bearing joints such as the knees, the hips, and the balls of the feet. Too much weight can also change the normal shape of the joint, which can increase your risk for arthritis.

– Be active . A lack of exercise can cause your muscles and joints to become weak. But light to moderate exercise can help keep your muscles strong, reduce joint pain and stiffness, and slow the time it takes for arthritis to get worse. For example, if your quadriceps (the muscles in the front of your thigh) is weak, you may be more likely to get arthritis of the knee. Regular exercise will improve the quality of the cartilage.

– Protect your joints. When you can, try not to do tasks that put repeated stress on your joints, such as kneeling, squatting. And try to use the largest joints or strongest muscles to do things. A single major injury to a joint or several minor injuries can damage cartilage over time. For example, young adults who have had a serious knee injury are more likely to get arthritis.

Exercise is one of the best things you can do to help prevent arthritis from getting worse. It can help keep your muscles strong and reduce joint pain and stiffness. And it can help you reach and stay at a healthy weight.

But you want to make sure that you don’t hurt your joints when you exercise. Before you get started, ask your doctor what kind of activity would be good for you.

Patient with ligament or meniscus injury need to be treated because these will predispose to osteoarthritis.

These tips can help you exercise safely:

– Pace yourself, especially if you haven’t exercised for a while. Start slowly, and don’t push yourself too hard. Then work your way up to where you can exercise for a longer time or do the exercise with more effort.

– Use medicine. If your joint pain gets worse after exercise, you may want to take an over-the-counter pain medicine before you exercise, such as acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen or aspirin. After you’re done, ice the joints that hurt.

– Rest your joints if they are swollen. For example, if your knees are swollen, don’t use the stairs for a few days. Walk a shorter distance, and switch to swimming or riding an indoor bike.

Know when you have sore muscles and not joint pain. If your muscles are sore, you can safely exercise through the soreness. (You could exercise through joint pain too, but it’s not safe to do so.)

If you have joint pain that lasts for more than a day after you exercise, you need to:

– Rest the joint until your pain gets back to the level that is normal for you.

– Exercise for less time or with less effort.

– Try another exercise that doesn’t cause pain.

Treatment for Osteoarthritis:

Weight management to relieve stress on weight-bearing joints, Glucosamine Sulphate 1500mg per day, Anti-inflammatory drugs and analgesics, Platelet Rich (PRP) Plasma TherapyInjection of lubricants into the knee, Arthroscopy to wash away the inflamed fluid, debris and loose fragments inside the joint, Total knee replacement (used when severe osteoarthritis is present).

Treat your Knee Osteoarthritis today. Discuss with our Knee Specialist for the Diagnosis, Treatment and Prognosis of your Knee Pain. Effective and Non-Surgery treatment. Call us +65 97731458 to schedule for an appointment.

Knee Pain

Dr Ambrose Yung Knee, Sports and Orthopaedic Centre Knee, Sports and Orthopaedic Clinic
 

Stop your Knee Pain today. Effective treatment, Non Surgery. Discuss with our Knee Specialist for the Diagnosis, Treatment and Prognosis of your Knee Pain. Call us +65 97731458 to schedule for an appointment.

Knee pain refers to pain that occurs in and around your knee joint. Knee pain can be caused by problems with the knee joint itself, or it can be caused by conditions affecting the soft tissues, ligaments, tendons, or bursae that surround the knee.

The severity of knee pain can vary widely. Some people may feel only a slight twinge, while others may experience debilitating knee pain that interferes with their day-to-day activities. In most cases, self-care measures can help you cope with knee pain.

The knee consists of two long leg-bones held together by muscles, ligaments, and tendons. Many knee problems are a result of the aging process and continual wear and stress on the knee joint. Other knee problems result from injury or a sudden movement that stiffens the knee.

Knee Pain

 

Some common conditions of Knee Problem include:

  • OSTEOARTHRITIS – Knee pain is a common problem in Asia, especially in individuals above the age of 40. The most common cause of knee pain is degenerative osteoarthritis. Women are more prone to the disease. It is characterized by mild to debilitating pain.
  • LIGAMENT INJURIES – Ligament injuries in the knee; such as an anterior cruciate ligament (ACL) are dreaded by professional and amateur athletes alike. They can be painful and debilitating. They can even permanently change your lifestyle.
  • MENISCAL TEAR – The meniscus is a small “c” shaped cartilage that acts as a cushion in the knee joint. They sit between the femur and the tibia bone, one on the outside and one on the inside of the knee.
  • PATELLAR TENDONITIS – Patellar tendinitis is a common overuse injury. It occurs when repeated stress is placed on the patellar tendon. The stress results in tiny tears in the tendon, which the body attempts to repair.
  • CHONDROMALACIA PATELLA – Chondromalacia patella is a common cause of kneecap pain or anterior knee pain. Often called “Runner’s Knee,” this condition often affects young, otherwise healthy athletes.
  • DISLOCATING KNEECAPS – Kneecap dislocation occurs when the triangle-shaped bone covering the knee (patella) moves or slides out of place. The problem usually occurs toward the outside of the leg.
  • BAKER’S CYST – A Baker cyst is swelling caused by fluid from the knee joint protruding to the back of the knee. The back of the knee is also referred to as the popliteal area of the knee.
  • BURSITIS – A bursa is a closed fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body.
  • PLICA SYNDROME – Often called “synovial plica syndrome,” this is a condition that is the result of a remnant of fetal tissue in the knee. The synovial plica are membranes that separate the knee into compartments during fetal development.
  • OSGOOD-SCHALLATER DISEASE – Osgood-Schlatter disease is a disorder of the lower front of the knee where the large tendon under the kneecap (patellar tendon) attaches to the bone of the leg below.
  • OSTEOCHONDRITIS DISSECANS – Osteochondritis dissecans is a joint condition in which a piece of cartilage, along with a thin layer of the bone beneath it, comes loose from the end of a bone.
  • GOUT – Gout is a rheumatoid form of arthritis that causes the inflammation, joint pain and swelling especially in the toe, knee and ankle, also reducing their mobility.
  • SHIN SPLINT – Shin splints are a member of a group of injuries called “overuse injuries.” Shin splints occur most commonly in runners or aggressive walkers.

When do you need to see Knee Specialist about your Knee Pain?
If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of knee pain must be directed at the specific cause of your problem. Some signs that you should be seen by a doctor include:

  • Inability to walk comfortably on the affected side
  • Injury that causes deformity around the joint
  • Knee pain that occurs at night or while resting
  • Knee pain that persists beyond a few days
  • Locking (inability to bend) the knee
  • Swelling of the joint or the calf area
  • Signs of an infection, including fever, redness, warmth
  • Any other unusual symptoms

Treatments for Knee Pain
Treatment of knee pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment plan.

Stop your Knee Pain today. Effective Treatment, Non Surgery. Discuss with our Knee Specialist for the Diagnosis, Treatment and Prognosis of your Knee Pain. Call us +65 97731458 to schedule for an appointment.

Singapore Knee, Sports and Orthopaedic Centre

Dr Ambrose Yung Knee, Sports and Orthopaedic Centre Knee, Sports and Orthopaedic Clinic
Orthopaedics, specialising in degenerative, chronic orthopaedic condition and sports injuries to the musculoskeletal system with an exceptional record in orthopaedic treatment especially to the Knees, Hip, Elbow, Foot and Ankle, Wrist and Hand, and Shoulder joints; with special interest in Sports Medicines, Partial and Total Joint Replacement, and Minimal Invasive Trauma Surgery.

Orthopaedics is the area of medicine focusing specifically on the body’s musculo-skeletal system. This includes bones, ligaments, joints, muscles, tendons, and even nerves – essentially, all the parts of the body needed move, work and enjoy your life.

At Singapore Knee, Sports and Orthopaedic Centre, we aim to partner with you to maintain your health, allowing you to lead an enriched, fulfilling life. In-house Orthopaedic Surgeon, Dr Ambrose Yung Wai Yin is an established professional with a solid medical background and qualifications.

In addition to our specialism in sports injuries of the musculo-skeletal system, we can also help with orthopaedic problems of all different natures.

We have an exceptional record in treating sport injuries, especially to the knees, shoulder and ankle joints. We specialise in:

  • Complex knee ligamentous reconstruction, using soft tissue tendon allographs
  • Meniscus repair
  • Meniscus allograft transplantation
  • Autologous chondrocyte implantation, using stem cells
  • Double bundle anterior cruciate ligament reconstruction
  • Arthroscopy of knee, elbow, shoulder, ankle and hip joints
  • Ankle sprain treatment
  • Treatment of stiff and painful shoulders
  • Complex Partial and Total Joint Replacement
  • Minimal Invasive Trauma Surgery

As professionals, we treat your health with passion and care through 4 key aspects: Diagnosis, Treatment, Rehabilitation and Prevention.

READ MORE ABOUT COMMON ORTHOPAEDICS PROBLEM