Osgood-Schlatter Disease in Children


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What is a Knee Replacement Revision?

Article featured on Summit Ortho

Hundreds of thousands of Americans have total knee replacement surgery each year to treat severe knee arthritis that no longer responds to conservative treatments. Conservative treatments are those such as medications, physical therapy, or injections. In this surgery, the damaged joint surfaces of the knee are replaced with artificial metal and plastic implants. These knee implants may last individuals 20 or more years. For some people, their knee implants will last the rest of their lives. However, some knee replacements do not last as long as patients and their providers hope or wear out over time.

“I think every knee replacement surgeon hopes that the knee replacement they do for each patient is the last knee surgery for that individual. But sometimes knee replacements wear out over time or may not function as well as we hoped,” said Summit hip and knee surgeon and total joint replacement specialist Brandon Kelly, M.D.

What is a knee replacement revision?

A knee replacement revision is a surgery to replace one or multiple knee replacement parts with new ones. The specifics of each revision surgery depend on how and where the original implant is failing. Other factors include the individual patient’s age, health, activity level, and other factors.

The need for a knee replacement revision surgery is an individualized decision made between the patient and the surgeon. It is typically recommended when there is a problem with the current knee replacement implants or if the knee is not meeting the patient’s quality of life goals. The decision for knee replacement revision is individualized to each patient’s medical and social factors. Sometimes, surgical intervention may not align with every patient’s goals of care.

“Knee replacement revision is usually a big decision for patients and surgeons. I like to educate my patients on what’s going well and what’s not going well with their current knee replacements. Then we discuss what may or may not be improved with revision knee replacement surgery before proceeding with surgery. I like to understand my patients’ goals to ensure I can meet them before proceeding with surgical intervention,” Dr. Kelly noted.

What else is important to know about knee revision surgery?

Revision knee replacement surgery is typically a more complex, longer, and technically challenging surgery than total knee replacement. That’s why it’s important to choose your knee revision specialist carefully. There are many factors that contribute to postoperative recovery, but recovery time after revision knee replacement surgery in most circumstances is similar to a total knee replacement surgery.

As with a first-time knee replacement, preoperative and postoperative physical therapy is vital to help condition and strengthen the lower extremities.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Take Care of Your Knees

Article featured on UCSF Health

Five Steps to Improve Strength and Flexibility

Although collateral ligament injuries often occur during sports and are difficult to avoid, there are several steps you can take to improve the overall strength and flexibility of your knees:

  • Manage your weight: Every pound in excess of your normal weight puts three or four additional pounds of pressure on your knee every time you take a step.
  • Keep your legs strong: The hamstrings, in the back of the thigh, and the quadriceps, the muscles in the front of the thigh, are crucial shock and impact absorbers. These muscles must be kept strong and flexible to protect the joint surfaces in your knee.
  • Stretch your muscles: Stretching before exercising should be a regular part of your warm-up; however, it is important not to over-stretch. Never push or pull on your leg with your hands while you are stretching, and avoid squatting during your warm-up, which can put stress on your knee joint.
  • Wear proper shoes: Well-cushioned, well-fitting athletic shoes can reduce the impact of the load exerted on the knees.
  • Ease into shape: If your activities require twisting and turning such as racket sports, skiing, soccer and basketball, don’t assume you can play yourself into shape. Make sure you are in good physical shape before you play.

The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

4 Things to Know About Meniscus Repair

Article featured on Noyes Knee Institute

Injuries to the meniscus are common, especially among athletes and individuals involved in physical activities. Pain, inflammation, and restricted mobility can result from torn or injured meniscus. Here are four things to know about meniscus repair:

1. The Importance of Early Diagnosis

Early diagnosis of a meniscus tear results in prompt and effective treatment. If left untreated, meniscus tears can worsen over time, leading to more significant pain and potential damage to the knee joint. As soon as symptoms like knee pain, swelling, and limited range of motion arise, consult an orthopedic knee surgeon for a thorough evaluation.

An early diagnosis allows the knee surgeon to recommend appropriate treatment options, including conservative measures like rest, physical therapy, and anti-inflammatory medications. In some cases, meniscus repair surgery may be the best course of action to restore knee function.

2. Meniscus Repair Surgery

Orthopedic knee surgeons perform meniscus repair surgery to mend the torn meniscus tissue and restore knee stability. The surgery can be done through minimally invasive arthroscopic techniques involving small incisions and a tiny camera called an arthroscope that guides the surgeon’s instruments.

During the surgery, the surgeon will carefully suture the torn edges of the meniscus together. This allows the tissue to heal and regain its strength. The success of meniscus repair largely depends on the type and location of the tear, as well as the patient’s age and overall knee health.

3. Rehabilitation and Recovery

Following meniscus repair surgery, a comprehensive rehabilitation program is recommended to promote healing and regain knee function. Orthopedic surgeons work closely with physical therapists to design a personalized rehabilitation plan for each patient.

Rehabilitation typically involves exercises to improve knee strength, flexibility, and stability. Patients are advised to diligently follow their physical therapy regimen and avoid activities that may strain the healing meniscus excessively. The recovery period after meniscus repair surgery varies from patient to patient. While some individuals may resume light activities within a few weeks, others may require several months to recover fully and return to more vigorous activities.

4. Complication Awareness

If the medial meniscus has been destroyed, the only treatment is to remove the damaged portions and repair the remaining area. As with any surgical procedure, meniscus repair surgery carries some risks and potential complications. Infection, blood clots, and adverse reactions to anesthesia are possible but rare. Patients are encouraged to discuss any concerns or medical conditions with their orthopedic knee surgeon before the procedure.

In some cases, meniscus tears may be too severe or located in a region with limited blood supply, making repair surgery unfeasible. The surgeon may opt for a meniscectomy, a procedure to trim and remove the damaged portion of the meniscus. While a meniscectomy provides symptom relief, it may also increase the risk of early-onset osteoarthritis in the knee joint.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What Are the Red Flags for Knee Pain

Article featured on The Noyes Knee Institute

Knee pain can result from overexertion, injury, or medical conditions like arthritis. This pain hinders daily activities like walking, decreasing your overall productivity. At Noyes Knee Institute, we’ll treat your knee pain to improve your quality of life. Here are some red flags that necessitate seeing an orthopedic knee surgeon:

Sudden Severe Pain

Sudden severe pain with no apparent cause can indicate a serious knee injury. This could include a meniscus tear, torn ligament, fractured bone, or a dislocated kneecap. Seek immediate professional help if the sudden severe pin limits your movement or ability to bear weight on the affected knee.

At Noyes Knee Institute, we have decades of experience helping patients with severe knee pain. We’ll identify the root cause of your pain and create a personalized treatment plan to get you back to your active lifestyle.

Buckling of the Knee

Knee buckling may signal instability in the knee joint or a ligament tear. Ligament tears like anterior cruciate ligament (ACL) tears can make the knee unstable. This results in a sensation of the knee giving way during weight-bearing activities.

At Noyes Knee Institute, we’ll ask questions about the buckling sensation and order imaging tests to determine if you have a torn ACL. We have a 95% rehabilitation success rate, having conducted over 5,000 ACL reconstruction surgeries. You’ll be in safe hands if you need ACL reconstruction surgery.

Swelling and Warmth

Swelling and warmth around the knee joint can indicate an inflammatory condition like arthritis or an infection. Inflammation can cause the knee joint to become painful and warm to the touch. Sometimes the swelling may be accompanied by a limited range of motion and joint stiffness.

At Noyes Knee Institute, we’ll determine the root cause of the swelling by conducting a physical examination and ordering blood tests. The examination allows us to determine whether your range of motion has been affected. Blood tests will enable us to identify underlying systemic conditions like infections or rheumatoid arthritis.

Knee Locking

Healthy knees are flexible. You should be able to rotate your knees slightly and bend them up and down. Their flexibility allows you to perform daily living activities like standing and sitting. If you can’t, you may be dealing with a locked knee.

Locked knees fall into two categories: true-locked knee and pseudo-locked knee. You can’t move your knee in any direction with a true-locked knee. A pseudo-locked knee occurs when pain in the knee joint is too severe to move the knee. True-locked knees can occur because of limited blood supply to the knees. Pseudo-locked knees can occur because of a tear in the ligament cushioning the knee joint, knee joint dislocation, or fractures.

At Noyes Knee Institute, we’ll conduct imaging tests like MRIs and CT scans to determine whether you have a true or pseudo-locked knee. Our orthopedic knee surgeon, Dr. Noyes, may recommend surgery to remove the obstruction limiting blood supply in the knee joints if our tests determine that you have a true-locked knee. If you have a pseudo-locked knee, we’ll recommend conservative treatments like activity modification and medication.

Persistent Pain

Persistent knee pain that doesn’t improve with rest, ice, compression, and elevation (RICE) or doctor-prescribed conservative treatments like pain medications can signal a serious underlying condition. Seek professional help if your pain progresses over time to find an effective solution.

At Noyes Knee Institute, we’ll conduct a joint aspiration to understand your condition. This involves removing a fluid sample from the knee joint to determine if there’s an infection, inflammation, or other underlying condition before recommending treatment.

Consistent Knee Pain After Surgery

It’s normal for patients to feel knee pain for a few weeks after surgery. The pain should wear off as your knee heals. Your surgery may have failed if you continue experiencing pain, swelling, and bruising around your knee months after surgery. This calls for revision surgery.

At Noyes Knee Institute, we only use grafts from FDA-approved tissue banks for our surgeries and take patients through an active rehabilitation program after their procedures. This, combined with Dr. Noyes’s expertise in orthopedic surgery, improves your chances of having a successful revision surgery.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

What Different Types of Knee Pain Mean

Article featured on Healthgrades

If you’ve ever experienced pain in one or both of your knees, you’re not alone. About one-third of all Americans have felt pain in this major joint at some point in their lives. Women are slightly more likely than men to be affected by it (about 20% of women versus 15 to 20% of men).

Yet the millions of people with this pain don’t all feel the same thing. Knee pain can be sharp or dull, burning or excruciating, accompanied by strange noises or silent. What does your knee pain tell you about what’s wrong?

1. Knee pain with a ‘crunch’

Sometimes knees creak, crack or crunch when you bend them. These sounds—called ‘crepitus’—may be alarming, but don’t necessarily signify a problem, unless your knee hurts at the same time.

If that happens, you could have an injury, such as a torn meniscus (a type of cartilage in your knee) or a dislocated kneecap. The sounds together with pain also could indicate osteoarthritis. Your doctor should check for the source of both your painful sensations and strange sounds.

2. Knee pain when running

If you have a dull pain in and around your kneecap when you run or are doing other activities, you may have ‘runner’s knee,’ also called patellofemoral pain syndrome. Other symptoms include kneecap tenderness, pain when you sit for a long time with your knees bent, and rubbing, grinding or clicking sounds when you bend or straighten your knee.

This syndrome can be caused by running and overuse, as well as structural defects in the knee, shoes that aren’t supportive enough, walking or running with your feet positioned improperly (such as turning in), and injury.

3. Knee pain in the morning

If you wake up with a painful and stiff knee, but find that the aching eases over the course of the day, you may have rheumatoid arthritis. This is an inflammatory disorder in which the body’s immune system attacks joints, such as the knee. Other autoimmune disorders, such as lupus, also can cause similar symptoms.

If you have rheumatoid arthritis symptoms, contact your doctor, especially if you are experiencing pain and stiffness in other joints. Left untreated, rheumatoid arthritis can lead to joint disfigurement.

4. Knee pain when climbing stairs

One of the first signs of osteoarthritis is pain in the knee when going up or down stairs. This pain tends to get worse throughout the day. While osteoarthritis knee pain is usually achy, it can also sometimes be sharp or burning. Other symptoms include swelling, stiffness and feeling like your knee is grinding or may give way.

Osteoarthritis is a degenerative condition in which protective cartilage at the end of your leg bones wears down. This can ultimately result in bones rubbing against each other, causing pain, swelling, and loss of motion.

5. Knee pain with a pop

One common type of knee injury is a tear to the anterior cruciate ligament, or ACL, which connects your thigh bone to your shin and helps keep your knee stable. When the injury happens, you’ll likely hear a loud pop or else feel a popping inside, along with severe pain.

A damaged ACL is likely to leave you with rapid, significant swelling; difficulty fully straightening your leg or bending your knee; and pain when you try to put weight on it. You may feel like the knee is going to give way. In some cases, surgery to repair the ligament may be necessary.

6. Knee pain that’s sudden and severe

If you experience a sudden onset of severe knee pain along with redness, warmth and swelling, especially in the early morning, you might have gout, an arthritic condition that is most commonly seen in the big toe. However, gout also can strike other joints, especially in the leg. Gout can recur and should be treated to help prevent permanent joint damage.

Another reason for sudden severe pain and swelling in a knee is Lyme disease. Children are especially likely to have this symptom of Lyme disease, an infection caused by bacteria from an infected tick. If you suspect Lyme disease, promptly seek care to reduce the risk for complications associated with the disease.

7. Knee pain with bending and kneeling

People in professions that require repetitive kneeling, such as roofers, floor installers, plumbers, coal miners, gardeners and maids, are most at risk for bursitis of the knee. Bursitis refers to inflammation of the bursal sacs of fluid that are around joints.

Repeated bending and kneeling, especially on hard surfaces, can irritate the bursa in the knees, causing gradually worsening symptoms. These symptoms include pain, redness, warmth, swelling, joint stiffness, and sometimes fever, which is a sign of infection. Notify your doctor for a full evaluation and to rule out infection. Bursitis also can be caused by an injury, but this is less common.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Painful Knee Caps: What Causes Them?

Article featured on The Noyes Knee Institute

Pain in the knee caps (patella) is caused by several factors, ranging from old age and overuse to injury and infection. A strenuous activity during the day can cause mild discomfort around the knee, which heals with rest and sleep. Knee cap pain can also be persistent and chronic, calling for the services of an experienced orthopedic knee surgeon. Here’s an overview of the five leading causes of knee cap pain:

1. Knee Overuse

The patella is a knee joint bone structure that suffers wear and tear. Your knee supports walking, jogging, running, jumping, kneeling, and squatting. Straining the knee joint through overuse can result in pain and discomfort around the patella. Knee cap pain resulting from overuse may stop if the strenuous activity is ceased or moderated. Other cases trigger a degenerative process with intermittent and worsening pain.

2. Knee Injury

The knee cap protects the rest of the knee joint structures, including ligaments, cartilages, and muscles. A traumatic blow to the front of the knee area is likely to hurt the patella first, resulting in severe pain. A knee injury can result from falling, participation in sports, a car crash, or other situation strenuous situations. Pain from injury may go away with functional medicine and physical therapy, but occasionally requires knee surgery to repair the damage.

3. Chondromalacia Patellae

Knee cap pain can stem from Chondromalacia, a condition in which the cartilage found behind the patella softens. Normal cartilage is tough and flexible to protect the ends of the joint bones from rubbing on each other. When the cartilage becomes soft, the shinbone and thighbone can move too close to each other or even touch. Chondromalacia weakens cushioning and shock absorption capabilities, resulting in pain around the knee joint, including the patella. With rest and treatment, this condition can heal.

4. Patellofemoral Pain Syndrome (PFS)

PFS or runner’s knee is a widespread condition highlighted by pain behind the knee cap area. It develops when the knee joint moves abruptly. PFS also results from knee overuse through running, cycling, climbing, and other strenuous activities. Pain levels vary from mild to severe and are felt around the front of the knee (patella). Runner’s knee is common among athletes and starts as dull recurring pain. This condition is reversible.

5. Muscle Imbalances & Tendonitis

The knee joint relies on the thigh, hip, and knee muscles, which work in tandem to ensure proper movement and support. Injury or imbalance can result in the wrong movements and reflexes, causing pain and inflammation. Conditions like tendonitis inflame the patellar tendons and quadriceps tendons, causing stiffness, tenderness, swelling, and knee pain. Injury, disease, or infection on one of the connected muscles and tendons can cause pain.

Working With a Trusted Orthopedic Knee Surgeon

Knee cap pain can be reversed with rest and sleep, but some conditions are severe and require proper medical attention. Others will need a corrective operation from a licensed orthopedic knee surgeon.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, foot and ankle conditions, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic and podiatric surgeons in Portland Oregon, contact OSM today.

Phone:

503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

Common ACL Tear Symptoms & When to Seek Treatment

Article featured on The Noyes Knee Institute

If you experience pain around your knee area, it is advisable to contact an orthopedic knee surgeon as soon as possible. The pain may stem from a torn anterior cruciate ligament (ACL). Such situations may call for surgery to prevent further damage to your knee joint.

The ACL is one of four ligaments in your knee. It is located behind the patella (kneecap) and connects the thigh bone to the shin bone. The posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL) are the other three ligaments.

ACL Tear Symptoms

ACL stabilizes the knee when you rotate and can get torn when you make sudden stops or changes in direction. Injuries can also result from high-impact sports and maneuvers such as jumping and landing. A torn ACL has many signs, depending on the severity of the injury. Popular symptoms include:

1. Popping Sounds

A loud popping sound is the most common symptom of a torn anterior cruciate ligament. You will hear the popping sound at the moment of injury. Silent pops may also occur when you try to stand or move the knee joint. ACL tears can also result in a painful grinding feeling of your kneecap and bones.

2. Pain and Swelling

A popping sound may indicate other issues but is often a result of torn ACL, especially when accompanied by pain and swelling. The pain is severe at the moment of injury and becomes sharper when you try to get up or put pressure on the knee. In most cases, the pain is quickly accompanied by inflammation/swelling of the knee area.

3. Inability to Bear Weight

You will barely be able to stand a few minutes after an ACL tear. The anterior cruciate ligament is responsible for stabilizing your knee when you move or change directions. Tears in the band of tissue compromise this function, making it difficult to bear your weight or continue with any activity.

4. Lost Range of Motion

ACL tears can result in loss of range of motion, making it impossible to bend, walk, or sprint. Lost range of motion usually stems from excruciating pain. Your knee surgeon will test the range of motion to determine the severity of your pain and injury. Regaining range of motion is also a good sign during ACL tear recovery.

When to Seek Treatment

The knee is one of the most complex joints and harbors ligaments, tendons, tissues, and bones. It is crucial to seek a medical diagnosis immediately if you experience the symptoms of an ACL tear. Proper diagnosis will reveal the scale of injury and determine the best remedy.

Some cases can resolve with rest and rehabilitation. Others require medication, physical therapy, or surgery to remove the damaged parts. Diagnosis involves reviewing your medical history and symptom patterns.

The physician will also conduct a physical examination and may use X-ray scans or request an MRI to assess damage to bones, cartilage, and menisci. After diagnosis, the knee doctor will determine whether you need non-surgical or surgical treatment.

Working With an Orthopedic Knee Surgeon

The first assessment will determine if knee surgery is essential. If such is the recommendation, you should immediately seek an experienced orthopedic knee surgeon. There are various types of surgeries used to treat ACL tears.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

9 Things You Didn’t Know About Runner’s Knee

Article featured on Healthgrades

Runner’s knee, the common term for patellofemoral pain syndrome, is a knee problem that affects many people. It happens when your kneecap (patella) is either misaligned because of a defect, or your knee is stressed, causing it to be out of alignment. Although it is painful, runner’s knee is usually not a serious knee injury, although it can have a significant impact on your life by limiting your activity. How much do you know about runner’s knee? Here are some facts about the condition that might surprise you.

1. You don’t need to be a runner to get runner’s knee.

Patellofemoral pain syndrome is called runner’s knee because it affects a lot of runners. However, many people who never run anywhere also develop runner’s knee. It’s like people who don’t golf can get golfer’s elbow, or those who don’t play tennis can get tennis elbow. Anyone who participates in an activity that bends the knee and puts a lot of strain on it is at risk of developing runner’s knee. This includes cycling, walking, jumping or climbing up and down stairs.

2. Repetitive movements can irritate your knee.

Do you have a job that requires you to bend and squat a lot? When you squat repeatedly, your knee makes the same movement and carries your body’s weight in the same places over and over again. You could be squatting to lift boxes, pick items off the floor, or reach lower shelves. Even parents of young children who have to pick them or their playthings off the floor are at risk of irritating their knees to the point of developing runner’s knee.

3. Your hamstring could be causing runner’s knee.

Your hamstrings are really three muscles in the back of your thigh. They help you extend and retract your leg. You may feel your hamstrings pull if you bend at your waist without bending your knees or you straighten your legs in front of you while sitting on the floor. When your hamstrings are too tight, they cause extra stress on your knees and could cause runner’s knee. Exercises and stretches to loosen the hamstrings can help reduce knee pain and keep it from coming back.

4. Your glutes can also cause runner’s knee.

Like your hamstrings, your gluteus medius, a muscle in your buttocks, may also be the culprit behind your runner’s knee. Instead of being too tight, like the hamstrings, if your gluteus medius, or glutes, are not tight enough, the rest of your leg tries to compensate. This puts stress on your knee. The gluteus medius is responsible for helping to pull your leg away from your body and rotate it externally. This is called hip abduction. If the muscle isn’t strong enough, the other muscles respond by trying to pull the leg inward instead.

5. Flat feet can equal knee pain.

Your feet play a vital role in your knees’ health. If you have flat feet, a low arch, or no arch at all, this puts your feet in an unnatural position when you step forward, particularly when you run. The impact of walking or running without arch support can cause extra tension on the muscles in your legs and pull on the knee, causing misalignment and stress. Wearing appropriate shoes and orthotics in your shoes can help fix how your foot lands when you take a step, taking stress off your legs and knees.

6. Where you exercise could cause runner’s knee.

Concrete and asphalt are unforgiving surfaces. If you’re running or playing sports on these hard surfaces, the stress on your legs and knees could cause runner’s knee. The solution is to run or play on more forgiving surfaces, like synthetic tracks, grass or dirt. This is also where good shoes appropriate for the activity are beneficial. They can help absorb some of the shock of running and jumping, taking away some of the stress on your knees.

7. Women are more prone to developing runner’s knee.

Doctors aren’t entirely sure why more women than men develop runner’s knee, but overall women do develop more knee problems. A woman’s pelvis is wider than a man’s. This wider pelvis affects how a woman stands and places a different type of pressure and strain on the knee. As well, women tend to have looser ligaments, the tough fibrous tissue that connects bones. Women also land on their feet differently when they run or jump, adding to the difference in knee stress.

8. Runner’s knee can be easy to treat.

Once you know what is causing your runner’s knee, it can be fairly easy to treat. If it is caused by improper foot support, good shoes or orthotics will help. If it’s caused by too tight ligaments or muscles, physical therapy and exercise can ease the pain and reduce the risk of it returning. Muscles too weak? Strengthening them at home or in a gym will help. Running on a hard surface? Switch locations for a gentler landing when you run or jump. The key is working at it and staying consistent.

9. Surgery is rarely necessary for runner’s knee.

Doctors only consider surgery for runner’s knee if you have tried non-surgical treatment for 24 months and you still have pain. It’s rarely necessary. If you have runner’s knee and you have faithfully tried all the exercises and changes recommended by your doctor or physical therapist, an orthopedic surgeon will assess you to see if surgery will help.


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm

6 Ways to Ruin Your Knees

Article featured on WebMD

Whether you’re a seasoned athlete, a weekend warrior, or totally laid-back when it comes to exercise, knowing how to protect your knees from damage can mean the difference between a fulfilling lifestyle and longterm, strained mobility.Cruising on the track in the heat of a roller derby match, 27-year-old Rachel Piplica was not at all prepared for the realization that her knee could sideline her from competitive skating for months, possibly years.”Suddenly, I heard a pop and it felt like my knee bent sideways. The pain was so bad I just fell and crawled away,” Piplica tells WebMD.The Los Angeles fashion designer who skates under the name Iron Maiven tried to keep going. “I took one more stride and my knee just let go again. The doctor immediately said, ‘I think you tore your ACL.'”

Piplica had experienced some warning signs during her previous season of skating as captain of her team, but she ignored them for the most part. “I had tremendous pain in my leg anytime I’d squat down so I just kept my right leg straight. But I never saw a doctor for it. I just assumed, ‘I’m in a contact sport and this is what happens,’” she tells WebMD.

Knee deep: A complex and vulnerable joint

Her torn ACL diagnosis confirmed, Piplica quickly learned how susceptible the knees can be to injury. According to the American Academy of Orthopaedic Surgeons, these joints are responsible for sending nearly 15 million Americans to the doctor every year.

And it’s not just athletes who suffer. Knee problems can happen to anyone.

“Because they’re the main hinge between the ground and the rest of your body, the knees serve as your ‘wheels’ that get you around and allow you to be active,” says University of Pennsylvania orthopedic surgeon and sports medicine specialist Nicholas DiNubile, MD. “Life can really go downhill when you damage your knees,” says DiNubile, who is a spokesman for the American Academy of Orthopaedic Surgeons and author of FrameWork – Your 7-Step Program for Healthy Muscles, Bones and Joints.

Bound by an intricate system of ligaments, tendons, cartilage, and muscle, the knee is highly prone to injury. It’s a complex hinge where the femur (thigh bone), tibia (shin bone), fibula (next to tibia) and kneecap all come together.

“It’s hard to find the right balance between mobility and stability; the knee needs to move back and forth, twist a little, and pivot too,” DiNubile says. The knee’s ligaments can tear, its tendons can swell up, osteoarthritis can take hold, and even everyday wear and tear can ruin a perfectly good set of knees.Here are six pitfalls you can avoid to save your knees.

1. Ignoring knee pain.

An occasional ache here and there is common. “But knowing when you can and can’t ignore pain is key,” says sports medicine specialist Jordan Metzl, MD, from the Hospital for Special Surgery in New York City.

Metzl’s rule of thumb: When the pain limits your ability to do what you normally do, you need to have it checked out.

“If your body is sending you signals, you need to listen to them. If they persist, you need to have it checked out,” he tells WebMD.

For Piplica, exploratory surgery revealed a torn meniscus she had endured in the past — unbeknownst to her — followed by the more recent ACL tear.

“In hindsight, maybe that first injury could have been repaired earlier, although I don’t know if I could have avoided this one altogether,” she says. “At least I would have been more careful.”

2. Being overweight.

Every pound of body weight yields five pounds of force on the knee, so even 10 extra pounds can put a considerable load on those joints.

Being overweight also increases your chances of osteoarthritis in the knee, a common and often disabling form of arthritis that wears away the knee’s cushiony cartilage. Excess pounds also cause existing arthritis to worsen more rapidly. According to the CDC, two out of three obese adults suffer from knee osteoarthritis at some time in their life.

Although diet and exercise are critical for weight loss, it’s a double-edged sword.

“If your knees hurt, it’s harder to lose weight through exercise,” says Metzl. So he recommends activities that go easy on the knee.

For example, opt for a stationary bike over running on the treadmill, and walk on a flat surface instead of hilly turf. If you’re a die-hard treadmill fan, then go for longer sessions of walking punched with brief intervals of brisk walking or running every three to five minutes, DiNubile says.

3. Not following through with rehab and rest.

The rest and rehabilitation period after a knee injury is critical to avoiding future pain or reinjury. Depending on the type of damage and treatment, recovery could last anywhere from a couple of weeks to several months.

“During the rehab period, you need someone to help you tell the difference between something that just hurts, and something that’s going to do you harm,” says DiNubile.He tells WebMD that many of his young athlete patients are too eager to return to regular play as soon as they stop limping. He advises patients to work with an orthopedic surgeon, a sports medicine physician, a physical therapist, an athletic trainer, or some combination of these pros, in order to ensure proper focus is placed on gradually strengthening the knees.

4. Neglecting your ACL.

One of the most commonly injured ligaments in the knee, the anterior cruciate ligament (ACL) is responsible for about 150,000 injuries in the U.S. every year.

As Piplica learned firsthand, sports like roller derby that involve quick cuts, twists, and jumping, put the ACL at higher risk for rupturing. More traditional high-risk sports include soccer, basketball, football, and volleyball.Women in particular have a two- to eight-times higher risk for ACL tears compared to men, mainly because the way women naturally jump, land, and turn puts greater strain on the ACL.However, male and female athletes alike can be trained to “rewire” themselves and thus lower risks of knee injury. That’s done through neuromuscular training, which involves supervised practice in improving agility, leg strength, and jump-landing techniques for better knee joint stability.These specialized techniques are effective in reducing risks of knee injury by almost one-half, according to a 2010 review of seven neuromuscular training studies.

“Given what we know in how useful it can be in reducing ACL tears, it’s irresponsible of coaches and parents to not require athletes to undergo neuromuscular training,” says DiNubile.

He recommends that athletes of any age who play ACL risk-prone sports should seek help from an athletic trainer or other trained professional to help avoid this debilitating injury.

5. Overdoing it.

“You make gains in fitness when you work hard and then allow your body to recover. You can’t do a hard workout every day,” Metzl says.

A sudden increase in intensity or duration of exercise can cause overuse injuries from repetitive strain. Tendonitis and kneecap pain are common symptoms in the knee.Pushing too hard is also related to overtraining syndrome, a physiological and psychological condition among athletes in which they exceed their ability to perform and recover from physical exertion, often leading to injury or lowered performance.Be sure to include stretching exercises before and after working out. And follow hard training days with easy ones so your body can recover.6. Overlooking other muscles around the knees.

Weak muscles and lack of flexibility are primary causes of knee injuries. When the muscles around the kneecap, hip, and pelvis are strong, it keeps the knee stable and balanced, providing support by absorbing some of the stress exerted on the joint.DiNubile stresses the importance of building the quadriceps and hamstring muscles, as well as proper strengthening of the body’s core muscles, including the obliques, lower back muscles, and upper thigh.
His favorite tool to help accomplish this strengthening is a Swiss medicine ball. Other exercises to try are knee extensions, hamstring curls, leg presses, and flexibility exercises.Piplica recalls realizing just how weak some of her leg muscles were.”Roller girls are striding out so much with their outer leg muscles, but we aren’t necessarily working our inner knees,” she says. “I remember when I would run for exercise, my calves and shins would hurt so bad. That surprised me, because I thought if anything was strong, it was my legs.”Piplica says she wishes she had been better educated about crosstraining activities for roller skaters, and what muscle groups they need to focus on to keep their knees healthy.

As she awaits surgery to repair her torn ACL, Piplica tells WebMD that her perspective on long-term care for her knees has definitely changed.

“Half of me is frustrated about not being able to skate sooner, but the other half knows how important it is to get better so I don’t do this again. I’m 27 years old with a serious knee injury preventing me from moving around. So I need to look beyond just skating, skating, skating. I don’t want to have knee problems when I’m 40 or 50 because I’m not giving my body the kind of attention it needs right now.”


The Orthopedic & Sports Medicine Center of Oregon is an award-winning, board-certified orthopedic group located in downtown Portland Oregon. We utilize both surgical and nonsurgical means to treat musculoskeletal trauma, spine diseases, sports injuries, degenerative diseases, infections, tumors and congenital disorders.

Our mission is to return our patients back to pain-free mobility and full strength as quickly and painlessly as possible using both surgical and non-surgical orthopedic procedures.

Our expert physicians provide leading-edge, comprehensive care in the diagnosis and treatment of orthopedic conditions, including total joint replacement and sports medicine. We apply the latest state-of-the-art techniques in order to return our patients to their active lifestyle.

If you’re looking for compassionate, expert orthopedic surgeons in Portland Oregon, contact OSM today.

Phone:
503-224-8399

Address
1515 NW 18th Ave, 3rd Floor
Portland, OR 97209

Hours
Monday–Friday
8:00am – 4:30pm