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Failed Microfracture

Microfracture Surgery Diagram - Failed Microfracture
Microfracture—the surgical procedure during which small holes are made in joint bones—has resulted in successful temporary repairs for thousands of injured athletes. Unfortunately, the repaired tissues often wore out—leading to more joint pain.

Update on ACL Injuries and Treatment

Update on ACL Injuries and Treatment
The ACL Study Group meets every two years to update the latest knowledge on ACL injuries and treatments. This year’s meeting was at the base of the Hahnenkamm ski race in Kitzbuhel Austria—the most famous downhill ski race on the World Cup circuit. One hundred and fifty of the world’s top ACL surgeons watched 30 of the world’s bravest ski racers hurtle down the ice-crusted hill at 140 km/h (84 mph). The outcome of the race was predictable: The Austrians dominated. The outcome of the scientific meeting, however, was less conclusive; the ACL is still a tough problem to solve.

Failed Surgeries

Surgeon Trust
News flash: Surgery doesn’t always work. The most important thing I tell my patients is that any effort to make a person better might make them worse.

Why ACL Repairs Fail

Why ACL Repairs Fail
For decades there have been unsuccessful efforts to repair the anterior cruciate ligament (ACL) after rupture. Why? Because the forces required to tear the complex weave of the ACL’s collagen fibers involve both tearing and pulling apart. Think of a climbing rope: When overstretched the rope fails within its sheath, not just at a single clean edge. Here is why the ruptured anterior cruciate ligament is most often replaced (reconstructed) rather than repaired.

What’s Hot & What’s Not in Knee Surgery: A Few of the Highlights

What’s Hot & What’s Not in Knee Surgery: A Few of the Highlights The Stone Clinic
Stem cells are both in and out. It was once thought that if these cells were injected into joints, they would turn into cartilage. Two problems arose. First, patients (unless they are infants) have very few stem cells left. Second, the injected cells died after releasing their instructional growth factors, never turning into cartilage. But what we have learned is that an increasing number of concentrated growth factors, immune stimulants, and even some drugs can induce the migration of the body’s own progenitor cells—some of them stem cells—cells that direct healing—to the injured area. These cells then optimize the environment around the injury to effect healing.

ACL Surgery: Where the Problems Are

ACL Surgery: Where the Problems Are The Stone Clinic
The ACL is the key stabilizer of the knee and is torn 300,000 times a year in the U.S. alone. The treatment of these torn ligaments has evolved in some ways, but not so much in others. Here is what we know today.

The moment you tear it is the moment to repair it.

The moment you tear it is the moment to repair it. The Stone Clinic
Almost all orthopaedic injuries are best repaired immediately. The old “wait and see” for most joint injuries has been proven to lead to scar tissue, loss of motion, and arthritis. With today’s accurate imaging, using repair and reconstructing techniques to restore normal anatomy beats living with deformities.

The Zen of Surgery

The Zen of Surgery The Stone Clinic
Calm, happy patients make calmer, happier surgeons. It adds up to better outcomes. Though it’s hard to prove, the more the patient helps the surgeon relax, the better the surgeon perceives the patient and the job ahead. I know, having been both the surgeon and the patient.

Outpatient Knee Replacement: The Great Debate

Outpatient Knee Replacement:  The Great Debate The Stone Clinic
The debate is always the same. “We do it the traditional way because that is the way we have always done it.” “It is safer for patients; the new ways are not time tested. And, there are more complications.”

The Patella Dilemma

Patella Injury
Though knee cap problems are common, current solutions have serious limitations.

Why “Useless” Surgery is Useful

Why “Useless” Surgery is Useful
Recent news stories proclaiming meniscus surgery to be useless miss the point, due to outdated information. And they can do considerable harm by convincing people that leaving a torn meniscus in the knee is a good choice when, in fact, it destroys the knee.

Surgical infections: Evolving Solutions.

Infections, fortunately, are uncommon in elective orthopaedic surgery.
Doctor, will I get an infection from surgery? If I do, then what? This is a question your surgeon never wants to hear, much less have to answer. Why? Because no one knows the answer for sure. Here’s why, and what to do if infection happens.

Partial knee replacement for athletes

Partial knee replacement for athletes
The results of partial knee replacement have become so good that my patients often ask me, “Can I run, can I play sports, can I return to my full range of activities?” Dr. Stone's answer is often “ Yes, but…”. Here is why.

Regrowing your knee

Collegen Meniscus Implant
How a biological device can act as a trellis for new meniscus tissue to grow into, reconstructing missing segments of the meniscus shape.

How to have a good knee replacement

Total knee replacement - best outcomes
If you're due to have a total knee replacement, here are some steps you can take to have the best possible outcome.
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