By Heidi Smith, Contributor
Knee pain is one of the most common complaints of active adults as they age. When pain progresses and mobility decreases, orthopedic physicians have many tools, techniques and medications that can help. Orthopedic surgeon Tracy Ng, D.O., of ShorePoint Medical Group in Venice, is fellowship-trained in sports medicine and arthroscopy – a minimally invasive procedure for diagnosing and treating joint problems. She also performs robotically assisted surgery for knee and hip replacements as a member of the medical staff at ShorePoint Health Venice. Additionally, she is the Atlanta Braves Spring Training orthopedic surgeon in North Port and the team physician for the North Port High School Bobcats.
Q. How can you help an adult suffering from knee pain, who also may feel unstable when standing or walking?
A. First I examine the patient, to learn about their issues based on medical history and a physical exam. In our community of active adults, I often see patients who have been competitive athletes and whose joints have undergone a lot of “wear and tear” over the years. I try to treat conservatively at first with physical therapy, exercises, weight loss, rest, bracing and over-the-counter, anti-inflammatory medication. The next step may be injections of a steroid or hyaluronic acid gel, which can help with pain. If those measures fail, then we order an MRI and consider surgical options.
Q. Could you describe what an MRI of the knee might find?
A. One example of an injury an MRI can reveal is tears of the meniscus, which is rubbery knee cartilage that cushions the shinbone from the thighbone. Additionally, an MRI may show a ganglion cyst – a noncancerous lump filled with fluid – surrounding the anterior cruciate ligament (ACL), which is a key ligament that helps stabilize the knee joint.
Q. How would you help a patient with those conditions?
A. Using the minimally invasive arthroscopic technique, I would trim the meniscus on both sides of the knee, remove the cyst, and smooth the cartilage that interferes with the joint’s movement. I would also consider applying amniotic fluid to facilitate healing and help reduce pain.
Q. When would you consider recommending a total knee replacement?
A. If the MRI or x-ray shows that cartilage is absent and the knee is “bone on bone,” that’s a clear indication for a replacement. As long as the patient is otherwise healthy with no heart or lung problems, for example, they could be a good candidate for replacement surgery using a minimally invasive, robotically assisted technique.
Q. What does that surgery entail?
A. We upload a CT scan of the patient’s knee into a computer and create a surgical plan. We then upload the plan to the robot. During surgery, I guide the robot and use the scan to align the replacement knee perfectly. To close the incision, I use bioabsorbable sutures, instead of staples. A waterproof dressing allows the patient to shower right away. Patients are usually up and walking with the assistance of a walker the same day as the surgery, and often don’t require an overnight hospital stay.
Q. Can you give another example of how technological advances are helping restore patients to active lifestyles?
A. One example of a knee defect that an MRI can reveal looks like a “pothole” in the kneecap. To repair the defect, I open the patient’s knee, remove the damaged tissue and apply a high-tech patch containing cartilage cells. Then I apply amniotic fluid. The cartilage graft and amniotic fluid are examples of “orthobiologics,” new technologies and products that help reduce inflammation, accelerate healing and reduce pain. These are the same advanced technologies that are used on professional athletes.
Q. What would you tell someone who is dealing with chronic knee pain that’s keeping them from enjoying life?
A. Recent advances in technology allow for greater precision, faster healing, and in the case of minimally invasive surgical techniques, a less noticeable scar from the incision. I’m so pleased to be able to offer these options, even to patients of advanced years, and see them regain a more active lifestyle.
ShorePoint Health
VeniceOrthoCare.com
(941) 841-0442