31. Orthopedic Surgeon Answers Your Submitted Questions About The Most Common Orthopedic Skiing Injuries at the Knee (feat. MD Nick Kennedy)

Dr. Nick Kennedy is an orthopedic surgeon that specializes in working with the knee and he comes on today's podcast to answer the questions you submitted about the most common knee injuries for skiers.

Meniscus

1. (00:02:25) A client has knee pain on the anterior lateral aspect after a meniscus repair, but their MRI comes back clean. What additional diagnostics or treatments can they pursue?
2. (00:04:29) What is the recovery time after a diagnostic arthroscopy? Can someone still ski if they have an upcoming trip?
3. (00:05:32) If someone has had a meniscus repair but their tissue looks clean, would you attempt another repair, or is a meniscectomy or another procedure a better option?
4. (00:06:58) Can you explain the differences between a meniscus repair, a meniscectomy, and a meniscus transplant? What determines whether someone gets one procedure over another?

Meniscus Root Tear

1. (00:09:21) What is a meniscus root tear, and what should someone do if they are diagnosed with one?
2. (00:10:21) How serious is a meniscus root tear? What are the long-term consequences if it is not treated?

Patellar Tendon

1. (00:11:19) What orthopedic interventions are available for someone with chronic patellar tendon pain after conservative management has failed?
2. (00:12:54) Many patients who have had a patellar tendon graft for ACL reconstruction report anterior knee pain. Are there specific cases where you would recommend a different graft type?

Tibial/Fibular Fractures

1. (00:15:03) After a tibial plateau fracture is repaired, is it beneficial to have the hardware removed, or is there a long-term risk of developing arthritis?
2. (00:16:49) Some people experience pain where their ski boot cuff meets the site of their previous tibial fracture. What can be done to manage this discomfort?

Osteoarthritis

1. (00:18:15) If someone has grade 4 osteoarthritis, what strategies can they use before considering total knee replacement?
2. (00:21:38) What are your thoughts on skiing with a total knee replacement? Is it possible, and what modifications should be made?
3. (00:21:50) Can you explain the Macy procedure and how it might help with osteoarthritis?
4. (00:23:32) What is the recovery time for the Macy procedure?

ACL Injuries

1. (00:24:58) What factors influence the timeline for returning to skiing after ACL reconstruction? What can be controlled vs. what is dictated by biology?
2. (00:25:52) Research suggests that returning before 9 months increases the risk of re-tear. What are your thoughts on this?
3. (00:28:38) How important are dynamic landing tests when assessing readiness to return to skiing?
4. (00:29:03) What should be considered when testing ACL function under fatigue, rather than only when fresh?
5. (00:31:16) What are the different types of ACL grafts, and who are the best candidates for each type?
6. (00:34:07) Can you explain the BEAR implant for ACL repair? How does recovery differ between BEAR and traditional ACL reconstruction?
7. (00:37:25) Can some people return to skiing without an ACL reconstruction? Who might be a good candidate for non-surgical management?

Returning to Skiing After Surgery

1. (00:39:19) What advice do you have for skiers in their first year back after ACL surgery?
2. (00:40:36) Should skiers wear a brace in their first season back? If so, what type of brace do you recommend?
3. (00:42:29) How do you determine when pain is a normal part of recovery vs. when it indicates a problem?
4. (00:44:05) If someone has limited knee flexion or extension after surgery, how aggressively should they work to regain full range of motion?
5. (00:46:56) If someone gets injured while skiing overseas, how long should they wait before flying home? Should they delay surgery?

If you want to ask Dr. Kennedy any questions, you can reach out via his instagram: https://www.instagram.com/nickthekneemd/

Visit his website: https://www.nickthekneemd.com/

Purchase his book “The Knee Injury Bible”

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