Knee Treatments

Knee Pain Treatment in Austin, TX

Dr. John McDonald is highly experienced with surgical treatment for knee conditions. The knee is one of the most commonly injured joints in the body, and problems can develop as a result of a sports injury, a fall, or degenerative diseases, like arthritis. Many times, arthroscopic knee surgery is an option that gets people back to doing what they want to do quicker than traditional open surgery.

Knee procedures include:

ACL Reconstruction

The goal with any orthopedic surgery, especially ACL reconstruction surgery, is to regain full mobility and pain-free movement.  A patient having ACL reconstruction has several choices when it comes to which graft will be used. Dr. McDonald will discuss the pros and cons of each graft option at the preoperative appointment and give his recommendation based on the individual patient's injury, history and goals. Below is a list of the pros and cons of each graft option.

BONE-PATELLAR TENDON-BONE

Pros

  • Bone to bone healing both tunnels
  • Comparable stiffness to native ACL
  • Historic gold standard

Cons

  • Risk of front knee pain
  • Larger incision
  • Risk of knee cap fracture
  • Fixed length
  • Numbness side of knee

HAMSTRING

Pros

  • Ease of harvest
  • Smaller incision
  • Minimal donor site problems

Cons

  • Soft tissue to bone healing (slightly slower initially)
  • Graft size can be unpredictable
  • Not as suitable for athletes that rely heavily on hamstring muscles (elite soccer, skiing)

ALLOGRAFT (CADAVER)

Pros

  • No donor site problems
  • Available in various types and sizes
  • Smallest incision
  • Excellent choice for revision surgery

Cons

  • Theoretical risk of disease (FDA regulated)
  • Longer healing time (9-12 months)
  • Increased risk of re-rupture in patients under 18 / young athletes

QUADRICEPS TENDON

Pros

  • Large graft
  • Option of one-sided bone block

Cons

  • Invasive, large incision
  • Risk of knee cap fracture

Dr. McDonald believes it is important for patients to understand that while smoking after an ACL reconstruction is not prohibited, when compared to patients who do not smoke, there is an increased risk of infection (2% vs 0.9%), deep venous thrombosis (DVT) (1% vs 0.5%), and re-rupture of the ACL graft (12.6% vs 7.8%) in patients who smoke.

Dr. McDonald emphasizes physical therapy and movement early on in order to recover full range of motion within 6 weeks after surgery. Strength and endurance will gradually develop over time, but Dr. McDonald says that if you cannot extend your knee completely at 6 weeks post-surgery, it will be difficult to achieve without additional strain on your muscles. This is true for any ligament or tendon repair in the knee.

Find additional knee conditions and procedures in our patient education library.

To make an appointment with Dr. McDonald in Northwest, Central, or South Austin, please call Texas Orthopedics at (512) 485-0517 or schedule an appointment online. We look forward to meeting you soon.