KNEECARES - The Superspeciality Knee Clinic

  Dr Amit Meena is a fellowship-trained orthopaedic surgeon specializing in Joint Replacement and Sports Injuries and an internationally recognized expert on the diagnosis and treatment of complex knee problems. Dr Amit  Meena  completed both his medical education and orthopaedic training at   Vardhaman Mahavir Medical College & Safdarjung Hospital, New Delhi . He then received a three-year appointment as a senior orthopaedic surgeon at the Central Institute of Orthopaedics, Safdarjung Hospital, New Delhi. Later on, he joined the world-famous  Rizzoli Orthopedic Institute, Bologna, Italy  and began his specialized training with Prof. Stefano Zaffagnini in knee surgery and performed numerous complex knee surgeries. He also carried out landmark research into knee replacement, knee ligament injuries, effects of immobility, injury prevention, and diagnosis and treatment of serious knee disorders. He further joined  Gelenkpunkt – Sports and Joint Surger...

  Multi-Ligament Knee Injury A complex knee injury is a situation where multiple ligaments in the knee have been damaged. The knee contains several major ligaments, including the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). When two or more of these ligaments are injured simultaneously, it's often associated with knee dislocations. Multi-ligament injuries are relatively uncommon and typically occur due to severe accidents, traumatic sporting falls, or high-impact events. Treating complex knee injuries and performing multi-ligament knee surgery is a highly intricate process. To achieve the best results, it's essential to consult with a knee specialist who specializes in complex knee surgeries. Description of Complex Knee Surgery In cases of two-ligament knee injuries, with the exception of combined ACL and MCL injuries, a combined surgical reconstruction is typically recommen...

  Why did my ACL Reconstruction surgery fail? Why might an ACL reconstruction surgery fail? While it's true that only about 10% of grafts fail, understanding the reasons is crucial. The most frequent cause is technical issues during the initial surgery. The precision required in ACL reconstruction is well-known, and surgeons with more experience tend to achieve better outcomes. Misplaced graft reconstruction tunnels, whether too posterior on the tibia or too anterior on the femur, are still common culprits for failure. Another prevalent reason is untreated secondary instabilities. These could involve injuries to the posterolateral corner, meniscal root detachment, or the absence of the posterior horn of the medial meniscus. These factors, along with others like an unnoticed PCL injury, medial knee issues, or alignment problems in patients with arthritis, contribute to ACL reconstruction failures. Consequently, a comprehensive evaluation of secondary knee restraints and the ...

Meniscus Injury Overview The knee's medial and lateral menisci are vital shock absorbers that safeguard the cartilage and prevent the onset of osteoarthritis. They also contribute significantly to knee stability, making them a fundamental part of knee anatomy. Loss of the menisci can lead to early osteoarthritis and knee instability, particularly when combined with ligament reconstruction. Menisci consist of fibrocartilage and have a meager blood supply. Consequently, meniscal tears along the edges, especially on the inner side of the knee, typically have a low likelihood of spontaneous healing. Surgical intervention is often necessary to address meniscal tears, particularly when they are closer to the joint lining, known as meniscocapsular separations. DESCRIPTION OF MENISCUS SURGERY. In general, Dr. Amit Meena will always try to preserve the meniscal tissues to prevent further development of osteoarthritis, especially if there is a concurrent ACL reco...

  Patella Dislocation Patients who have a tracking problem in the patellofemoral joint - the patella does not stay in the groove on the femur - are vulnerable to a spectrum of conditions. These include subluxations, in which the patella slips partially but not completely comes out of the trochlea, as well as dislocations, a traumatic injury in which soft tissues are damaged as the patella completely “jumps” the track and then comes forcibly back into place. Because the bone always dislocates outward, the ligament on the inside - the  medial patellofemoral ligament  (MPFL) tears or stretches. People who experience a first-time patella dislocation frequently do so while participating in sports, causing the knee to suddenly buckle and they fall. “Because ACL tears often happen in the same way, and because they are much more common than patella dislocations, it is important to rule out an ACL tear. Physical signs of dislocation include significant swelling of the knee an...

  Overview of LCL Pathology In patients who have a complete lateral, or fibular collateral ligament (LCL), tear and noticeable side-to-side instability with activities, a lateral collateral ligament surgery is recommended. The term fibular collateral ligament (FCL) is more anatomically correct, but is more commonly referred to as lateral collateral ligament (LCL). LCL surgery is very effective in restoring side-to-side stability to the knee and preventing varus gapping. During a clinical exam and varus stress radiographs, we will be able to confirm whether or not there is a complete LCL tear. It is important to note that an MRI scan can be inaccurate – especially in cases of a chronic situation where the LCL heals improperly – that is why it is important to properly analyze the pathology. Treatment for LCL Injury The treatment approach for an LCL (Lateral Collateral Ligament) injury depends on its severity. In less severe cases, the RICE method (Rest, Ice, Compression...

  Tips for Avoiding Twisting After a Knee Replacement After undergoing knee replacement surgery, it is crucial to engage in specific exercises that promote strength, flexibility, and stability in your new knee joint. These exercises will not only help you regain your mobility but also protect your knee from unwanted twisting and potential injury. In this article, we will explore various  knee replacement exercises  that you can incorporate into your daily routine. Prevent knee injury Protecting your new knee from twisting is essential to prevent potential injuries and ensure a successful recovery. By following a few simple tips and precautions, you can minimize the risk of complications and maintain the longevity of your knee replacement. Let's take a closer look at some effective strategies to avoid twisting after a knee replacement. Knee replacement precautions During the recovery period after knee replacement surgery, it is vital to take certain precautions and avoid ...

  Articular Cartilage Damage Treatment Osteoarticular cartilage, a remarkable tissue within our joints, constantly faces stress and is susceptible to traumatic injuries or degenerative conditions, particularly in weight-bearing joints like the knee. When individuals, whether teenagers, young adults, or mddle-aged adults, develop localized full-thickness cartilage or cartilage and bone defects, this essentially mirrors a localized form of osteoarthritis. For patients with substantial defects, especially those involving bone, a highly effective treatment for cartilage deficiency is the utilization of fresh osteoarticular allografts. These allografts are sourced from young donors with knee sizes matching the affected patient. Our findings show that fresh osteoarticular allografts have led to significant functional and clinical enhancements, with outcomes similar to historical reports from other centers for patients treated with such implants, after an average follow-up...

Osteochondral Autograft Transfers Our joints are equipped with a resilient, smooth substance known as cartilage. This essential surface facilitates the effortless and painless gliding of joints, granting us the freedom to move and flex. However, as the natural aging process unfolds or as we engage in sports and physical activities , this cartilage can begin to deteriorate and sustain damage. This deterioration can give rise to specific conditions that manifest as knee joint pain, stiffness, and swelling. One of the notable procedures designed to alleviate these issues is osteochondral autograft transfer (OATS). In this surgical technique, a small plug consisting of both bone and cartilage is extracted from a less weight-bearing area of the knee using a specialized cylindrical coring device. This plug is then transplanted into an area of the knee that exhibits a symptomatic osteochondral defect. Typically, OATS procedures are performed arthroscopically. It’s worth noting that the targe...

  Essential Guidelines on How to Drive Safely After Joint Replacement Surgery After undergoing joint replacement surgery, ensuring your safe return to driving involves following several essential guidelines. These steps will help you build confidence and promote your well-being as you transition back to driving. Effective Tips for Driving Safely After Joint Surgery Driving safely post-surgery requires adopting specific strategies and practices that cater to your unique recovery needs. Here are some effective tips to help you regain driving independence safely: Follow your doctor's recommendations and advice on when it's safe to resume driving. Take pain medications as prescribed to manage any postoperative discomfort effectively. Engage in physical therapy exercises to improve strength, flexibility, and mobility. Perform trial runs in less congested areas to gauge your readiness and adapt to driving again. Understanding the Relationship Between Joint Replacement Sur...

  PCL Reconstruction If you are experiencing pain in the ligament behind the knee, you may be a candidate for PCL knee surgery. The posterior cruciate ligament, often referred to as the PCL, stands as the most robust ligament within the knee joint. Regrettably, a torn PCL is frequently overlooked and remains undiagnosed. The primary role of the posterior cruciate ligament is to prevent the backward translation of the knee, particularly at higher knee flexion angles. Consequently, individuals often experience issues related to deceleration, navigating stairs or inclines, and participating in activities that involve twisting, turning, or pivoting. PCL injuries are typically classified based on the extent of damage to this critical ligament: GradeGrade 1 PCL Sprain: Involves a partial tear of the PCL. Grade 2 PCL Tear: Indicates a nearly complete tear of the PCL. Grade 3 PCL Tear: Represents a complete tear of the PCL, rendering the ligament non-functional. Understanding the severity ...