Men\'s Health Australia - 11.2018

126 menshealth.com.au

Do You Really

Need A New Knee?

A recent study found that a third of the more

than 600,000 knee replacements done

a n n u a l l y i n t h e U S m a y n o t b e n e c e s s a r y.

Other research inds that more than

10 per cent of patients aren’t satisied

w i t h t h e r e s u l t s. “ Yo u n e e d t o h a v e

moderately advanced arthritis and to

have failed conservative care for total

knee replacement to be appropriate,” says

orthopedic surgeon Dr Nicholas DiNubile.

So before going under the knife (and

hammer and drill), ask yourself these

ive questions:

How bad is it?

People who are dissatisied after surgery

te n d t o h a v e h a d o n l y m i l d o r m o d e r a t e

pain, or no severe limitations on function,

beforehand. Your surgeon should be able to

see X-ray evidence of narrowed space in the

joint or bone-on-bone.

How strong are my quads?

Thigh muscles move and stabilise the joint,

so the bigger and stronger they are, the

more satisied you’ll likely be after surgery,

reports a study published in the Journal of

Orthopaedic Science.

How do I deal with pain?

People who ixate on pain or feel helpless

in the face of it can have trouble coping

with post-op discomfort and tend to be less

satisied with the results. If you are taking

narcotics or opioids, DiNubile strongly

advises making every efort to get of them

before surgery. You’ll have better pain relief

after surgery and a signiicantly better

s u r g i c a l o u t c o m e , h e s a y s.

A m I p r e p a r e d t o d o t h i s

again someday?

Prosthetic materials like titanium and

cobalt-chromium alloy still don’t have the

longevity of natural bone and soft tissue, so

switching out knees in your 50s and early

60s may mean needing a repeat procedure

i n a b o u t 2 0 y e a r s. T h a t ’s e s p e c i a l l y t r u e fo r

men, whose revision rates are signiicantly

higher than those of women – possibly

because we tend to resume strenuous

activities that injured us originally.

Have I tried everything else?

Don’t think of knee replacement as a

quick ix. Despite its popularity, keep in

mind that it’s still a major operation with

potential risks and extensive rehab.

–Laura Beil

TOP THREAT:

ANTERIOR

CRUCIATE

LIGAMENT TEAR

What it is:

A sprain of the front-most of

two ligaments that cross

each other (hence cruciate)

inside the knee. A mild sprain

may stretch the ligament

without affecting stability,

but more severe sprains can

partially or completely tear it,

leaving the joint loose and

likely to further damage the

knee’s cartilage.

Cause:

Excessive force from pivoting

in a pick-up basketball game,

jumping to spike a volleyball

or colliding with something

much larger than you. That’s

why ACL tears are common

among athletic younger men.

Treatment:

Surgery is usually needed,

especially if you want to play

sports again. Most ACLs can’t

be stitched together, so the

surgeon usually takes a graft

of your patella or hamstring

cause ACL tears can also

damage the meniscus, a

rubbery cartilage wedge that

provides cushioning inside

the knee. Normal ageing also

weakens the cartilage, so just

getting up from a crouch (or

couch) can tear an older

knee. “We see it a lot in

baseball catchers, plumbers

and carpet layers – anybody

who torques their knees for a

living,” says DiNubile. The

aforementioned leg-

strengthening program for

protecting the ACL is a good

defence here, too.

Watch Out!

Unless their meniscus tears

are due to trauma such as a

sports injury or a fall, people

who undergo a partial

meniscectomy do no better

than those receiving sham

surgery or physical therapy,

according to recent studies.

“If you’re over 50, when a torn

meniscus is probably

degenerative, you’re likely

better off with physical

therapy and maybe cortisone

injections,” Sennett says.

tendon (or a cadaver tendon)

and uses it as scaffolding to

reconstruct the ligament.

Defence:

Stronger leg muscles make

knee joints more stable. To

strengthen yours, do these

three exercises: walking

lunges (3 sets of 10 reps);

Russian hamstrings (kneel on

the floor with a partner

holding your ankles, then

lean forward with a straight

back for 3 sets of 10 reps);

single toe raises (30 reps

each leg). For a complete

knee-protection plan, visit

aflcommunityclub.com.au

and search for the Footy First

program developed by a

group of leading academics

funded by the NHMRC. It

provides a regimen that

includes leg exercises, plus

warm- ups, stretches,

strengthening exercises and

plyometrics aimed at

reducing ACL injuries.

Future-Proof

Your Knees:

The forceful movements that

KNEE

TYPE OF JOINT:

Hinge

Four main ligaments bind

the thighbone (femur)

with the shinbone (tibia)

and kneecap (patella).

Knees are versatile and

strong but vulnerable to a

variety of breakdowns.

THE AFL’S LUCKLESS ALEX JOHNSON

HAD HIS SIXTH BOUT OF MAJOR KNEE

SURGERY AFTER SUFFERING ANOTHER

ACL TEAR IN AUGUST.