I have a particular interest in treating injuries in athletes.
In my 20+ years in practice I have treated thousands of professional, Olympic, and recreational athletes. As a keen skier and tennis player myself and having treated many recreational, professional and Olympic athletes including skiers and snowboarders, I have a stated aim to get every injured skier and snowboarder back on the slopes and every injured athlete back on the field. I understand what it takes to get professional and recreational athletes back to their pre-injury sporting level.
Acute Knee Injury Clinic
To cater for the sports injury patients I run regular Acute Knee Injury Clinics. In my practice we keep specific appointments for urgent knee injuries so patients can be seen urgently, for prompt assessment and management of these injuries. Call 83826199 and ask for an urgent appointment at the Acute Knee Injury Clinic.
COMMON SPORTS INJURIES OF THE KNEE
Muscle strains – an injury where a muscle is torn causing pain and loss of function. Minor muscle tears are treated with rest, ice, elevation, and compression (RICE), support bandaging and physiotherapy.
MCL tear- Medial Collateral Ligament tears can occur with bending, twisting, or a quick change of direction. Medial collateral ligament tears often occur when the knee is hit or receives a direct blow from the outside. MCL injuries are graded from 1 to 3. Grade 1 being a mild strain and 3 a complete tear. Most MCL tears heal with a brace and conservative treatment but occasionally surgery may be required to stabilise the joint.
ACL tear – An Anterior Cruciate Ligament rupture can occur when the foot is planted and the knee twists to change direction. ACL tears and ruptures are one of the most common knee injuries. They do not heal satisfactorily and so the knee remains unstable and likely to give way. ACL tears are often associated with damage to other structures in the knee such as meniscal tears, MCL tears, injury to chondral surfaces, bone bruising and occasionally bone fractures. Reconstruction of the ACL is important to provide stability and help reduce the possibility of further injury or damage in the knee. ACL rupture occur accross a variety of sports including skiing, all football codes and netball. If patients opt not to have the torn ACL reconstructed, I strongly recommend against returning to sport with an unstable knee.
PCL tear – The Posterior Cruciate Ligament is most commonly injured with a blow to the front of the leg just below the knee, or with a hyperextension injury. This can occur with collisions in contact sports, skiing and other sports such as baseball and basketball. A PCL tear is also often associated with injuries to other ligaments and structures in the knee. Isolated PCL injuries do not always lead to an unstable knee and can often be managed without surgery.
LCL and PLC complex injuries- Injuries to the Lateral Collateral Ligament and posterior lateral corner result from a rotational force across the knee. A direct blow to the medial side (inside) of the knee, or a non-contact injury, such as a hyperextension injury may damage this ligament complex. It may be associated with an ACL. The LCL does not heal as well as the MCL but minors tears are usually best treated conservatively with rest and icing or a brace. Prompt surgical management is required for high grade acute LCL tears and possibly PLC complex tears.
Patellar dislocation- is an injury of the knee, typically caused by a direct blow or a sudden twist of the leg or both. The patella generally slips (dislocates) laterally out of its normal position in the femoral trochlea (groove) This causes acute intense pain, disability and swelling. Hyperextension of the knee usually accomplishes reduction and relocation of the patella. Young athletes, in particular females, suffer dislocation more commonly than any other group. Assessment for surgery either arthrocopic to remove articular cartilage dislodged by the dislocation or open surgery to stabilise the patella is delayed until swelling is settled and mobility has improved.
SPORTS INJURIES OF THE HIP
Labral tears –
The hip labrum is the ring of fibrocartilage that joins the hip capsule to the outside rim of the acetabulum or socket of your hip joint. It acts a a seal to help securely hold the the femoral head within the socket. A labral tear occurs when the labrum is torn from its attachment. Injuries forcing the hip into extreme positions or playing a sport that causes regular rotation of the hip such as golf, hockey or ballet, can cause the labrum tear. Symptoms may include pain, stiffness, clicking or catching. Most labral tears can be treated by resting the hip and avoiding the activities that cause aggravation. When symptoms are persistent and troublesome an arthroscopy of the hip may be required to remove the damaged portion and stabilise the labrum.
Platelet-rich plasma injections or PRP injections utilize the patient’s own blood platelets to promote healing of wounds and soft tissue disorders. They can be very useful in the treatment of sports injuries. PRP injections have been successfully used to help heal tendons, ligaments, muscles and joints.The may also help to reduce symptoms of osteoarthritis .
Platelets are derived from the cells in our bone marrow and are a component of the blood, along with red blood cells and plasma. In this procedure, the patient’s blood is drawn into a tube which is then spun down in a centrifuge in the office to isolate the platelet-rich plasma. The platelet-rich plasma is then injected into the injured area under local anaesthesia. Ultrasound imaging may be used to guide the injection. The concentrated blood components are rich in cytokines and growth and healing factors which, when released into the injured, promote and stimulate healing.
PRP injections are showing good results with improved function and decreased pain in clinical studies.
During my 20+ years as a sports orthopaedic surgeon I have been actively involved in the surgical management of sportsmen and athletes from the following teams and organisations:
Rugby League, NRL competition:
- Canterbury Bankstown Bulldogs
- Cronulla Sutherland Sharks
- St George Illawarra Dragons
- Penrith Panthers
- Australian Kangaroos
- NSW Blues
- Australian Wallabies
- Sydney University Football Club, Consultant knee surgeon since 2002
- Eastern Suburbs Rugby Union Football Club
- Australian Women's Rugby Team
Australian Rules Football, AFL competition:
- Sydney Swans
Basketball, NBL competition:
- Sydney Kings
- Sydney Razorbacks
- Consultant knee surgeon to the Sydney Olympic Games 2000
- Australian Cricket Team
- NSW Cricket Team
- Australian Women’s Cricket Team
- Thredbo Ski Patrol
- Perisher Valley Ski Patrol
- Thredbo Ski School (instructors)
- Perisher Valley Ski School (instructors)
- Scots College