Category Archives: News and Events

Knee Pain? Learn about Knee Tendinitis

Consider this statement, “Many people who participate in sports or fitness activities will get tendinitis at one time or another.” If you’re an avid athlete or fitness enthusiast like myself, chances are you have felt the discomfort of pain in your knees.

What is tendinitis?

Tendinitis is a persistent inflammation in the tendons. Typically in the knee, this involves the patella tendon between the kneecap and the tibia bone or the quadriceps tendon between the quadriceps muscle and the kneecap. The illiotibial band and the hamstring tendons can develop tendonitis as well. Injuries that do not adequately heal result in persistent inflammation and scar formation.

knee_dr stickneyOveruse is a common risk factor for tendinitis. When the tendon is stretched repeatedly by doing the same kind of exercise over a long period of time, the tendon can become strained and inflamed. Runners often get tendinitis for this reason. Tendinitis can also be caused by intense exercise over a short period of time.  For example, exercising all weekend to make up for the lack of physical exercise during the week. As we age our tendons become more brittle which makes our knees more vulnerable to stress and strain.

Tendinitis is usually treated with therapy, anti-inflammatory medications, and activity modification that allows for healing. Here are some tips to treating knee tendinitis:

  • Rest – Refrain from the activity that caused the tendinitis.
  • Ice – Apply ice wrapped in a towel for 15 minutes once or twice a day. Ice helps reduce swelling, which will lessen knee pain and speed healing of the tendon.
  • Elevate – Lie down and place your knee on a pillow so that it’s higher than your heart. This will aid blood flow and help reduce swelling.
  • Compress – Wrapping the knee in an elastic knee bandage can help reduce swelling and ease knee pain.
  • Ease back into activity – After your tendinitis disappears, don’t immediately go back to the same level of activity that caused your knee pain. Overdoing it can cause a recurrence of tendinitis. Warm up and stretch before beginning exercise. Then go slowly for a few weeks.

If you are suffering from knee tendinitis and would like more information on how to treat it, please call me at 425-823-400 or email me at ProOrthoAppointment@proliancesurgeons.com to schedule an appointment.

Hip Replacement – Performing the Anterior Approach

Considering a hip replacement is no easy decision. There are various procedures in the orthopedic marketplace. There are 3 common approaches to the hip replacement. The Posterior Approach is the most common traditional approach. The lateral approach has a lower dislocation risk but a much higher incidence of limp after surgery. I have been performing the anterior approach for total hip replacement for years. In fact, I am the only orthopedic surgeon in Kirkland, WA that performs this procedure.

How does the anterior approach to total hip replacement differ from the traditional hip replacement surgery? For one, the anterior approach is a tissue-sparing alternative. The approach to the hip from the front does not involve cutting any major structures to get to the hip. Instead, the interval between two muscles is separated, leading to the hip capsule. I work between your muscles and tissues without detaching them from either the pelvis or thighbones – sparing the tissue from trauma. The Traditional posterior approach from the back requires dividing the gluteus maximus (butt) muscle and splitting part of the ilio-tibial band on the side of the hip and then cutting several small tendons off the back of the hip.

Many surgeons are hesitant to perform the anterior approach because it is new since their training. The special equipment necessary to perform this approach has only been popularizer in the past 5 years. This approach is through a much smaller incision and is technically demanding. The anterior approach uses a special table called a Hana table that allows me to position the leg in a very specific way to place the hip components. All of the operating room staff and my assistants are used to doing this approach.

Benefits to the anterior approach for hip replacement include:

  • Faster recovery time and improved mobility – The muscle tissues are spared during the surgical procedure
  • Less pain – No hip precautions when at home like having to put a pillow between the legs when at rest
  • Limping is eliminated on average 16 days after anterior hip approach vs. 24 days after a posterior approach. Pain relief is faster, 98% of patients are off narcotics 2 weeks after an anterior approach, vs. 70% off narcotics after a posterior approach.
  • Agility – There are no restrictions on hip flexion after an anterior approach.

If you are considering hip replacement and would like more information, please call me at 425-823-400 or email me at ProOrthoAppointment@proliancesurgeons.com to schedule an appointment.

Dr. Jeff Stickney Recognized as 2014 Top Doctors by Seattle Met Magazine

seattle-met-logoCongratulations Dr. Stickney for being recognized as a “Top Doctor of Seattle” by Seattle Met Magazine!

 

According to Seattle Met Magazine, “The panel’s criteria to select the finalists included a provider’s years of experience and competency within his or her specialty, rapport with patients, including patient satisfaction and compliance with care recommendations, and ability to work effectively with colleagues across specialties to deliver the best care for patients.”

Dr. Jeff Stickney practices in Kirkland Washington. He subspecializes in sports medicine and joint reconstruction. He is board certified in orthopedic surgery and specialty board certified in sports medicine. His primary interest is in knee, hip, and shoulder problems. His joint replacement practice emphasizes minimally invasive procedures and computer guided navigation in knee replacements. He was educated at the University of South Florida and The University of Washington.

Visit Dr. Stickney’s web site at www.stickneymd.com or call and schedule an appointment at 425-823-4000.  You can also email him at ProOrthoAppointment@proliancesurgeons.com.

Common Weightlifting Injuries

Weight lifting is a sport as well as part of someone’s exercise regimen.  Experienced weight lifters rarely suffer serious injuries but newcomers to the sport or exercise are more prone to musculoskeletal injuries.

 

Distal biceps rupture:

This is a rupture of the biceps tendon that attaches the biceps muscle in the arm to a bone of the upper forearm. A weightlifter can rupture this tendon at the elbow with a sudden force that extends the elbow while trying to contract the biceps. Performing a biceps curl and then losing control of the weight is an example. Surgery to reattach the tendon is usually needed. Choosing a weight that a person can lift and control can help prevent a distal biceps rupture.

 

Labral tear:

The labrum is a cartilage bumper in the shoulder that surrounds the glenoid (socket). With repetitive compression of the labrum or possibly an acute motion that injures the shoulder, the weightlifter can feel discomfort or a clicking sensation deep within the shoulder. An orthopedic surgeon can perform a physical exam and tests that suggest a labral tear. An MRI with contrast injected (MR arthrogram) can demonstrate a tear. Surgery is often required to treat a shoulder labral tear if it limits activity. Proper technique and having shoulder pain evaluated early if it is not improving can be helpful.

 

Shouldering impingement:

This is more of a cause of chronic shoulder pain in a weightlifter rather than an acute injury. Avoiding exercises that cause pain can help the problem. Working with a physical therapist to improve shoulder mechanics and strengthen the muscles around the shoulder can often speed recovery. Seeing an orthopedic surgeon or a physical therapist when this problem develops and starting a treatment program can often accelerate return to overhead lifting.

 

Lower back muscle strain:

A strain of the muscles of the lumbar spine can occur from using improper technique with exercises or picking up or putting down weights awkwardly. Fortunately most don’t require more aggressive treatment than rest and activity modification. Proper lifting technique is key.

 

Quadriceps or hamstring muscle strain:

Acute strains of the quadriceps and hamstring muscles from squats, leg presses, lunges and other lower extremity exercises can occur. Most heal without surgery and require only rest and short-term exercise modification. Proper exercise techniques and choosing an appropriate amount of weight can help prevent injuries.

 

 

Patellar or quadriceps tendonitis:

These are also more chronic issues with the tendons around the knee than acute injuries. Pain in the tendons above or below the kneecap with lower extremity exercises can develop and worsen over time. Often short-term avoidance of exercises that reproduce the pain, anti-inflammatory medication, and ice can resolve the problem.

 

Many of the injuries listed above can be prevented by using proper technique. Often simply rest and short-term activity modification can prevent a minor pain from turning into a more serious injury.

 

If any musculoskeletal pain continues to limit your ability to work out the way you want, consider visiting Dr. Stickney to learn and understand possible treatments by calling 425-823-400 to schedule an appointment or email him at ProOrthoAppointment@proliancesurgeons.com.

 

 

Housemaid’s Knee (Prepatellar Bursitis) – Know the Signs and Symptoms

Housemaid’s knee is also known as prepatellar bursitis. It is caused by inflammation of the bursa (a small fluid-filled sac) in front of the kneecap. It more commonly occurs in people who spend long periods of time kneeling. Housemaid’s knee is more common in tradesmen who spend long periods of time kneeling -for example, carpet fitters, concrete finishers and roofers.

Any age group can be affected by housemaid’s knee. It is generally more common in males than in females. Housemaid’s knee in children is more likely to be caused by infection. Infection is also a common cause of housemaid’s knee in people whose immune systems are not working normally; people include those receiving steroid treatment or those on chemotherapy treatment for cancer.

What is bursitis?

Bursitis means inflammation within a bursa. A bursa is a small sac of fluid with a thin lining. There are a number of bursae in the body. Bursae are normally found around joints and in places where ligaments and tendons pass over bones. They can also be found in other places if there has been unusual pressure or friction placed on that area.

Generally, the function of a bursa is to help reduce friction and allow maximum range of motion around joints. When there is inflammation within a bursa (bursitis), the bursa swells due to an increase in the amount of fluid within the bursa sac.

 

What is housemaid’s knee?

There are four bursae located around the knee joint. They are all prone to inflammation, or bursitis. However, the prepatellar bursa (the bursa in between the skin and the kneecap) is most commonly affected. Its position is shown in the diagram. Housemaid’s knee is the name given to inflammation of the prepatellar bursa.

What causes housemaid’s knee?

There are a number of different things that can cause housemaid’s knee:

·      A sudden, one-off, injury to the knee – For example, a fall or direct blow on to the knee

·      Recurrent minor injury to the knee – This usually happens after spending long periods of time kneeling down, putting pressure on the kneecap (patella). Historically, this was typical of housemaids who spent long periods of time on their knees scrubbing floors; hence, the term housemaid’s knee.

·      Infection – The fluid in the prepatellar bursa sac can become infected and cause inflammation within a bursa (bursitis). This is particularly common in children with housemaid’s knee. This usually follows a cut, scratch or injury to the skin on the surface of the knee. This injury allows germs (bacteria) to spread infection into the bursa.

·      Another inflammatory disease – If you already have an inflammatory disease such as rheumatoid arthritis, you have an increased risk of developing a bursitis. Rheumatoid arthritis is a form of arthritis that causes inflammation, pain and swelling of joints.

·      Gout – If you have gout or pseudogout, you have an increased risk of developing a bursitis. Gout is caused by a build-up of uric acid crystals. Uric acid is a chemical in the blood that is usually harmless and passed out with the urine. In gout, it builds up and collects within a joint, causing pain, inflammation and joint swelling.

 

How is housemaid’s knee diagnosed?

Dr. Stickney is usually able to diagnose housemaid’s knee simply by examining your knee. He may ask you questions about your occupation or if you have had any recent knee injury and if you have any history of other joint problems.

If Dr. Stickney suspects that housemaid’s knee is caused by infection, he may suggest that they draw some fluid from the bursa. This is a straightforward procedure. The skin on the front of your knee is sterilized with some fluid and the procedure is carried out in a clean environment. A small needle is used to take a sample of the fluid from your prepatellar bursa, which is directly underneath the skin in front of your kneecap. This fluid is sent off to the laboratory to look for signs of infection. If infection is confirmed, the laboratory may be able to suggest which antibiotic medicines will treat it.

Treatment options for Housmaid’s Knee

Episodes’ of housemaid’s knee will settle with medical or supportive treatment unless infected, in which case, your Dr. Stickney may draw fluid, send for lab tests and prescribe some form of antibiotics. Drug or surgical treatment is determined in the treatment plan if the injury is recurring and/or infection is extreme.

If you are suffering from housemaid’s knee, call Dr. Stickney and schedule an appointment at 425-823-400 or email him at ProOrthoAppointment@proliancesurgeons.com.

Jeff Stickney, M.D. Launches Web Site

Dr. Stickney is pleased to announce the launch of his web site, www.stickneymd.com. Staying true to his commitment of helping everyone stay healthy, active, fit and free of injury, Dr. Stickney hopes that by launching his site, patients and people suffering from pain and injury are able to determine their next course of action when faced with an orthopedic injury.

The site, www.stickneymd.com features:

Post Op Protocols: Knee and Shoulder
Patient Education: Ankle, Elbow, Fractures, General Health, Hip, Knee & Shoulder information
Links to Office Registration Information
• Links to Dr. Stickney’s latest Facebook and Twitter posts
• Link to Dr. Stickney’s YouTube videos

Dr. Jeff Stickney practices in Kirkland Washington. He sub-specializes in Sports Medicine and Joint Reconstruction. He is Board certified in orthopedic surgery and Specialty board certified in Sports Medicine. His primary interest is in Knee, Hip, and Shoulder problems. His joint replacement practice emphasizes minimally invasive procedures and Computer guided Navigation in Knee replacements. He performs minimally invasive anterior and posterior approach hip replacement. He was Educated at the University of South Florida and The University of Washington.

Dr. Stickney is the chief of the department of Orthopedics at Evergreen Medical Center, the Managing Partner at ProOrtho. He is an active member of the Arthroscopy Association of North America and the American Academy of Orthopedic Surgeons.

Visit www.stickneymd.com and learn more about Dr. Stickney and his orthopedic services. If you are suffering from an orthopedic-related injury, call Dr. Stickney at 425-823-4000 to schedule an appointment.