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Joints are held together with ligaments. Sometimes a ligament can tear causing a great deal of pain. The anterior cruciate ligament is located at the center of your knee. It prevents your tibia (shin bone) from moving forward onto your femur (thigh bone).

A torn ACL (anterior cruciate ligament) can cause your knee to collapse during strenuous activity. Not only is this immediately dangerous, it can lead to repeated collapse, causing cartilage damage and arthritis.

Fortunately, damaged ligaments can be replaced. ACL reconstructive surgery replaces your old anterior cruciate ligament with a new one. This new ligament could come from you (autograft) or from a cadaver (allograft).

If you decide to use an autograft, the tissue will probably come from your hamstring or the front of your knee (your patellar tendon).

There are pros and cons to both types of grafts; however, both are usually successful for most people. Talk with your surgeon to find out more.

Click here for more on treating ACL tears .

ACL Reconstruction is usually done under general anesthesia using arthroscopy.

Arthroscopy allows your surgeon to see the interior of your knee via a tiny camera inserted through a poke-hole. This allows your surgeon to see, not only the torn ACL , but also any other problems you may be having with your knee. These problems can be addressed during your ACL reconstruction.

There will be a few other incisions in addition to the poke-hole. First, if you are using your own tissue, an incision will need to be made to remove it. This is rather a larger incision. Then a few smaller incisions will be made to access and remove your damaged tissue. Your new tissue will be inserted via bone tunnels. It will be placed perfectly and secured with screws or a variety of surgical fasteners as appropriate.

When your surgery is done and your incisions have been closed, your knee will be bandaged, and you will be given time to recover from your anesthesia. At this time, you may be able to see the video of your surgery and confer with your surgeon on his or her findings and any concerns or questions you may have in mind.

One of the most frequent musculoskeletal injuries is the rotator cuff injury. Sometimes this type of injury is not associated with symptoms, but usually it is quite painful. A rotator cuff tear or rotator cuff tendonitis can cause you to experience pain and weakness in the shoulder when using your arms. It can be especially painful to lift the arm higher than shoulder level. Luckily, there are a number of ways to treat rotator cuff injuries – both surgical and non-surgical. The type of injury you have, your condition, and your age will be determining factors in deciding which type of treatment is right in your situation.

There are two categories of rotator cuff injury. One is rotator cuff tendonitis. The other is rotator cuff tear. Be aware that there are several other conditions that could be the cause of shoulder pain. The only way to get an accurate diagnosis of rotator cuff injury is to see a doctor. He or she will first look at the symptoms and perform a basic physical examination. After this, the physician may use a local anesthetic that will be injected into the injured shoulder. This will help determine whether the injury is a muscle tear or tendonitis. If the injury seems to be a rotator cuff tear, the doctor may order some imaging tests. These will help confirm that the injury is a tear and isolate the location of the injury.

It is far more common for the diagnosis to be rotator cuff tendonitis; however, the treatment for tears is very similar to the treatment for tendonitis. Both can be treated conservatively with what is known as RICE therapy. That is: rest, ice, compression, and elevation. You may also want to use an over-the-counter pain medication like ibuprofen. Additionally, your doctor may give you a referral to a physical therapist to learn how to modify your movements and to get a list of exercises that may be beneficial to you. If your tendonitis pain persists, your doctor may give you injections of a steroid/anesthetic mixture. These would be administered to the joint to relieve pain.

About half the patients using this kind of non-surgical treatment experience an increase in ROM (range of motion) and a decrease of pain within 2 or 3 months. This kind of treatment has several advantages. First of all, non-invasive treatment avoids surgical risks such as infection, anesthesia complications, and permanent stiffness. Second, there is no recovery time involved. Of course, there is also a downside in that this route could lead to an increase in the size of the tear. Additionally, the patients activity level may be decreased during the healing period. And, there is the risk that a non-invasive method may simply not work. If this is the case, and the non-invasive option fails, then surgery may be the alternative. The doctor may also decide that surgery is the better option if he or she feels that the injury is severe enough to merit it as the first option.

Click here for more on rotator cuff tears .

Rotator cuff injuries can be treated surgically in three ways:

The method that allows the surgeon to operate most freely is called open repair surgery. This method utilizes a full incision in the shoulder. This option can leave a rather large scar.

The second method is mini-open repair surgery. While this method is similar to open repair surgery, it differs somewhat in that it utilizes arthroscopy. The use of arthroscopy allows the surgeon to make a smaller incision, leaving a smaller scar. This method is an outpatient procedure.

3. All arthroscopic surgery: This option is an outpatient procedure, and it uses the smallest incision.

The doctor will determine which procedure will work best based on the specific injury.

Happily, rotator cuff surgery is a highly successful surgical procedure. Eighty to ninety-five percent of patients who have this type of surgery report successful results, improved range-of-motion and a significant decrease in pain in six months or less.

The expertise of the surgeon is a very important factor in the successful outcome of the surgery. However, there are some variables to keep in mind when considering speed and success of recovery. Among them are the type of tear, tissue quality, the patients age, and the amount the patient complies with the doctors instructions.

It is rare to experience complications with rotator cuff surgery. Tendon re-tear, which is the most commonly experienced complication, only occurs in about 6% of patients. One or two percent may have nerve injury. As little as one percent of patients may contract infection. Detachment of the deltoid muscle and/or stiffness are experienced by fewer than one percent of patients.

When you tear the anterior cruciate ligament in your knee, your doctor will probably recommend ACL (anterior cruciate ligament) Reconstruction surgery. When this is the case, it is important that you understand that the tissue to be used in your surgery can come from a variety of sources.

You may wonder where this tissue will come from. There are a couple of ways to get tissue for an ACL (anterior cruciate ligament) reconstruction. One way is to take the tissue from the patients body. This is called an autograft. The tissue is usually taken from the hamstring or the patellar tendon. This is the tendon at the front of the knee.

You may also receive tissue that has been taken from a cadaver (dead person). This is called an allograft.

There are good and bad points about each choice. Your surgeon will talk with you about the options and help you decide which would work best in your situation.

Arthroscopy is usually used when performing ACL (anterior cruciate ligament) reconstruction. In this type of surgery, a small incision called a poke-hole is created to allow the surgeon to insert a very small camera into the knee. This lets the surgeon see the condition of the interior of your knee.

Your surgeon will examine the ligaments and the cartilage in your knee. If he or she finds that there has been other damage (for example, a meniscus tear) it will be taken care of during your surgery.

Several types of anesthesia are used for arthroscopic knee surgery, but you will probably receive general anesthetic. This will allow you to sleep during the surgery. While you are sleeping, your surgeon will replace your ACL (anterior cruciate ligament).

Click here for more on ACL Reconstruction .

Your surgeon will also make a few other small incisions around the knee. These will allow the surgeon to place your new ligament properly. Your damaged ligament will be taken out with a shaver or some other instrument. The exception to this is that, if you will be using an autograft, a larger incision will be needed to remove the tissue that is to be used for grafting.

Your surgeon will create bone tunnels that will allow the new ligament to be placed in exactly the same position as the old ligaments. Screws or other surgical fasteners will be used to secure the ligaments into their proper positions. When the surgery is done, your surgeon will place a dressing on your knee.

Your surgeon will probably take photos and/or film your operation so that you can watch it on the video monitor after your surgery is done. This technique allows the surgeon to discuss findings with you in detail.

To be considered for ACL (anterior cruciate ligament) reconstruction, some symptoms you might be experiencing include, knees that give way, weakness and instability in the knees, and knee pain. If your ADL (activities of daily living) are affected and/or you are not able to participate in sports as you wish, these are further reasons to consider ACL (anterior cruciate ligament) reconstruction.

As with any surgical procedure, there are some risks involved. Excessive bleeding, nerve damage and infection occasionally occur. Patients also report weak knees and pain and stiffness in the knees. Sometimes, the surgery does not resolve the symptoms. Occasionally, the ligament does not heal.

The anterior cruciate ligament (ACL) is located around your knee. It prevents the shin bone from moving forward over the thigh bone. If it tears, it can be instantly painful and can lead to structural damage.

A torn ACL (anterior cruciate ligament) can cause your knee to collapse during strenuous activity. Not only is this immediately dangerous, it can lead to repeated collapse, causing cartilage damage and arthritis.

You can have this torn ligament replaced with ACL reconstruction. This surgery replaces your damaged ligament with a new ligament. Your surgeon could get a new ligament from you (autograft) or from a deceased donor (allograft).

If you decide to use an autograft, the tissue will probably come from your hamstring or the front of your knee (your patellar tendon).

There are pros and cons to both types of grafts; however, both are usually successful for most people. Talk with your surgeon to find out more.

Click here for more on ACL injury .

ACL Reconstruction is usually done under general anesthesia using arthroscopy.

When arthroscopy is used, your surgeon will have a clear view of the inside of your knee. He or she will make one small incision to insert a tiny camera into the knee chamber. This camera will send a picture of the interior structure of the knee to a video monitor. In this way, your surgeon can see and repair any problems in the knee at the same time that he or she attends to your ACL damage.

There will be a few other incisions in addition to the poke-hole. First, if you are using your own tissue, an incision will need to be made to remove it. This is rather a larger incision. Then a few smaller incisions will be made to access and remove your damaged tissue. Your new tissue will be inserted via bone tunnels. It will be placed perfectly and secured with screws or a variety of surgical fasteners as appropriate.

When your surgery is finished, your incisions will be closed, and a bandage will be put on. When you wake up from your anesthesia, you will probably be able to see pictures and the video of your surgery. Your surgeon will discuss the procedure with you and answer your questions.

In 2006 a radical new hip replacement device called the Zimmer Durom Cup Replacement was approved for use in the United States. This one-piece design was a radical change from the three-part implants that had been used in previous decades. Doctors were impressed by the track record the implants had enjoyed in Europe for three years prior to the device being introduced into American markets. However, the thrill of victory was rapidly overcome by the agony of defeat as hundreds of U.S. patients started suffering pain from loosening implants.

Patients started complaining of pain in their hips. Although there is some pain to be expected for the first few months after hip replacement surgery, Durom Cup recipients were starting to complain of problems well after the three-month recovery period. Doctors are now convinced that revision surgery will be needed in almost 5.7% of the patients who received the transplants prior to July, 2008.

After being removed from the American market for a period of time in July, 2008, the Durom Cup Replacement component was reinstated in August, 2008 along with new training programs for physicians doing the implant surgeries. By following the techniques taught to them in an internet-based training program, surgeons can greatly reduce the number of problems patients suffer from loosening of the implants. Unfortunately, only about half of the doctors who were using the Durom Cup previously have elected to take the extra training necessary to use the technology now.

Patients who have experienced problems with their Zimmer Durom Cup Replacements are filing lawsuits against the company, and even stockholders have filed a class action lawsuit in Indiana stating that Zimmer should have notified shareholders about what was taking place long before they did. By the end of the 3rd quarter of 2008, Zimmer had set aside $47.5 millions to pay claims brought against them in these lawsuits. Although their testing did not find any defects in their product, they do admit that they were negligent in training doctors properly in its use.

Patients who are experiencing unexplained hip pain more than three months after having hip replacement surgery, have loosening and slippage in their artificial hip implant, or require hip replacement revision surgery are being encouraged by product liability attorneys to file suit against the company. Per the laws in most states, patients are entitled to compensation for their pain and suffering, medical expenses, and lost wages due to defects in the Zimmer Durom Cup Replacements they received prior to July, 2008.

The Durom Cup Replacement device is once again being used in the U.S., but many physicians are still opting to use something else rather than risk the high rate of failure that has been associated with its use in this country. These doctors still believe that there is something intrinsically wrong with the design and are reluctant to spend the time it would take to be trained in the correct implant procedures. Patients need to look at the facts and decide for themselves if they want to take the risk, even with the improved odds brought about by better training. There is another way to look at the situation, though, and many patients are beginning to see the Durom Cup in a new light. After all, in spite of the 5.7% estimated failure rate for the device, it also has had an American success rate of 94.3%.

In 2006 Zimmer Durom Cup Hip Implants were approved for use in the United States. Within less than 2 years, more than 12,000 patients were functioning using a Durom Cup as a replacement device for a defective hip joint. Although these implants had been used for 3 years in Europe prior to being approved in the U.S. and had exhibited a high rate of success, in the U.S. patients started developing problems, some almost immediately after surgery. Their doctors, looking for reasons why the implants failed, decided that the Durom Cup was a defective device.

Most states within the U.S. have laws designed to help patients who incur pain and suffering caused by defects in prosthetic devices. Per these laws, patients are entitled to compensation for their pain, medical expenses, and lost wages if it can be proven that a defective implant was to blame for their problems. Although Zimmer still stands fully behind its device based on its track record in Europe, it voluntarily pulled the product from the American market in July, 2008 in order to develop better training methods for doctors who insert the implants.

If you perform a search on the Internet for “Zimmer Durom Cup Lawsuits”, you will find a host of attorneys who are looking to help file lawsuits against Zimmer on behalf of patients. As the number of cases of implant failures continues to grow, these attorneys have done their research and believe that they can file successful individual or class action lawsuits against the manufacturer.

Some physicians have performed exploratory surgeries to try and determine what is causing their patients so much trouble. In some cases they have discovered that the cup has become so loose in the socket that it just pops out when touched. In other cases, the entire device has been found to have migrated a short distance away from where it should be located. Since the device has reputedly been so successful in Europe, Zimmer continues to deny any wrongdoing. Even so, physicians have estimated that almost 6% of the Durom Cup implants will fail and need revision within the next few years.

Zimmer stockholders take the position that Zimmer should have announced a suspension of U.S. sales before January 22, 2008 instead of waiting until July. Because of this belief, they have filed a class action lawsuit in Indiana requesting damages for those investors who purchased stock between January 22 and July, 2008 when the product was finally pulled from the market.

Zimmer is still taking the position that its product is not defective. Instead they believe that the inadequate training given to physicians prior to performing the procedure is to blame. With this in mind, Zimmer announced in October, 2008 that it would be setting aside $47.5 million in order to pay off lawsuits resulting from the surgical failures referring to a July report which said that as much as 5.7% of the surgeries could require revision. This fund has been earmarked to pay for “revisions associated with surgeries that predate the company’s voluntary suspension and which also occur within two years of the original surgery date.