There are two types of haemarthrosis – one is a mild one that follows surgery that has approximately 25cc in the joint - that does not need draining.

The moderate haemarthrosis where you have 50cc in the joint definitely needs draining because it will shut down your quadriceps and your hamstrings – they will lose 30-40% of their strength. Those are the haemarthroses that are not mild or not severe. The severe one needs draining because it is very tense and the patient is painful. The moderate one is about 50cc and that does need draining.

Dr Ben Graff, University of Wisconsin, wrote a paper, oh it’s been maybe 6 or 7 years ago, where he showed that if he didn’t use the epidural after surgical release approximately 30-40% of the patients reverted.

That’s what we’ve been saying for many many years. When you do surgery for arthrofibrosis the knee is now inflamed, it’s painful. You need to have a very gentle re-establishment of the range of motion using an epidural.
[Read More!]

Timing of ACL reconstruction is a clinical decision. We have to make sure that we have full motion, the swelling is gone, the effects of the acute injury are gone, and most importantly that we have a really good muscle contraction. I think that if you ask 90 percent of orthopaedic surgeons they would tell you that that’s at least four to six weeks.
[Read More!]