Dr. Jeff Witty is a sports medicine and arthroscopic fellowship trained orthopaedic surgeon with the North Oaks Orthopaedic Specialty Center. He treats a variety of conditions and injuries to the upper and lower extremities. He has specialized training in arthroscopic surgery of the shoulder, elbow, hip, and knee. In addition, he also treats injuries and other conditions to the wrist, hand, ankle, and foot. Know more at www.drjeffreywitty.com
Had 60% of my medial meniscus trimmed at 47 and was bone on bone 12 months later and i live in pain as a result. No discussion at the 10 min pre op consult regarding repair was mentioned. Apalling that theres surgeon's out there like this so do your research thoroughly
I really appreciate your explanation of the shoulder anatomy! I am facing having reverse shoulder surgery as I have full thickness, full width tears of the supraspinatus tendon and the infraspinatus tendon, along with arthritis changes in the joint. This helps me so much in understanding what has happened with this injury to my shoulder. Thank you!
I just got an MRI report saying I have a mild sprain of the "fibular collateral and conjoined tendon"--- is this the same thing as the LCL? I noticed that they used the word "sprain" which makes me think it's a ligament and not tendon. Strains are associated with tendons from my understanding. In the same MRI report I also have a mild strain or tendinopathy of the "proximal popliteus tendon".
Thanks for the question. The fibular collateral ligament (FCL) and the lateral collateral ligament (LCL) are the same thing. These two terms are used interchangeably. The ligament attaches to the fibula thus "fibular collateral ligament". It is on the lateral side of the knee which is where the "lateral" comes from. "Conjoined tendon" is likely the radiologist using terminology to describe the biceps femoris (there is a "short head" and a "long head" which sort of blend together at the knee). The biceps femoris is one of the hamstring tendons that also inserts onto the the fibular head right next to the LCL/FCL attachment. It is common to injure both at the same time and I have repaired / reconstructed complete tears of this type of injury (Usually reconstruction of the ligament and repair of the ruptured biceps femoris tendon from the bone). Often the FCL/LCL and biceps femoris can actually pull off a piece of bone of the fibula with it during the injury. This is called an "avulsion". You are correct regarding sprain vs strain. The popliteus tendon is a small muscle that start/inserts along the back of the tibia and wraps around to attach on the femur near the FCL/LCL. It provides rotational stability to the knee. The combination of the FCL/LCL and the popliteus is often termed the "posterolateral corner" (PLC). In severe injuries with complete tears (not sprains or strains) the knee can have significant instability requiring surgery. PLC injuries are often combined with ACL and PCL injuries so the physician needs to do a careful clinical exam and often special X rays to accurately diagnose the injury. ___________________________________________________________________________ Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure.
I sprained my acl and pcl and have just healed(got told yesterday) , this helped me understand a bit more , ik i diddnt tear it but ik where it is and stuff
Thanks for sharing your technical knowledge with us, the naive simple minded patients. I am having this surgery Thursday and now know what is involved.
I'm sorry you are having this amount of trouble. This is posted under a shoulder oriented video so I will assume you are referring to your shoulder. If it is your shoulder, I would recommend you have this evaluated by an orthopaedic surgeon for a full workup including discussion of symptoms, examination, x rays, and possibly a MRI. ___________________________________________________________________________ Please understand that this does not represent the formation of a formal doctor patient relationship and is for educational purposes only. All comments should be considered as informal suggestions regarding any matters of medical care. Please also be aware that this is a public forum and any information you share is not secure.
Thank you so much! Your respond to others here has helped me so much to understand the critical of getting surgery asap to protect the meniscus and prevent further damages.
Thank you Dr. you did the much better job than my surgeon explaining this to me. I haven’t done the surgery yet, but this certainly help me to decide if I need to do surgery or not.
Thank you, so well explained & illustrated! Too many doctors do not want to explain what’s going on as far as your injury goes. Almost seem to want to keep you in the dark. Thanks!😊
I am a patient in my early 30's who recently had MR imaging of a shoulder that repeatedly sublaxes and has fully dislocated more than once. Watching both parts of this video took a while, but I greatly appreciate that someone is taking the time to produce this content. Talking through basically every word in the report, making a demonstration, and building up the full explanation of each sentence was surprisingly easy to follow. Your specific comment on the lack of sufficient demonstrative imagery of the labrum was something I encountered as well, and I am so happy that you made your own model to speak about it. My case involves some kind of labral tear, and I could not for the life of me get any handle on what the labrum actually was. Thanks to this series, I've been able to reread my medical team's notes and reports with a much better idea of what's actually happening. Thank you!
Thanks for your comment. I was worried that the length of the videos would be a turn off to people but I thought it was necessary to help people understand everything. These reports can get very confusing and going through them with the ortho surgeon is really critical to avoid over or under treating the problem!
Trying to understand my report. Right shoulder MRI It states that "There is predominantly tendinopathy type signal changes in the supraspinatus and infraspinatus. " There is heterogeneity of the marrow signal with relative sparing of the epiphysis which can be associated with red marrow hyperplasia among other etiologies. Left shoulder basically states the same results. I would appreciate some insight on what this means. Thank You
Thank you, Dr. Jeffrie for answering all queries and such an amazing video. I have bucket handle on my lateral miniscus and was confused whether to go for surgery or not, but you have explained well.
This is the best explanation of the rotator cuff I have ever seen!! Kudos to you!! I agree you should consider a career in teaching. I am a teacher as well.
No one told me to do that. It’s been over three months, and my leg only bends a little past 90 degrees. I’m really worried about this. Is it still possible to get a full range of motion, or am I pretty much screwed? It's not a common injury and it's been difficult to find information on this. I don't really trust my PT anymore due to inconsistent feedback.
How u feeling now. Im 19 years old 1,5 years ago I had a direct blow in my knee . Due to the bad decision of my doctor like I had only an x-ray and no mri He misdiagnosed . Actually my patellar tendon almost tear And I had to have surgery but i didn't . The MRI I did 8 months later says that my tendon is okay but even now I can't walk for a long distance, i can't go up and down the stairs without pain I can't even straighten my leg when im sitting. ? Is there a chance that I can get my strength in my tendon? Now its too late for surgery,maybe a tendon graft its good idea?
Thanks for the question. A bucket handle meniscus tear should be repaired as soon as possible in young, more active, physiologically young people without osteoarthritis. A repair of an old tear can definitely be harder and in some cases impossible to do. If the patient has osteoarthritis of the knee (meaning there is no cartilage in the joint left) we don't typically do a repair. In that situation we perform a debridement of the tear (take out the torn tissue)
Best presentation of the shoulder structure I have ever seen! Three weeks out from a fractured scapula and it is really helping me understand the bigger picture. And helping my relief knowing that the rotator cuff survived my bike crash with minimal impact
Great video! Is there any risk that the anchors come out? I'm a volleyball player and I just had the rotator cuff repaired (2 tears, 1 in suprasupinatus, 1 in infrasupinatus). There are 2 PEEK anchors.
Thanks for the question. The chance of an anchor pulling out is very low. I have only seen it happen after a patient actually fell onto the shoulder right after surgery!
Fabulous content! I finally understand it completely. After a revisit after a surgery in 2001, my dr said: “well, we can go back in and do this or that. It may work and it may not. After that, it’s plastic and screws.” Never laid a hand on me to feel how my shoulder is now popping. Thinks he is above studying an MRI. He just wants to “go back in”. I think I’m switching drs. Might even make a trip to Louisiana haha.
So interesting! Looks like I had the 3rd method done on my right shoulder. I’ve got 3 images I snapped of the computer screen while my Dr was going over what was done. I envisioned the screw to be about 3/8” in diameter. Interesting to see how tiny they are. I wish I could say my surgery was 100% successful, but it wasn’t. Better than before though.
What a great and helpful explanation of the MRI. I recently had surgery to repair my >70% tear in my supraspinatus tendon, bicep tendon and Labrum. My Question to you is, what does a partially torn ligament look like in the MRI? Thank you
Very helpful for a non radiologist - will help me show an inquisitive patient their partial supraspinatus tear on their MRI. Thanks so much for your clear and excellent presentation
