The Tendon transplant to work in a cross-band OP

In many cases, a SURGERY after a cruciate ligament tear is useful. Often, the cruciate ligament is replaced by the graft by a Tendon. As the OP runs out and what to keep in mind after the Operation.

An adverse movement, a sound like a whip, and a sudden pain, a ligament tear, sometimes faster than many suspect. The two cruciate ligaments are actually very robust, because they play for the stability of the knee joint has an important role: Together with the Outer and inner band forming the ligamentous apparatus of the knee joint, the knee with each movement and strengthens.

Seen from the side, the two bands intersect – therefore, you will have your name. A cross band runs from the Shin bone down the front to the thigh bone obliquely upward and backward (anterior cruciate ligament), the other one from the Shin from the bottom rear of the thigh obliquely to the front upper (posterior cruciate ligament). You have to prevent the femur sliding too far backwards and the Shin bone too far forward. Is one of the bands ripped (cruciate ligament rupture), can only produce an Operation with the necessary stability in the knee joint.

After an injury, and is suspected to have a ligament tear you should definitely go to the doctor. This can clarify with the patient what therapy is for a cure is necessary. Conservative methods, such as a targeted muscle building through physiotherapy, in each case, necessary in order to strengthen the knee after the injury. However, a pure muscle – building can replace alone, never a broken cross-band that shows the statistics: over 90 percent of the patient’s instability in the knee joint after sole treatment with conservative methods still.

About the author

Norbert Wynands is a specialist in surgery, accident surgery and sports medicine. He is senior physician of the Department of trauma and reconstructive surgery at the red cross hospital in Lindenberg.

Although the healing from the physical condition of the Person and your personal claim to your physical activity, the person Concerned, however: The younger and the more active, the more recommend is a surgery in which the ligament is replaced. With the following operational method of a cruciate ligament rupture can be treated.

Cross-band SURGERY with tendon graft

A virtually universal method of operation of the cruciate ligament by a tendon graft, the tendon of the thigh muscle (semitendinosus tendon, or quadriceps) or the patellar tendon of the patient is taken. The latter is the connection between the lower leg and kneecap. This minimally invasive, arthroscopic surgery (single-bundle reconstruction) is now one of the Standard methods of treatment and can be done up to one year after the injury.

When the Operation is first removed through a small incision in the replacement tendon. This is about a twenty to thirty centimeters long tendon is then placed four on top of each other, so that you are reduced to a quarter of the length and their tensile strength is significantly increased. Then be drilled in both the femur and in the tibia bone a small, approximately two-centimeter-long channels. By this, the two Ends are pulled tendon Replacement, tensioned and then fixed. The aim is that the replacement tendon in the subsequent conservation phase, with the bone fully fuses, so that the function of the cruciate ligament is largely restored.

Fasten the cross band set with a tear-resistant thread

The Fixation of the cruciate ligament set can be done using various techniques. One of these is the “Tight Rope”method is: The replacement tendon is pulled with a particularly tear-resistant medical thread (Tight Rope) by hauling technique in the drilled bone channels – first through the channel in the leg rail, then into the channel in the femur. This type of pulley allows the replacement tendon to take up slack in the best possible way.

In order to fix the string on the thigh bone, rolling papers, a small Metal about the filament introduced. As soon as the tendon was pulled through the top of the bone canal, the leaves on the outer side of the femur. Now it has a larger surface than the Radius of the drilled bone channel and thereby prevents a sliding Back of the cross-band set. Subsequently, the tendon is tensioned, and on the outer side of the opposite Shin bone is fixed with a screw.

With the time, the thread and the replacement tendon around the fabric, the Replacement ligament is based. In the subsequent conservation phase, the Tendon axes with the bone. The screw loosens over time, the metal flakes and the thread will remain in the knee of the patient.

Physical therapy is a Must

After a cruciate ligament tear should be waiting with the Operation until the knee of the patients want to completely off, and also is pain-free. Only then is it possible that the cruciate ligament replace the normal proportions of the Body. Often, concomitant injuries associated with cruciate ligament tears such as a meniscus tear. These are also only in a worn woolen knee completely visible and need to be treated in order to obtain an intact joint.

Even if surgery, everything runs optimally, can be replaced the function of the natural cruciate ligament, never to 100 percent. However, it can be manufactured by means of a minimally invasive procedure and the relevant volume set, the stability of the knee joint.

Without an accompanying physiotherapy and without the will of the patient, regain mobility and strength in the leg, but. Those who make the effort and diligently by the skilled person recommended, and injury to and healing degree of coordinated Exercises, therefore, has the prospect to be able to his knee after six to eight months to fully re-charge. An external knee brace (orthosis) is the patient in everyday life also safety, and prevents Twisting of the knee.

With 2 simple knee Exercises, you prevent joint pain

Our knees need to withstand quite a lot: every Day, we bow down to you, on average, more than 1000 Times. Each time you walk the multiple rests of our body weight on them. The largest and most complex joints in spite of continuous load fit, we should be active.

Millions of people complain of inflamed, swollen or aching knees. No wonder: No other joint is daily burdened and stressed like this. Not just Sprinting, or skiing, it must keep the face of tremendous pressure: At each knee flexion the largest and most complex of our joints wearing the Seven – to-eight times our weight.

So it crunches in the short or long-each time you Bend or stretch, pinches or hurts, movement is important. A good Alternative to the gym or sports field offer aerobics or Zumba: The combination of dance and Fitness brings the body into swing, can the pounds and promotes flexibility and strength.

The benefit not least to the knees: Regular exercise also improves the metabolism and blood circulation of the knee joint. In addition, a strengthened muscles protects the knee joint injuries and diseases.

In order to prevent Overuse of the musculoskeletal system, we recommend a moderate, age-appropriate and not too intense workout. In the case of existing complaints of the feet or knee joints, you should avoid, however, be on sports completely, or with an orthopedic surgeon, a gentle approach discuss.

Two Exercises for healthy knees

1. Flat on your back and raise one leg. The foot towards the buttocks. After a few seconds stretch out. The Whole thing a dozen Times with each foot repeat.

2. Sit on the table and the legs swing freely. As a result, the joint is spread grease over the entire cartilage surface of the knee joint. Cartilage nutrition is significantly improved.

The best sports for healthy knees

Whether Zumba, Running, or Jogging – regular exercise, without excessive ambition, the best medicine is “”. Muscles, Tendons and ligaments to be strengthened in a healthy way – a slow warm – up and training. As particularly knee-friendly apply

  • Swimming
  • Hiking
  • Gymnastics or water aerobics

    To the PDF guide

Simple measures in everyday life

Of the (knee)health and conducive to regular Cycling to work or for shopping. Improper loading, such as when Running can occur are virtually eliminated. All of the muscles that stabilize the knee, to be trained.

But smaller steps can achieve quite a lot. One of the simplest Precautionary measures: often times take the stairs instead of the lift. Each stage strengthens the muscles, invigorates the knee metabolism and thus prevents osteoporosis.

Long hours of Sitting in the car, office or TV chair increases the need to be active: Remains of a joint in a rigid Position, so that the cartilage layer is loaded permanently on a body and to lose excessive joint fluid. This happens more often in the day, so the risk of cartilage damage is increasing rapidly, as when a clothing is claimed always in the same place and a hole forms.

  • You can change as often as possible the work or the position of the seat.
  • Get up once in a while.
  • You are going short distances.
  • Stretch at your Desk more often the knee.

The less strain on the joints

In addition to a lack of exercise is a prolonged Standing “poison” for the knee. Because then the full body weight rests on the connection point between the upper and lower leg bones. Better time to take a breather in the Sitting load, and several times a day, the legs dangle. This promotes the formation of synovial fluid.

Should avoid, to the extent possible, longer Work in stop position (for example, when Mounting or crafts), as well as a strong knee flexion, so the cross-legged or with frequent Squatting. Problematic is also the following sports are:

  • Football
  • Handball
  • Squash
  • Tennis
  • Rowing
  • Skiing

In the case of rotational movements of the knee under load, typically for the Kick, or skiing, are the the cartilage protective menisci are especially prone to injury.

Instead of high shoes that make it difficult to straighten the joints, better flat shoes with soft sole wear. They dampen vibration while walking and protect the joints. The Same is true for an “acceptable” body weight. Because obesity is one of the main risk factors for osteoarthritis or other knee ailments.

About the expert

Sven Ostermeier Orthopaedics and accident surgery, sports medicine, chirotherapy and special orthopedic surgery. The shoulder and knee expert, works as a senior orthopaedic surgeon of the joint-clinic Gundelfingen. He is also the instructor of the German Association for arthroscopy.

Treatment with antibiotics: How a quick restoration of the intestinal flora manage to

The intestinal flora suffers a lot by the intake of antibiotics. Because the drug also kills the good bacteria. The right diet and probiotics to promote the Regeneration.

5 tips to intestine regeneration in the Overview:

  1. The easiest way to the intake of probiotics using a nutritional supplements is
  2. In a sustainable diet: prunes, barley, and Okra, will take on the dining plan, Sauerkraut, and natural yogurt.
  3. Alcohol and fast food avoid!
  4. Acidic food – canned vegetables such as carrots, beans, radish, and fennel help with the acid balance in the gut.
  5. A regular intake of probiotics – at least two hours before or after taking antibiotics over a period of at least three weeks.

Antibiotics make no distinction between “good” and “bad” bacteria. After taking the intestinal microflora, therefore, is also often affected. The micro bacterial balance in our gut is tilted. This usually has a serious impact on our health. Diarrhea and vaginal fungal infections, the short-term result – in the long term, a disturbed intestinal flora can cause damage, but our entire immune system.

A weakened immune system in turn has the result that the antibiotic sales increases. That re-emergence of bacterial infection to combat the most effective with Penicillin and co. What, then, is usually comparable with a vicious circle – the literal hell is to say a circle.

To The Person

Marcel Becker is the managing Director of the Apovid GmbH. The trained pharmacist is also co-owner of the Munich-based Dr. Beckers Central Apotheke, as well as founder and partner of the Vita-point GmbH.

The antibiotics-taking consequences of which are still visible for a long time

To find out how long damage to the intestinal flora by stopping the intake of antibiotics, studied Dutch researchers at Amsterdam’s Academic Centre for Dentistry, the impact of 66 subjects. Before the therapy, as well as during and after antibiotic intake, the researchers examined stool and saliva of the subjects samples. The result: After taking certain antibiotics, such as Ciprofloxacin, which reduces the intestinal bacterial diversity, 12 months later.

Quick help with probiotics

The Easiest way to the intestinal cleansing is done by the simultaneous intake of antibiotics and so-called probiotics, such as Omniflora or Perenterol. Probiotics comes from the Latin “pro”, what as much as “means” and the Greek “bios” for “life”. This “life-affirming” drugs collect in capsule form, live bacteria cultures that give the good bacteria in the gut the necessary updraft, our intestinal mucosa, nourish the digestion, regulate and harmful germs to fend off. Probiotics work as a kind of protective shield and prevent the bad bacteria in our healthy organism.

Proper nutrition restores balance

Even more sustainable, it helps his health, however, by a targeted nutrition to the jumps. Alcohol and fast food damage. Prunes, barley, and Okra work building. Important especially probiotic foods such as Sauerkraut or natural yoghurt. They hold a Wealth of probiotic bacteria for our body.

To do this, especially lactic acid bacteria. You are the most important and best-known of the 400 to 500 bacteria in the gut, which are important for our digestion and health responsible. Especially, lactic acid-containing foods are made. Earlier they were a more frequent part of our daily food: Canned cucumber, and herb were a number of times per week on the tables of our grandparents.

The Fermentation, so the fermentation of food, one of the oldest methods is to make food durable. In the case of the Fermentation of vegetable food is refined literally. Because the effect of the ingredients is concentrated, whose bioavailability is increased, allowing an easier absorption of the food in our body is possible.

Almost any vegetable is suitable

In the modern health kitchen, the Fermentation is therefore experiencing a Renaissance. Because in the process of fermentation of milk acid and its acidic environment provides the agents simply have no Chance. What vegetable comes in a glass, the intestine no matter: carrots, beans, radish, fennel – the vegetable variety in the glass and in the intestine, there are no limits.

Also, the Japanese are aware of the effect of probiotic food: Miso, the Japanese seasoning paste that is traditionally input in almost every dish. The condiment is made from soybeans and rice or barley, and is aged, often for more than a year. Also Kombucha, a fermented tea beverage, or the Korean Kimchi made of Chinese cabbage taste delicious and are great for the intestinal flora is a real health booster.

For at least three weeks

Important is the regular intake of probiotics, or the sufficient consumption of probiotic food is – as with any medication. It is also important to consume probiotics at least two hours before or after taking antibiotics. Just so the good bacteria have a Chance to be not directly from the antibiotic attacked. The duration of intake should be based – according to the complaint, after the personal well – being. Taking probiotics during, or after antibiotic therapy, is, however, a minimum intake of three weeks useful, the results in a review of 82 studies on this topic.

Sunday Is ‘Fall Back’ Time for Your Clock — Sleep Experts Offer Tips

FRIDAY, Nov. 2, 2018 — The hour you “lost” with daylight savings time in the spring you “gain back” on Sunday, when clocks are set an hour back.

And every time shift takes a subtle toll on the human mind and body, experts say.

Still, “for most people, it is easier to stay up an hour later than to go to bed an hour earlier,” said Dr. Steven Feinsilver, who directs sleep medicine at Lenox Hill Hospital in New York City. “This is thought to be because for most of us our ‘internal clock’ is closer to a 25-hour cycle than a 24-hour cycle.”

He said the furthest you can comfortably shift your internal clock is about an hour a day, and “what sets [your] clock is the wake time more than the bedtime.”

Feinsilver said that to get back to a normal sleep rhythm, “set the alarm for your target time and get out of bed when it goes off, even if your night sleep was not perfect.

“For the time change, set the alarm for Monday — for most of us the Sunday morning wake-up is less critical — and enjoy the extra hour,” Feinsilver said.

A single night of imperfect sleep is easily gotten over — “it is when bad sleep becomes a habit we get into trouble,” he said. Feinsilver’s advice is to try to sleep a regular seven to eight hours — and “stick to a constant wake time.”

Triggers such as light, food and exercise are the cues that tell your body what time it is.

“Getting exposed to light early in the day wakes us up,” Feinsilver said. “This is harder in the winter when there is less and later light, but the autumn time shift helps a bit.”

Dr. Daniel Barone is a neurologist and sleep medicine expert at the Center for Sleep Medicine at New York-Presbyterian/Weill Cornell Medical Center in New York City. He said that people shouldn’t expect that the extra hour of sleep they’ll get on Sunday will erase any accumulated “sleep debt.”

“We as a society sleep one hour less than we did 100 years ago, so we are still ‘behind the clock’ so to speak when it comes to being sleep-deprived,” Barone said.

He said the body’s sleep clock can be directly affected as autumn days grow shorter and people spend more time indoors. The body manufactures vitamin D via sunlight’s action on the skin, and too little vitamin D can affect sleep and emotions.

“When you’re not getting as much sunlight, it has an effect on your mood,” Barone said. For some people, this can even mean the onset of a kind of depression known as seasonal affective disorder (SAD).

Barone offered these tips for better sleep:

  • Switch to LED lightbulbs. They’re made to simulate sunlight and can help you maintain a healthy circadian rhythm as seasons change.
  • Cut out the evening nap. Dozing off after dinner sends confusing signals to your brain that can make bedtime later more challenging.
  • Try mindful meditation. It can cut stress and encourage healthy sleep.
  • Ban TVs, smartphones and laptops from the bedroom. The backlight display can disrupt sleep if used before lights-out.
  • Keep bedrooms dark. Light creeping in can send a wake-up signal to the brain.

If you’re still having trouble sleeping, consult a sleep specialist for testing, Barone said.

“If you’re continually waking up in the night or you’re constantly waking up tired, a sleep test is definitely warranted,” he said.

“We should view sleep as something that’s sacred,” Barone said. “Our bodies are designed to get seven to nine hours. In this 24-hour society, a lot of times the amount of sleep we get suffers. We should focus on getting good-quality sleep and dealing with any problems that exist.”

More information

There’s more on getting good sleep at the National Sleep Foundation.

Posted: November 2018

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