Degenerative meniscus tears are the most common reason for knee arthroscopy, yet whether these tears benefit from surgery is controversial, according to an evidence-based, expert consensus statement on the treatment of degenerative meniscus tear published in Arthroscopy: The Journal of Arthroscopic & Related Surgery (February 2020).¹ K. Donald Shelbourne, MD, an orthopedic surgeon at Shelbourne Knee Center, was one of 20 international experts who provided input on the consensus statement.

With more kids playing competitive sports earlier and year-round, anterior cruciate ligament (ACL) tears in skeletally immature adolescents are on the rise. “Kids are exposed to the potential for injury at a much higher level than ever before,” says K. Donald Shelbourne, MD, an orthopedic surgeon at Shelbourne Knee Center.

Over-treatment of isolated posterior cruciate ligament (PCL) tears with surgery is becoming increasingly common, due to lack of understanding of the natural history of this rare injury and the belief that surgery prevents joint degeneration.

While many orthopedic surgeons no longer perform bilateral total knee arthroplasty (TKA), for some patients the procedure is appropriate and beneficial. “Some patients are too anxious or too busy to go through TKA twice. They want to get it over with and move on with their lives,” says Rodney Benner, MD, an orthopedic surgeon at Shelbourne Knee Center.

Without proper surgical repair, a patellar tendon rupture is extremely disabling. The rarity of this knee injury, which occurs in less than 0.5% of the population annually, and the variable length of the patellar tendon when the leg is extended or flexed increase the difficulty of repair.

Quadriceps strength plays a large role in returning patients to pre-injury function after an anterior cruciate ligament (ACL) reconstruction. Yet little was known about the impact of surgical timing on strength.

“We wanted to be able to tell patients what to expect in terms of preoperative quadriceps strength and the progression of quadriceps strength postoperatively based on whether they have an acute or chronic ACL tear,” says Rachel Slaven, PT, DPT, a physical therapist at Shelbourne Knee Center.

When orthopedic Surgeon K. Donald Shelbourne, MD, began his practice in 1982, the mother of a 15-year-old girl whose anterior cruciate ligament (ACL) he had reconstructed asked him a question he couldn’t answer. “She wanted to know what was going to happen to her daughter’s knee in 20 years. I had no idea,” he says.

Demand for total knee arthroplasty (TKA) is expected to soar and is likely to exceed the supply of joint replacement surgeons in the coming years. Shelbourne Knee Center’s research-backed Knee Rehabilitation Program for Osteoarthritis (OA) is an effective nonsurgical treatment for most patients with knee OA.