20Shoulder Care
AC Joint Injuries
Arthritis
Biceps Tendon Injuries
Calcific Tendinitis
Clavicle Fractures
Frozen Shoulder
Labral and SLAP Tears
Rotator Cuff Injuries
Shoulder Dislocation/Instability
Subacromial Impingement/Busitis
A-C Joint Stabilization
Biceps Tenodesis
Clavicle Fracture Fixation
Pectoralis Major Repair
Rotator Cuff Repair
Shoulder Instability Surgery – Bankart Repair
Shoulder Instability Surgery – Latarjet Procedure
Subacromial Decompression and Acromioplasty
Superior Capsular Reconstruction
Total Shoulder Replacement
28Knee Care
ACL Tear
Cartilage Injury
Lateral Meniscus Tear
LCL Injury
MCL Injury
Medial Meniscus Tear
Osteoarthritis
Patellar Instability
Patellofemoral Chondromalacia
Posterolateral Corner Injury
Trochlear Dysplasia
Anterior Cruciate Ligament (ACL) Reconstruction
Cartilage Restoration Surgery – Autologous Chondrocyte Implantation (ACI-Carticel)
Cartilage Restoration Surgery – Donor Graft
Collagen Meniscal Implant (CMI)
Lateral Collateral Ligament (LCL) Reconstruction
Medial Collateral Ligament (MCL) Reconstruction
Meniscus Repair
Meniscus Root Repair
Meniscal Transplant
Nanofracture
Osteochondral Allograft Transfer
Osteochondral Autograft Transfer (OATS)
Partial Meniscectomy
Posterior Cruciate Ligament (PCL) Reconstruction
Posterolateral Corner (PLC) Surgery
Tibial Tubercle Osteotomy
Trochleoplasty
17Hip Care
Cartilage Injury
Femoroacetabular Impingement (FAI)
Gluteal Tears
Hamstring Tears
Hip Instability
Labral Tears
Psoas Impingement (Internal Snapping Hip)
Trochanteric Bursitis
Acetabuloplasty
Chondroplasty
Femoroplasty
Gluteal Repair
Labral Debridement
Labral Repair
Labral Reconstruction
Nanofracture
Trochanteric Bursa Debridement
2Biologics
Bone Marrow Aspirate Stem Cell Concentrate (BMC)
Platelet-Rich Plasma “PRP”

COLLAGEN MENISCAL IMPLANTATION (CMI)

The meniscus is a pliable substance that sits between two bones in the knee joint, the femur (thigh bone) and tibia (shin bone). Some patients with meniscus tears can be treated with a combination of activity modification and a focused physical therapy program. Other patients with persistent symptoms or certain tear patterns require surgery. In patients with certain tear patterns, Dr. Keller may recommend surgical reconstruction of part of the meniscus.

Dr. Keller always tries to retain as much healthy meniscus as possible during surgery because patients are more likely to develop arthritis without a meniscus. Large meniscus tears in the central region do not heal and these tears are often excised (partial meniscectomy). If a large portion of the meniscus is torn and/or removed, Dr. Keller may recommend a surgical reconstruction of part of the meniscus. This procedure is called “Collagen Meniscal Implantation.” Collagen is a natural scaffold found in the human body that helps promote cell growth and new tissue formation.

During surgery, Dr. Keller measures the length and width of the damaged part of the meniscus. Next, he sizes the collagen graft to match the area of damaged meniscus in the patient’s knee. Dr. Keller then uses a special device to pass stiches, and he sews the collagen graft to the patient’s healthy remaining meniscus. Over time, the collagen graft matures into a fibrous-meniscal substance that helps protect the cartilage in the knee. There are several peer-reviewed articles that suggest that this procedure helps protect the knee joint and may help prevent the onset of arthritis in the knee.

Post-Operative Rehabilitation

Following surgery, patients are placed in a hinged brace that is locked straight. Dr. Keller recommends partial weight bearing for 4-6 weeks in the brace. When the patient is sitting or lying down, Dr. Keller encourages knee range of motion exercises with the brace removed. Dr. Keller also recommends intermittent icing and straight leg raise exercises to strengthen the quadriceps muscle. Dr. Keller recommends starting physical therapy two weeks after surgery. Physical therapy focuses on reducing swelling in the knee, restoring full range of motion, and eventually, restoring strength to the knee. Most patients can start full weight bearing on the affected leg 4-6 weeks after surgery. Most patients start cutting activities and sporting activity approximately 4-6 months after surgery.