Anterior Cruciate Ligament Injuries – Treatment

Bones are connected to other bones by ligaments. There are four primary ligaments in your knee. They act like strong ropes to hold the bones together and keep your knee stable.

The cruciate ligaments are found inside your knee joint. They cross each other to form an “X” with the anterior cruciate ligament (ACL) in front and the posterior cruciate ligament (PCL) in back. The cruciate ligaments control the back and forth motion of your knee.

When the ACL gets disrupted, your knee will feel unstable and it becomes more difficult to run and perform sudden changes in direction and acceleration

Anterior Cruciate Ligament (ACL) Ruptures

The anterior cruciate ligament runs diagonally in the middle of the knee. It prevents the tibia from sliding out in front of the femur, as well as provides rotational stability to the knee. If you have injured your anterior cruciate ligament, you may require surgery to regain full function of your knee. This will depend on several factors, such as the severity of your injury and your activity level. The anterior cruciate ligament can be injured in several ways:

  • Changing direction rapidly

  • Stopping suddenly

  • Slowing down while running

  • Landing from a jump incorrectly

  • Direct contact or collision

When you injure your anterior cruciate ligament, you might hear a “popping” noise and you may feel your knee give out from under you. Other typical symptoms include: Pain with swelling. Within 24 hours, your knee will swell. If ignored, the swelling and pain may resolve on its own. However, if you attempt to return to sports, your knee will probably be unstable, and you risk causing further damage to the cartilage of your knee.

Your orthopedic doctor will be able to diagnose if you had a severe injury to the ACL by conducting a physical exam and obtaining imaging studies such as a MRI


Nonsurgical treatment may be effective for patients who are elderly or have a very low activity level. If the overall stability of the knee is intact, the orthopedic doctor may recommend simple, nonsurgical options.

If your knee remains painful and unstable, surgical reconstruction may be indicated. Most ACL tears cannot be sutured (stitched) back together. To surgically repair the ACL and restore knee stability, the ligament must be reconstructed. Your doctor will replace your torn ligament with a tissue graft. This graft acts as a scaffolding for a new ligament to grow on.

Grafts can be obtained from several sources. Often, they are taken from the patellar tendon, which runs between the kneecap and the shinbone. Hamstring tendons at the back of the thigh are a common source of grafts as well. Sometimes a quadriceps tendon, which runs from the kneecap into the thigh, is used. Finally, cadaver graft (allograft) can be used.

There are advantages and disadvantages to all graft sources. You should discuss graft choices with the orthopedic surgeon to help determine which is best for you.

Surgery to rebuild an anterior cruciate ligament is done with an arthroscope using small incisions. Arthroscopic surgery is less invasive. The benefits of less invasive techniques include less pain from surgery, less time spent in the hospital, and quicker recovery times. Because the healing and regrowth takes time, it may be six months or more before an athlete can return to sports after surgery.

Meniscal Injuries – Treatment

At the Orthopedic Center our Providers can diagnose and treat the different types of meniscal injuries. Most of the times conservative management is all that is needed.

When indicated, minimally invasive arthroscopic surgery is usually the best option. Make an appointment today for a complete evaluation of your knee.

What are Meniscal Tears?

Meniscus tears are common knee injuries. Athletes, particularly those who play contact sports, are at risk for meniscus tears. However, anyone at any age can tear a meniscus. It is often referred to as a “torn cartilage” in the knee.

Anatomically, the menisci are two wedge-shaped pieces of cartilage acting as “shock absorbers” and dispersing the joint forces between your thighbone (femur) and shinbone (tibia). They are tough and rubbery to help cushion the joint and keep it stable.

Meniscal tears  are classified by location and whether they are due to sports or age-related degeneration of the tissue. Tears are also noted by how they look and their location on the meniscus. Common tear types include bucket handle, flap, and radial.


Sudden meniscus tears often happen during sports. Players may squat and twist the knee, causing a tear. Direct contact, like a tackle, is sometimes involved.

Older people are more likely to have degenerative meniscus tears. Cartilage weakens and wears thin over time. Aged, worn tissue is more prone to tears. Just an awkward twist when getting up from a chair may be enough to cause a tear, if the menisci have weakened with age.


You might feel a “pop” when you tear a meniscus. Most people can still walk on their injured knee. Many athletes keep playing with a tear. Over 2 to 3 days, your knee will gradually become more stiff and swollen. The most common symptoms of meniscus tear are:

  • Pain

  • Stiffness and swelling

  • Catching or locking of your knee

  • The sensation of your knee “giving way”

  • You are not able to move your knee through its full range of motion

Without treatment, a piece of meniscus may come loose and drift into the joint. This can cause your knee to slip, pop, or lock.

Orthopedic Evaluation

Your orthopedic care provider at The Orthopedic Center will perform a thorough physical exam. If your provider suspects an unstable meniscal injury additional imaging tests may be obtained including X-raya and/or a magnetic Resonance scan (MRI) of your knee. These tests will confirm the diagnosis and extent of a meniscal injury since other conditions give similar symptoms. 


Treatment of your particular injury will depend on the type of tear you have, its size, and its location.

The outside one-third of the meniscus has a rich blood supply. A tear in this “red” zone may heal on its own, or can often be repaired with surgery. A longitudinal tear is an example of this kind of tear.

In contrast, the inner two-thirds of the meniscus lacks a blood supply. Without nutrients from blood, tears in this “white” zone cannot heal. These complex tears are often in thin, worn cartilage. Because the pieces cannot grow back together, tears in this zone are usually surgically trimmed away.

Along with the type of tear you have, your age, activity level, and any related injuries will factor into your treatment plan.

Nonsurgical Treatment

If your tear is small and on the outer edge of the meniscus, it may not require surgical repair. As long as your symptoms do not persist and your knee is stable, nonsurgical treatment may be all you need.

Surgical Treatment

If your symptoms include frequent locking and buckling of the knee and persist despite following the “PRICE” principle of conservative management, your doctor may suggest arthroscopic surgery.

Arthroscopic surgery is a minimally invasive technique that uses advanced, high-definition optics and specialized tools to access the knee joint. Arthroscopic knee surgery has the advantage to allow greater access and clear visualization while only using a few small incisions. These interventions are typically performed as outpatient procedures, which means you get to go home the same day. Depending on the meniscal damage your surgeon may perform:

  • Partial meniscectomy. In this procedure, the damaged meniscus tissue is trimmed away and the remaining meniscal tissue is sculpted to prevent instability.

  • Meniscus repair. Some meniscus tears can be repaired by suturing (stitching) the torn pieces together. Recovery time for a repair is much longer than from a meniscectomy due to the extra healing time needed.

Immediately after surgery you will be seen and evaluated by a physical therapist. Regular exercise to restore your knee mobility and strength is necessary. You will start with exercises to improve your range of motion. Strengthening exercises will gradually be added to your rehabilitation plan.

Rehabilitation time for a meniscus repair is about 3 months. A meniscectomy requires less time for healing — approximately 3 to 4 weeks.

Rotator Cuff Tears – Treatment

Our Board Certified Orthopedic Surgeons have many years of experience treating shoulder injuries including rotator cuff tears, labral tears, bursitis, bone spurs, impingement, and arthritis.

While most injuries can successfully treated conservatively with therapy, and anti-inflammatory medication, some will require surgery to repair the damage.

The Orthopedic Center Surgeons offer a variety of arthroscopic, outpatient techniques that will successfully put you back in the action.  Get a consultation to find out which option is indicated in your particular situation.

The rotator cuff is a group of four muscles that come together as tendons to form a covering around the head of the humerus. The rotator cuff attaches the humerus to the shoulder blade and helps to lift and rotate your arm.

When one or more of the rotator cuff tendons is torn, the tendon no longer fully attaches to the head of the humerus. Most tears occur in the supraspinatus tendon, but other parts of the rotator cuff may also be involved.

In many cases, torn tendons begin by fraying. As the damage progresses, the tendon can completely tear, sometimes with lifting a heavy object.

There are different types of tears.

  • Partial tear. This type of tear is also called an incomplete tear. It damages the tendon, but does not completely sever it.

  • Full-thickness tear. This type of tear is also called a complete tear. It separates all of the tendon from the bone. With a full-thickness tear, there is basically a hole in the tendon.

Symptoms of a Cuff Tear

The most common symptoms of a rotator cuff tear include:

  • Pain at rest and at night, particularly if lying on the affected shoulder

  • Pain when lifting and lowering your arm or with specific movements

  • Weakness when lifting or rotating your arm

  • Crepitus or crackling sensation when moving your shoulder in certain positions


The majority of patients improve with nonsurgical treatment including:

Nonsurgical treatment options may include:

  • Rest. Specially limiting lifting and overhead activities. The PRICE therapy

  • Activity modification. Avoid activities that cause shoulder pain.

  • Nonsteroidal anti-inflammatory medication. Drugs like ibuprofen and naproxen reduce pain and swelling.

  • Strengthening exercises and physical therapy. 

  • Steroid injection. An injection of a local anesthetic and a cortisone preparation may be helpful.

Surgical Management.

Surgery as an option for a torn rotator cuff if your pain does not improve with nonsurgical methods.  If you are very active and use your arms for overhead work or sports, surgery may be an option. Other signs that surgery may be a good option for you include:

  • Your symptoms have lasted more than 6 monhts

  • You have a large tear and the quality of the surrounding tendon tissue is good

  • You have significant weakness and loss of function

​Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of humerus (upper arm bone). At The Orthopedic Center our surgeons are experienced with minimally invasive, arthroscopic techniques to repair your shoulder injury. 

Osteoarthritis Management and Treatment

At the Orthopedic Center we are proud to offer our patients state of the art treatments and procedures for arthritis and other traumatic and developmental joint disorders. Many of our patients benefit from non-surgical techniques such as viscosupplentation (gel injections), physical therapy and medication. For those who may not respond to these measures, advanced minimally invasive surgical techniques are now offered. These include joint arthroscopy, cartilage transplant, partial knee replacement, as well as advanced total knee replacement. Our physicians also perform complicated revision surgery, which involves removing failed implants and reconstruction of the joint.

What is Osteoarthritis?

Osteoarthritis is the most common cause of joint pain and dysfunction. It is a degenerative joint disease characterized by the breakdown of joint cartilage which is the most common form of arthritis. Today, one in five American adults report having doctor diagnosed arthritis. In fact, arthritis is the nation’s leading cause of disability. The cardinal signs and symptoms of arthritis are: PAIN, STIFFNESS, SWELLING, and DEFORMITY.

What are The Causes of Osteoarthritis?

  • Excessive wear on the joints

  • Joint injuries from sports and other high-impact activity

  • Age, although osteoarthritis does not occur in all people as they age

  • Obesity, especially with osteoarthritis of the knees

  • A small deformity of the bones in a joint

  • Work-related activities or accidents

Conservative Treatment Modalities`

  • Physical Therapy,

  • Home Exercises,

  • Bracing,

  • Therapeutic Joint Injections, Viscosupplementation,

  • Non-Steroidal Anti-inflammatory Pain Medications,  

  • Lifestyle and Nutritional Modifications.

Surgical Treatment Modalities

  • Arthroscopic Chondroplasty and Microfracture,

  • Cartilage Transplantation, 

  • Partial Joint Replacement

  • Total Joint Replacement.


Medicolegal / 2nd Opinion

Second opinions and Independent Medical Examinations can be sought or initiated by patients, primary physicians, specialists, insurance companies, claimants, attorneys, and others for opinions regarding medical care, work related incidents/injuries, insurance determinations, or legal action.

Our Board certified Orthopedic Surgeons have the clinical and leadership experience to evaluate orthopedic conditions at every stage of acuity and healing. As Fellows, our Surgeons abide by the American Academy of Orthopedic Surgeons Code of Ethics.

Whether you are seeking an Independent Medical Evaluation (IME), a valued Second Opinion, or a review of medical records, rest assured that regardless of the source of the request, the opinions formulated by our Physicians will be governed by strict ethical and legal considerations in order to avoid any potential conflicts of interest and to remain fair and objective in all determinations and opinions.

Please contact our office to discuss and schedule your specific case. We understand your time is valuable. We are committed to keep all communication prompt and confidential. You can trust we will process your report in a timely and efficient fashion.

Arthroscopic Surgery

Arthroscopic surgery is a minimally invasive technique that uses advanced, high-definition optics and specialized tools to access joints and other structures in order to diagnose and treat a multitude of orthopedic conditions.

Arthroscopic surgery has the advantage to allow greater access and clear visualization while only using a few small incisions. Depending on the joint being treated, there is a multitude of specialized instruments and implants that can be used to correct the problem.

These interventions are typically performed as outpatient procedures, which means you get to go home the same day.

At The Orthopedic Center our Surgeons have extensive experience using these arthroscopic techniques and tools. We offer a multitude of arthroscopic interventions including:

Knee meniscal repair
Knee anterior cruciate ligament reconstruction
Shoulder rotator cuff repair
Shoulder decompression, spur removal
Loose body removal
Hip labrum repair
Elbow, wrist, and ankle arthroscopy

Diagnostic Services

The Orthopedic Center offers convenient on-site Digital X-Ray services. Digital imaging allows higher resolution and contrast, affording faster and more accurate diagnoses, all of this while using less radiation. Our providers are trained and experienced in the interpretation of these exams.

Diagnostic Ultrasound and Ultrasound-Guided injections are also available. This technology permits accurate and less painful placement of needed medicine into joints and soft tissues as well as the diagnosis of tendon, ligament, and muscle injuries.

Electrodiagnostic services are also available at The Orthopedic Center. These are indicated to find the cause of numbness, weakness or other nerve dysfunction. 

Digital Radiography

The Orthopedic Center is proud to offer patients Digital X-Ray services at both locations. Digitial radiography offers many advantages over conventional film including:

  • Speed – Without the need for chemical development, images are immediately available to the technologist and the physician. This reduces your wait time significantly.

  • Dose Reduction – Digital image receptors are much more sensitive to low levels of radiation compared to film/screen, therefore require less radiation to produce a diagnostic radiographic image.

  • Post-processing Manipulation – Digital radiography  provides high-resolution images that can be magnified and digitally manipulated post-processing to reveal additional anatomical features not seen in the initial image set.  

  • Portability – Imaging studies can easily be viewed in the cloud and/or transferred to different other locations via CD or other electronic means if needed.

  • Archivability – Storage of images occurs on servers, rather than entire warehouses of archived hard copies. This means that your digital images will be available permanently and not manually purged every 7 years.

The Orthopedic Center is proud to offer patients Digital portable Ultrasound services at both locations. Ultrasound uses non ionizing high-frequency sound to image soft tissue structures in the body. Ultrasound is well suited in orthopedics for the diagnosis of tendon, ligament and muscle injury. It is also invaluable in helping deliver injectable medication such as cortisone to the intended anatomic compartment. Some of the advantages of portable digital ultrasonography follow:

  • Speed – Images are immediately available to the provider and the physician. This reduces your wait time significantly.

  • Safety – Unlike X-ray that uses ionizing radiation, ultrasound utilizes high-frequency sound waves. These are know to be safe if current imaging protocols are used. The amounts and duration of the exposure for most orthopedic exams is generally quite safe.

  • Real-Time Imaging – Ultrasound can be used to visualize moving structures and fluids allowing the physicians to diagnose conditions that will only become evident during activity.

Electrodiagnostic Testing

The Orthopedic Center is proud to offer patients electrodiagnostic services. These exams are indicated to diagnose the cause of extremity pain, numbness and weakness. It can aid the physician in locating the potential cause of nerve dysfunction including neuropathy, nerve compression and pinched nerves in your neck or low back.

Electrodiagnostics are used in conjunction with clinical examination to test the function of muscles and nerves and can help determine the causes of back or neck pain, numbness and tingling, and strength loss.

This diagnostic information can be invaluable in order for your physician to provide you with the most appropriate treatment for your specific condition. 

Joint Injections

As part of the treatment for pain and inflammation, your provider may recommend injections. 

The most commonly used injectable medication given in our office is a corticosteroid preparation (cortisone). For knee joints we also use Viscosupplementation (hyluronate injections).

These injections can provide lasting relief of your symptoms and are generally safe and well tolerated.

Work Injuries

If you have been referred to the Orthopedic Center for your work-related injury, please be assured we will make every effort to ensure that your experience is as comfortable as possible.

We strive to accomplish this by providing the highest quality care in a friendly, healing environment. Our goal is your safe and complete return to your working environment and activities.


Please be sure to bring any films (X-ray or MRI) or other records you have had previous to your appointment with The Orthopedic Center. You must obtain these from the referring physician’s office/urgent care and hand carry them to your appointment with us.


Fracture Care

Our Board Certified Orthopedic Surgeons have many years of experience treating different fractures. Their management includes conservative techniques as well as complex reconstructions and repair of fractures that fail to heal.

Only an orthopedic doctor can determine which treatment is best for you. Request an appointment for a consultation regarding your particular injury.

Bone is a remarkable material. Our bones not only support and protect our bodies, but they can withstand tremendous bending, shear and twisting forces. A fracture occurs when the forces applied to the bone exceed its mechanical strength. 

Most fractures occur in the context of an accident, like a fall, a twisting injury or a vehicular collision. Some fractures occur due to repetitive activities that don’t allow the bone time to self repair. These are called stress fractures and are often observed in athletes. Other fractures are due to abnormally weak bone such as in cases of osteoporosis, other bone diseases and certain cancers.

At the Orthopedic Center our providers will treat bone fractures using different techniques such as closed reduction and casting, bracing, and when indicated sophisticated surgical techniques including internal and external fixation.

Depending on the specific bone and location and your overall health, most fractures, when properly cared for, will heal in 6 to 12 weeks. 

Proper nutrition, avoiding smoking and having your other chronic conditions under control will help prevent a so-called fracture non-union, or failure to heal.

Common Fractures We Treat Are:

  • Wrist Fractures

  • Forearm Fractures

  • Collarbone Fractures

  • Hip Fractures

  • Shoulder Fractures

  • Ankle Fractures

  • Knee Fractures

  • Stress Fractures

The day of your visit with us remember to bring all your pertinent x-rays studies and documents. 

Explore Wrist Fractures

Joint Replacement

Joint Replacement Surgery - Knee, Hip, & Shoulder

When a particular joint has been damaged by arthritis or trauma to the point that conservative management is no longer effective, Joint Replacement surgery, also called arthroplasty, becomes the next option.

Replacing a joint consists of removing worn and deformed joint surfaces and replacing them with high-tech, bio-compatible materials that restore friction-free and pain-free motion.

The ultimate goal of joint replacement surgery is to provide patients with a durable, pain-free joint that will perform well for many years.

Your Surgeons at the Orthopedic Center are  fellowship-trained in joint replacement and have many years of experience in these procedures. They have performed over four thousand joint replacements. 

Rest assured that the surgeons at The Orthopedic Center have carefully chosen their techniques and implants based on quality, patient safety, patient comfort, and durable outcomes.

​At the Orthopedic Center we offer several advanced joint replacement interventions including:

  • Total Knee Replacement

  • Partial Knee Replacement

  • Total Hip Replacement

  • Partial Hip Replacement (fracture)

  • Total Shoulder Replacement

  • Reverse Total Shoulder Replacement

  • Revision Joint Replacement

  • Radial Head Replacement (elbow fracture)

You can be confident that at The Orthopedic Center,  your surgeons are not only Board-Certified, but also Fellowship-Trained in Joint Replacement and Adult Reconstruction.

Our Orthopedic Surgeons have many years of experience. They perform over 400 joint replacement per year. They consistently offer their patients superior and durable outcomes. Our surgeons have earned the trust of their patients, the respect of their peers and the support of the community.

Explore Total Knee Replacement

Physical Therapy

The Orthopedic Center offers convenient on-site Physical Therapy to all patients. Our physical therapists specialize in orthopedic and postoperative rehabilitation. We possess modern equipment and adjunct modalities.

On-site Therapy guarantees that all orthopedic care is tightly integrated keeping all providers focused on getting you back in the game

What do Physical Therapists Do?Physical Therapy in Merritt Island & Palm Bay, Florida

  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.

  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.

  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.

  • Plan and provide interventions including therapeutic exercise, manual therapy, electrotherapy, education.

  • Conduct re-examinations, modify interventions as necessary to achieve anticipated goals and expected outcomes, and develop and implement discharge plans.


  • The Biodex™ System offers a highly sophisticated way to diagnose, treat and document progress for musculoskeletal injuries and disease.

  • This robotic, computer-controlled dynamometer is highly sensitive to patients’ limits.

  • The Isokinetic, Isometric, Isotonic and Passive modes for testing and rehabilitation are totally accommodating throughout the entire range of motion and ensure that your recovery will be optimized.

  • Biodex’s unique impact-free acceleration and deceleration eliminates joint trauma, allowing patients to exercise and be tested at more functional speeds.

  • This technology is now available at The Orthopedic Center physical therapy department in Palm Bay.

Sports Medicine

Sports Medicine - Treatment & Orthopedic SurgeryAt The Orthopedic Center we are experts in the treatment and rehabilitation of sports related injuries and conditions.

Whether you are a hard-core competitive athlete, a weekend warrior or just get hurt chasing the grandchildren, The Orthopedic Center providers are expert in the diagnosis and treatment of many sports related injuries.

Our goal is your rapid and safe return to the activities you love. We provide non-surgical and surgical management to acute and chronic injuries.

Some of the most common injuries include ankle sprain or strains, groin pulls, hamstring strain, shin splints, knee meniscal tearsknee ligament tears (ACL tears), runner’s knee (pain behind the kneecap), tennis elbow, shoulder sprain, patellar dislocations, and low-back pain among others.

Sprains are basically injuries to the connecting collagen between bones in a joint. Strains are injuries to muscle fibers or tendons, which anchor muscles to bones.

The occurrence of sports injuries is often beyond our control, however, there are ways to mitigate and reduce the frequency and severity of these injuries by following some basic advice. First, we must gradually condition ourselves to the activity by consistently increasing the intensity and duration of the activity until you reach your goals. Before you start your workout, a gentle warm-up and stretching session is mandatory.

Your ability to overcome your body’s pain during this process will determine your likelihood of getting injured. Pain is a natural response of your body to excessive use therefore ignoring it too long will lead to overuse injuries. Learn to recognize when you have reached your comfort level and allow your body to recover.

When to get medical attention

It’s OK to put up with some initial discomfort, but don’t ignore a serious injury. If you suspect a serious injury or if you have any of these signs, see a doctor:

  • The pain is not controlled by the “PRICE” therapy and over-the-counter analgesics.

  • There is a deformity in the joint or the extremity. It looks warped or moves abnormally.

  • You cannot bear weight or can’t use the limb without it not supporting you or buckling.

  • There is excessive swelling

  • Your skin is very discolored or severely bruised

  • It’s not getting any better after a few days of PRICE therapy

Orthopedic Surgery

You can be confident that at The Orthopedic Center,  your surgeons are not only Board-Certified, but also Fellowship-Trained in their respective fields of interest.

Our Orthopedic Surgeons have many years of experience. They consistently offer their patients superior outcomes. Our surgeons have earned the trust of their patients, the respect of their peers and the support of the community.

Our surgeons are proud to continue to provide Brevard and surrounding area residents with expert orthopedic care as they return to active, productive, and pain-free lives.


Orthopedic Surgeons

An orthopedic surgeon is a physician dedicated to the diagnosis, treatment, prevention and rehabilitation of injuries, disorders and diseases of the body’s musculoskeletal system. This includes bones, joints, ligaments, muscles, nerves and tendons.

Orthopedic surgeons are familiar with all aspects of the musculoskeletal system. However, many orthopedists specialize in certain areas, such as the foot and ankle, hand, shoulder and elbow, spine, hip or knee. Orthopedic surgeons may also choose to focus on specific fields like trauma, joint replacement, or sports medicine.

By the time they start practicing, orthopedic surgeons have completed approximately 14 years of formal education and training. It is important to visit orthopedic surgeons who are board certified. To become board certified, an orthopedic surgeon must undergo a peer-review process, and then demonstrate his/her expertise in orthopedics by passing both oral and written examinations given by the American Board of Orthopedic Surgery.