Skilled efficient office staff, not having to utilize the quiet relaxing waitng room for long, obtaining a needed professional evaulation by this physican – not an assistance, efficiency gained in this first visit if xrays and MRI are brought to the initial office visit, and leaving understanding the reason of the knee's dysfunction as well as options for improvement.

This office is focused on the performance of your knee. Since we only evaluate knees concerning their difficulties, dysfunction, or change of performance, a high level of expertise is maintained. From experience, continuing medical education, and observation, there is high accuracy in establishing the correct diagnosis. It is great that the patient and individual understand the anatomy and function of the knee. With this education and understanding, the numerous treatment options will be reviewed in detail. Thus the goal of this clinic in understanding and being educated and making a better decision on each option is achieved.

From the history, exam findings, duration of dysfunction, limitation of activity, ease of irritability, in conjunction with any narrowing of standing X-rays, and impressions gained from a high resolution closed MRI, the different pathways of treatment options can be discussed accurately to obtain the best options to return to the desired activity level.

At times modification pf activity which generates impact such as a walking program, running, treadmill, and certain sports, must be modified. Therfore foscusing and participating in actiyities such as swimming, cycling, lifting weights, and possible elliptical instead of impact, this type of cross training results in decrease stress therefore promoting performance with longevity.

If standing x-rays obtained at 40 degrees of flexion reveal narrowing of medial or lateral compartments, loss of articular cartilage has occurred due to the owner's mileage, age, and activity levels. The wear of this polmer of glycosamine, chondroitin, aminoglycosides, and polysaccarides continues to progress at variable rates. Chondromalacia is thinning and roughness of the hyaline articular cartilage with fissures, flaps and ultimately exposed subchondral bone. The rate of of wear and progressive loss of the articular cartilage is accelerated with imact, shear, torgue, and stress which is usally associated with job responsibilities, types of conditioning exercises, and level of competitive sports. With analysis basketball, football, softball, tennis, running, and volleyball generate significantly more forces than cycling, lifting weights, elliptical trainers, golf, monopoly,and swimming.

The goal of this physician and patient being a team is to restore performance. With use of available modalities, the goal is to remove limitations therefore having the ability to return to adesired level of activity

If the knee is older than its owner's spirit, heart, and body, suggestions should be considered in cross training to blend performance with longevity.

Promote longevity with a level of performance.