Sports Medicine Conditions

There are two main tendons in the knee – the quadriceps tendon that connects the thigh muscles to the kneecap, and the patellar tendon that connects the kneecap to the shin bone (tibia). These tendons can be torn through a fall or a sports injury, and they must be reattached to the bone. Surgery for knee tendon injuries is usually an outpatient procedure with a high success rate. Dr. Bushnell has published extensive research about knee tendon injuries and repair using suture anchors – a minimally-invasive technique that he helped develop while in training at the University of North Carolina.

For more information about knee tendon injuries, please visit:

Patellar Tendon Tear

Quadriceps Tendon Tear

Suture Anchor Repairs

Tennis elbow, also known as lateral epicondylitis, is a painful inflammatory condition that affects the outer side of the elbow.  It can caused by many different factors – not just tennis!  It is common in patients who perform repetitive activities with their elbow at work or in other forms of recreation.  The pain can range from annoying to crippling.  This condition usually responds well to anti-inflammatory medication, physical therapy exercises, and special braces.  Occasionally, a corticosteroid injection into the area may be required to calm down the inflammation.  In rare and resistant cases, surgery may be needed.

For more information about tennis elbow, please visit:

Tennis Elbow – OrthoInfo
Tennis Elbow – WebMD

The rotator cuff is perhaps the most frequently injured tendon in the entire body. It is actually a collection of four tendons that help rotate and elevate the shoulder joint. Because the rotator cuff lies directly beneath the bone of the shoulder blade, it can rub against the bone and become inflamed – a condition known as impingement. Impingement can be made worse in the presence of bone spurs on the shoulder blade. The inflammation and mechanical stress can sometimes progress to gradual breakdown and tearing of the rotator cuff. While these chronic tears can often be successfully treated with injections, medications, or physical therapy, they do sometimes require surgery. The rotator cuff can also suffer an acute tear, in which the tendon is ripped off of the bone due to an injury. Acute Tears usually require surgical repair.

For more information about Rotator Cuff Tears, please visit:

Rotator Cuff Tears
Rotator Cuff Tears – FAQ
Rotator Cuff Surgical Treatment Options
Regenten Bioinductive Implant 

A shoulder “dislocation” is when the ball (the humerus ) comes completely out of the socket (the glenoid). This is an emergency condition that must be treated immediately by putting the ball back in the socket. Sometimes this can be done by a first-responder or a paramedic, or even the patient. More often, however, the shoulder must be put back in place in an emergency room under sedation. After a shoulder dislocation, the patient may have shoulder instability, or recurrent full or partial dislocations. This is usually due to tearing of the labrum, or the “o-ring” around the socket – a condition that is often treated with surgery. Dr. Bushnell has advanced training in arthroscopic repair of the shoulder labrum.

For more information about shoulder dislocation, please visit:

Shoulder Dislocation
Shoulder Arthroscopy
Shoulder Surgery
Labrum Tear

The biceps tendon can tear at its insertion in the shoulder. Many times, this injury is also associated with a tear of the rotator cuff – since the two tendons are right next to each other in the shoulder. While a biceps tendon tear rarely needs surgery to fix it, a traumatic tear of the rotator cuff usually does need surgical treatment. The biceps tendon can also tear at its insertion at the elbow, and this problem usually needs surgical fixation.  Any injury of the biceps tendon at the shoulder or the elbow should be evaluated thoroughly by a specialist such as Dr. Bushnell.

For more information about biceps tendon tears, please visit:

Biceps Tendon Tear (Shoulder)
Biceps Tendon Tear (Elbow)

A shoulder “separation” is when the collar bone (the clavicle) is completely torn away from its normal position next to the top of the shoulder blade (the acromion). The degree of separation is variable, and less severe cases usually only need medication. More significant separations, however, usually require surgical reconstruction. Many techniques exist for reconstruction of a separated shoulder, and Dr. Bushnell can discuss all of these options with you.

For more information about shoulder separation, please visit:

Shoulder Separation
Shoulder Arthroscopy
Shoulder Surgery

Meniscus Tear

One of the most common injuries in the knee involves tearing of the meniscus. The meniscus is a thick, rubbery “shock absorber” made of fibrocartilage, which is a different type of cartilage than the articular cartilage that lines the ends of the bones. Tears of the meniscus can happen suddenly, from a fall or accident, or from a sports injury. Sometimes the meniscus may heal on its own. In younger patients, the meniscus can sometimes be repaired if the tear has a good blood supply. In older patients, however, a tear of the meniscus usually requires a partial meniscectomy – a surgical procedure in which the torn part of the meniscus is removed from the knee using special arthroscopic instruments and a minimally-invasive approach. Arthroscopic surgery is the most common procedure that Dr. Bushnell performs in the knee.

For more information about meniscus tears, please visit:

• Meniscal Tears
• Meniscal Tears
• Meniscus Tear Treatment Overview
• Meniscal Tears (Spanish)

Chondral Defect

The ends of the bones in the knee are covered with smooth articular cartilage, which is different from the fibrocartilage of the meniscus. This cartilage can be injured and develop a chondral defect. A chondral defect must be diagnosed by an MRI, and the thighbone (the femur) is the most common site of injury. These defects are essentially “holes” in the cartilage, and can be a major source of pain and disability. These holes can be “patched” using a surgical technique known as microfracture. Dr. Bushnell trained at the Denver branch of the Steadman-Hawkins Clinic in Colorado – the institution where the microfracture technique was invented by Dr. Richard Steadman.

For more information about knee cartilage injury, please visit:

• Microfracture Surgery
• Knee Microfracture Surgery

There are several tendons in the shoulder, and any of them can become inflamed – a condition known as tendinitis. The severity of tendinitis can range from annoying to crippling. Usually, anti-inflammatory medication, rest, ice, and activity modification will improve the symptoms of tendinitis. In resistant cases, an injection near the tendon will usually fix the problem. Surgery is rarely required. For more information about shoulder tendinitis, please visit:

Rotator Cuff Tendinitis
Shoulder Injuries in the Throwing Athlete

The kneecap (patella) can sometimes dislocate out of its position in the middle of the knee, usually to the outer side. This injury can then result in kneecap instability, or repeated dislocations. This instability can be frustrating and dangerous, as patients never know when their knee will “give out.” Sometimes, a dislocation can be successfully treated with a brace. Other times, however, the dislocation requires surgery to rebuild the ligaments that stabilize the kneecap. A cartilage injury to the kneecap may also have occurred during the dislocation, and these injuries are also treated as part of the same surgery.

For more information about kneecap instability, please visit:

• Unstable Kneecap
• Unstable Kneecap (Children)

Fractures of the ankle are common injuries sustained in sports, recreation, and accidental falls.  Most people cannot walk on a broken ankle.  Ankle fractures often involve a break of both bones of the ankle – the smaller fibula on the outer side of the ankle, as well as the larger tibia on the inner side of the joint.  A broken fibula usually requires treatment with a plate and screws.  A broken tip of the tibia usually requires treatment with screws.  Sometimes a cast will suffice for treatment of an ankle fracture.  Dr. Bushnell has treated ankle fractures in all kinds of situations – from simple missteps to major injuries from skydiving and rodeo accidents.

For more information about Ankle Fractures, please visit:

Ankle Fractures

One of the most common conditions affecting the shoulder is subacromical impingement. The rotator cuff rubs up against the undersurface of the acromion, or the shoulder blade, and can become very inflamed. As this condition progresses, the rotator cuff can become frayed or partially torn. Bone spurs or osteophytes can form on the shoulder blade, which make this condition worse. In some cases, an arthroscopic decompression, or “clean out” may be needed. In most cases, however, Dr. Bushnell is able to treat impingement successfully with medication, injections, and physical therapy.

For more information about shoulder impingement, please visit:

Shoulder Impingement
Shoulder Injuries in the Throwing Athlete
Shoulder Arthroscopy
Shoulder Surgery

The knee has several important ligaments, which are thick cords of tissue that connect the bones to each other.  These ligaments can be injured in sports, work, recreation, or even everyday activities.  Some ligaments may heal on their own with appropriate braces.  Other ligament injuries, however, usually require surgical repair or reconstruction.  Dr. Bushnell maintains an active interest in ligament surgery since his training at the Steadman-Hawkins Clinic in Denver, a busy ligament reconstruction center where he was also able to publish research about ligament injuries in professional athletes.

ACL Tear

The anterior cruciate ligament (ACL) is the most commonly torn ligament in the knee. It usually tears from a twisting and/or hyperextension injury. It is more common in younger patients and in female athletes, but it can affect patients of any age and activity level. Once torn, the ACL usually requires surgical reconstruction. Various surgical techniques exist to reconstruct the ACL, and Dr. Bushnell has training and experience in all of the major methods of ACL reconstruction. He has performed ACL surgery on patients as young as 11 years old and as old as 63. He meets with each patient individually to discuss the most ideal choice of reconstruction technique, based on each patient’s age, activity level, athletic goals, and other factors.

For more information about ACL tears, please visit:

• ACL Tear
• ACL Injury: Does it Require Surgery? 
• ACL Tear (Spanish)

MCL Tear

The medial collateral ligament (MCL) is the second-most commonly torn ligament in the knee. It stabilizes the knee from side to side and is located on the inner side of the knee. Injury to the MCL is very common in contact sports in which athletes are tackled or impacted from the side. A tear of the MCL is usually treated without surgery, using a hinged brace to protect the joint while the ligament heals.

For more information about MCL tears, please visit:

• Collateral Ligament Injuries

PCL Tear

The posterior cruciate ligament (PCL) is another major ligament in the knee that can frequently be torn in athletic or recreational activities. The injury usually occurs when a person falls and strikes the front of their knee hard against the ground or another object. While this injury may occasionally need surgery, it can usually be managed with an appropriate brace.

For more information about PCL tears, please visit:

• PCL Injuries

LCL Tear

The lateral collateral ligament (LCL) also stabilizes the knee from side to side, just like the MCL, but the LCL is located on the outer side of the knee. Isolated injuries to the LCL usually do not need surgery, but often they are part of a more complicated injury to the knee involving more than one ligament. Dr. Bushnell has published research about LCL injuries in professional football players.

For more information about LCL tears, please visit:

• Collateral Ligament Injuries
• LCL Injuries in NFL Athletes (A Paper by Dr. Bushnell)

MPFL Tear

The medial patellofemoral ligament (MPFL) stabilizes the kneecap and keeps it from slipping out to the side.  When an injury results in a full patella dislocation, the MPFL can be torn.  In some cases, the tear of the MPFL can be treated successfully with a brace.  In other situations, the MPFL must be repaired or reconstructed.  In association with his partner, Dr. Piller, Dr. Bushnell has developed a minimally-invasive technique for MPFL reconstruction that has had great success.

For more information about MPFL tears, please visit:

• Unstable Kneecap (OrthoInfo)