Sports Medicine Procedures

Knee meniscectomy is the most common surgical procedure performed on the knee.  A meniscus tear can occur as an acute injury or through degeneration.  Patients usually experience pain with weight-bearing, squatting, and twisting.   Meniscectomy is performed as a minimally invasive surgery using knee arthroscopy.  The meniscus is trimmed and smoothed with small instruments through 2 small stab incisions in the knee.  Patients usually recover quickly and completely.

Dr. Bushnell has advanced training in arthroscopic treatment of knee injuries.

For more information about Knee Meniscectomy, please visit:

Meniscal Tears (AAOS OrthoInfo)
Meniscal Surgery (E-Orthopod)

Articular cartilage injuries of the knee are characterized by pain and sometimes mechanical symptoms such and catching or locking.  After MRI evaluation, a more detailed exploration by knee arthroscopy is often performed.  The area of missing articular cartilage is examined and unstable pieces are trimmed.   Then, multiple small channels are placed into the bone to allow bone marrow and its accompanying stem cells to flow into the knee.  This matrix of cells ultimately heals as fibrocartilage and covers the exposed bone.  Range of motion exercises are begun immediately, but weight-bearing is restricted up to 8 weeks.  Full recovery may take several months to one year.  Microfracture was invented by Dr. Richard Steadman – the patriarch of the Steadman-Hawkins Clinic in Denver, Colorado, where Dr. Bushnell received his fellowship training.

For more information about Knee Microfracture, please visit:

Microfracture (Steadman Clinic)
What’s New in Cartilage Repair (AAOS Orthoinfo)
What’s New in Cartilage Repair (HSS)

Articular cartilage injuries of the knee are characterized by pain and sometimes mechanical symptoms such and catching or locking.  After MRI evaluation, different methods of cartilage repair are discussed.  Depending on the size of the cartilage lesion, age of the patient, and activity level, a surgical plan is developed.  Dr. Bushnell has advanced training in cartilage repair and can help determine the best treatment option for your specific injury.

For more information about cartilage repair of the knee, please visit:

Articular Cartilage Restoration (AAOS OrthoInfo)
What’s New in Cartilage Repair (Hospital for Special Surgery)
Advances in Articular Cartilage Defect Manegement (Mayo Clinic)

The medial patellofemoral ligament (MPFL) can be torn with a dislocation of the kneecap.  In some cases, patients may have suffered multiple dislocations over time.  Although tears of this ligament can sometimes heal in a brace, many cases will require ligament reconstruction – especially if the patient has suffered recurrent dislocations.  Dr. Bushnell offers a minimally-invasive technique for MPFL reconstruction, based on a method developed by his senior partner, Dr. Christopher Piller.  This surgical technique uses a cadaver ligament to rebuild the ligament on the inner side of the knee, stabilizing the patella and allowing the patient to return to full function and athletic participation.

For more information about MPFL reconstruction, please visit:

• MPFL Reconstruction (YouTube Video)

A torn or ruptured tendon at the knee can prevent a person from working or playing sports and even make normal walking impossible.  Knee tendon repair can be performed through a minimally-invasive incision using suture anchors to repair the torn tendon back down to the bone.  Dr. Bushnell is an internationally-published authority on the repair of tendons in the knee.

For more information about Knee Tendon Repair, please visit:

Patella Tendon Tear

Quadriceps Tendon Tear

Suture Anchor Repair of the Patellar Tendon (A Paper by Dr. Bushnell)

The ACL is the most commonly torn ligament in the knee.  When the ACL is torn in a young, active person, surgery for reconstruction of the ligament is usually required.  Dr. Bushnell has extensive training and experience in treatment of ACL injuries, including several techniques of ACL reconstruction.  Dr. Bushnell most commonly performs ACL reconstruction using the hamstring tendon technique, but he also performs patellar tendon and cadaver tendon reconstructions.

For more information about ACL Reconstruction, please visit:

ACL Injury: Does it Require Surgery?

ACL Reconstruction with Hamstrings (Video)

Animated Surgical Procedures

A meniscus tear can occur as an acute injury or through degeneration.  Patients usually experience pain with weight-bearing, squatting, and twisting.   The decision to repair a torn meniscus is based on several factors including patient age and location of the tear.   Meniscus repair is performed as a minimally invasive surgery using knee arthroscopy.  The meniscus is sutured with specialized, small instruments through 2 small stab incisions in the knee.  Recovery is longer as weight-bearing and activity restrictions are placed on the patient to allow the meniscus to heal.  Dr. Bushnell has advanced training in arthroscopic treatment of knee injuries.

For more information about meniscus repair, please visit:

Meniscus Repair (WebMD)
Meniscus Repair (AAOS OrthoInfo)

Elbow arthroscopy is a procedure in which the surgeon places a small video camera into the elbow joint for diagnostic purposes or to guide an interventional procedure.  This camera can show the important structures of the elbow joint, such as the cartilage on the surface of the bones, the ligaments, the tendons, and even the nerves near the elbow.  Using the camera, the surgeon can clean the joint out, repair cartilage injuries, remove bone spurs or cartilage fragments, repair or clean out damaged tendons, or other procedures.

For more information about Elbow Arthroscopy, please visit:

Elbow Arthroscopy

Arthroscopy

When the biceps tendon at the shoulder suffers from partial tearing or tendinitis, or if the labrum tear of the shoulder, a biceps tenodesis may be indicated.  In this procedure, the biceps tendon is reattached to the humerus (arm bone) through a small incision and using suture anchors to secure the tendon down to the bone.  Usually, this procedure is performed through the same incision used to insert the scope and/or various instruments as part of a shoulder arthroscopy procedure.  When a tenodesis is performed, it is usually to maintain relatively normal appearance of the biceps muscle and to improve long-term function, strength, and endurance of the biceps muscle.  Alternatively, some patients choose to have a biceps tenotomy procedure, in which the tendon is simply clipped off of the labrum.  In many cases, the functional and cosmetic loss from a tenotomy are negligible – and the rehabilitation and healing process are much faster.

For more information about Biceps Tenodesis, please visit:

Biceps Tendinitis (AAOS Orthoinfo)

Injection of medication into the shoulder can provide rapid and significant relief of pain and stiffness.  Dr. Bushnell performs hundreds of shoulder injections a year.  These injections are performed during a regular office visit.

Sometimes, the rotator cuff tendons do not have enough room for moving underneath the shoulder blade, or the acromion.  This can lead to impingement, or rubbing of the tendon against the bone that causes the tendon to break down.  Sometimes this process can even lead to a full-thickness rotator cuff tear.  In a decompression procedure, the bone of the shoulder blade is thinned slightly using arthroscopic tools to create more room for the tendons.  Bone spurs are trimmed away.  The rough edges of the tendon are cleaned up or debrided.  This procedure eliminates the rubbing of the tendon against the bone and stops further damage from occurring.  Ideally, the procedure can be performed before the tendon impingement progresses to a full-thickness tear, since a decompression procedure has a much faster recovery than a rotator cuff repair.

For more information about Decompression surgery in the shoulder, please visit:

Shoulder Arthroscopy (AAOS Orthoinfo)

The biceps tendon can tear at its insertion at the elbow as a result of a sports injury or an accident.  Often, this injury occurs when a person is lifting a heavy object or if the elbow is hyper-extended.  A tear of the biceps tendon at the elbow, if not treated with surgical repair, can result in deformity of the muscle, weakness, and loss of function.  Dr. Bushnell performs biceps tendon repair using the Biceps Button technique, which involves a small incision on the front of the elbow.

For more information about Biceps Tendon Repair, please visit:

Biceps Tendon Tear at the Elbow

Distal Biceps Tendon Repair Using the Biceps Button and Tension Slide Technique (Video)

In knee arthroscopy, the surgeon inserts a small video camera (a “scope”) into the knee through a poke-hole incision.  A second poke-hole incision is made to insert various tools.  The surgeon can “tour” the knee and make definitive diagnosis of various different injuries and conditions.  Using arthroscopy, the surgeon can repair ligaments, clean out or repair cartilage, remove debris, or perform other procedures.

For more information about Knee Arthroscopy, please visit:

Knee Arthroscopy

Knee Arthroscopy (Spanish)

Repair of the rotator cuff is Dr. Bushnell’s #1 most frequently performed surgical procedure. While many tears may not require surgery, Dr. Bushnell uses advanced arthroscopic and minimally-invasive techniques when surgery is required. Arthroscopic repair of the rotator cuff involves placing several small “portal” incisions (usually about ¼ inch each) in the shoulder and using a small video camera to guide the surgery. With the use of special equipment, the rotator cuff is repaired with sutures and usually “suture anchors,” which are like small corkscrews that screw into the bone and provide a stable attachment for the stitches. Sometimes even more advanced techniques are needed, such as artificial patches and tendon slides.

For more information about rotator cuff tears, please visit these links:

Rotator Cuff Tears – Surgical Treatment Options
Rotator Cuff Repair – (National Library of Medicine)
Rotator Cuff Repair – (WebMD)
Arthroscopic Rotator Cuff Repair with video (AAOS Orthoinfo)
Regeneten Bioinductive Implant (Smith and Nephew)

Shoulder arthroscopy involves the placement of a small camera into the shoulder joint for diagnostic purposes or to guide an interventional procedure, such as a rotator cuff repair.  Using this video camera, the surgeon can “tour” the entire joint.  The camera can show the cartilage, labrum, rotator cuff tendons, shoulder ligaments, and other parts of the joint.

For more information about Shoulder Arthroscopy, please visit:

Shoulder Arthroscopy