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Welcome to the 

Knee Expert

 web site!

It was created to meet the needs of sophisticated knee patients and their families, as well as to assist physicians and therapists who desire to know more about the knee than is available from standard sources.

I have often found, as a practicing orthopaedic surgeon, that the conventional clinical concepts of the knee are not only inadequate, but on occasion can lead to treatment choices that can actually make the patient=s symptoms worse. The ideas presented here are the result of over twenty years of intense clinical and research interest in the knee. The site name is "Knee Expert," but of course no one person can know everything about a particular subject. However I do have a deep and long-standing research passion for the knee as well as the privilege of having diagnosed and treated thousands of patients with knee problems.

Over the years I have come to a deeper understanding of the knee from many different aspects including its evolution, anatomy, physiologic function and its responses to injury, an understanding that has directly resulted in improved treatment for my own patients. I wish to share these accumulated insights so that you can better understand your condition - which should allow you to manage your own knee problem better.

I have found it valuable for the knowledgeable knee patient to have access to actual published professional, academic articles concerning the knee. This web site will initially offer for your interest a selection of articles on the knee that have been published in some of the best orthopaedic professional journals. Taken together, they represent a considerably different perspective of the knee than can be found in current medical textbooks.

The fundamental concept for you to understand is that the knee should be viewed as a complex living, self-repairing, self-maintaining system of extremely ancient origin, designed to accept and transfer loads between the femur (thigh bone) and the tibia (leg bone) within a certain range. Thus the knee can be thought of as a kind of living biologic transmission system, whose various parts (e.g., ligaments, cartilage, bone, etc.), work together to transfer a broad variety of biomechanical loads while still maintaining tissue homeostasis (normal biochemical processes at the molecular and cellular level). Maintenance of tissue homeostasis is the platinum standard of musculoskeletal health.

For those of you with an injury of the anterior cruciate ligament or with patellofemoral (Kneecap) pain - these articles should prove to be particularly of interest. But these concepts are also applicable to virtually every knee condition including meniscal injuries, synovitis and osteoarthritis.

The concept of the Envelope of Function is one that you will see being referred to frequently. This simple, commonsense representation of knee function is the critical concept upon which this new view of musculoskeletal function and indeed, orthopaedics itself, is based. The Envelope of Function reflects the capability of the knee (or any joint or musculoskeletal system) to transfer a range of loads over a given period of time, but to do so while still remaining uninjured at the molecular or cellular level (i.e., while still maintaining tissue homeostasis).

From a simple clinical standpoint the ability to do certain activities totally without pain, or without any adverse symptoms such as swelling or aching, means that one is functioning within his or her envelope. This envelope is not unlike the flight envelope that defines safe performance for an aircraft.

The presence of pain, swelling, instability, catching, etc., indicates that one is loading out of one=s envelope for a given joint (An alternative but still appropriate term is the "Envelope of Load Acceptance").

The whole purpose of orthopaedic treatment, whether for the knee or for some other joint system, is to maximize the Envelope of Function as safely and predictably as possible. All of my treatment recommendations, whether medication, physical therapy, braces or surgery, conform to this basic principle.

From time to time I intend to add to this web site further academic articles and specific explanations of ideas that may be of value to you as a patient. If there appears to be interest, I may make available extended explanations of these ideas in non medical language in the form of audio CDs, cassettes or video cassettes.

I hope that the information contained on this web site will result in improved understanding and appreciation for your own knee condition.

Best wishes,

Scott F. Dye, M.D.

A Selected Curriculum Vitae for Scott F. Dye, M.D.

(Full CV is available on this site)

Born in Seattle, Washington in 1949

Bachelor of Arts degree in Anthropology from the University of Pennsylvania in 1971

Doctor of Medicine degree from the University of Virginia School of Medicine in 1975

Residency in Orthopaedic Surgery at Shriners Children=s Hospital and Letterman Army Hospital

Chief of Knee Service, Department of Orthopaedic Surgery, Letterman Army Hospital

Private Practice in Orthopaedic Surgery and Sports Medicine in San Francisco, 1984 to present

Associate Clinical Professor of Orthopaedic Surgery, University of California at San Francisco

Fellow, American Academy of Orthopaedic Surgeons

Board Certified as orthopaedic surgeon in 1981

Member, American Orthopaedic Society for Sports Medicine

Member, International Knee Society (currently ISAKOS)

Elected to Association of Bone and Joint Surgeons

Elected to American Orthopaedic Association

President, Bay Area Knee Society

How to Reach Dr. Dye

If you wish to make an appointment to see Doctor Dye, please contact Ramona or Jessica, the Office Receptionists or Marsha Summers, the Office Manager, at 415-861-9966.

The office is located in Suite 117, the Medical Office Building, California Pacific Medical Center, Davies Campus, San Francisco, CA, 94114.

Need directions?

 

If you have any questions, or just want to comment on this web site, please contact me at

  DrDye@kneeexpert.com

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