Knee Surgery

Meniscal tears are one of the most common knee injuries. Meniscal tears can cause knee pain, decreased range of motion, locking and/or clicking in the knee. Depending on the pattern of meniscal tear, Dr. Horner may recommend a trial of non-surgical management such as physical therapy, injections and/or medications. Other meniscal tears may require minimally invasive arthroscopic management to excise or repair the tear.

Anterior cruciate ligament (ACL) injuries may occur because of either a contact or non-contact injury, and frequently initially presents with a “popping” sensation and sudden onset of knee pain and swelling. In the majority of young and active patients Dr. Horner recommends ACL reconstruction surgery for these injuries to allow patients to return to sports and other day to day activities without issues with persistent knee instability. Patients typically require bracing for 4-6 weeks after ACL surgery, can begin running at 3-4 months after surgery and are fully cleared for return to sport at 6-9 months post-operatively.

First time kneecap (Patella) dislocations are most commonly treated non-operatively, however if patients have issues with persistent patellar instability, they may benefit from patellar stabilization surgery. The most common form of patellar stabilization is medial patellofemoral ligament (MPFL) reconstruction, however the decision on which surgery to perform is based on the anatomic factors that are contributing to a patient’s patellar instability.

Lastly, Dr. Horner uses a wide range of newly available cartilage restoration and cartilage transplantation techniques to treat patients with isolated cartilage defects in their knees.

Knee Arthroscopy

• Meniscus surgery
• ACL reconstruction
• PCL/LCL/MCL reconstruction
• Cartilage restoration (MACI/OATS/Osteochondral allograft/Microfracture)
• Osteochondritis dissecans fixation

MPFL reconstruction (Patellar stabilization surgery)
Patellar tendon repair
Quadriceps tendon repair
Osteochondritis dissecans fixation

Dr. Horner has also published extensive research on shoulder surgery. Below is a list of peer reviewed journal articles and book chapters by Dr. Horner on this topic.

Published Book Chapters

1. Horner NS, Gohal C, Ayeni OR, Whelan DB. Acute Posterolateral Corner Injuries. In: Bhandari M, Chief ed. Evidence-Based Orthopedics. 2020.
2. Gohal C, Horner NS, Abouali J, Theodoropoulos J. Posterior Cruciate Ligament Injury. In: Bhandari M, Chief ed. Evidence-Based Orthopedics. 2020.
3. Kay J, Macdonald A, de SA D, Horner NS, Phillips M, Parmar D, Peterson D, Ayeni OR. Chapter 2: Autograft and Allograft Options in Knee Ligament Reconstruction. In: Mascarenhas R, Bhatia S, Lowe WR, eds. Ligamentous Injuries of the Knee. 2016.

Published Journal Articles

1. NO PAin Investigators (Horner NS – Principal Investigator). Multimodal Opioid Sparing Postoperative Pain Protocol versus Standard of Care for Patients Undergoing Knee and Shoulder Arthroscopy: A Randomized Controlled Trial. JAMA. In Press.
2. NO PAin Investigators (Horner NS – Principal Investigator). Protocol for a randomized controlled trial comparing a non-opioid prescription to the standard of care for pain control following arthroscopic knee and shoulder surgery. BMC Musculoskelet Disord. In Press.
3. Gupta A, Tejpal T, Shanmugaraj A, Horner NS, Gohal C, Khan M. Indications, Outcomes, and Complications of All-Epiphyseal Anterior Cruciate Ligament Reconstruction: A Systematic Review. Accepted to KSSTA. In Press.
4. Sedrak P, Hache P, Horner NS, Adili A, Khan M. Acute Pseudoseptic Arthritis after Viscosupplementation. 2020. In Press.
5. Gazendam A, Ekhtiari S, Horner NS, Nucci N, Dookie J, Ayeni OR. Perioperative Nonopioid Analgesia Reduces Postoperative Opioid Consumption in Knee Arthroscopy: A Systematic Review and Meta-Analysis. KSSTA. 2020. In Press.
6. Ekhtiari S, Horner NS, Shanmugaraj A, Duong A, Simmunovic N, Ayeni OR. Narcotic Prescriptions following Knee and Shoulder Arthroscopy: A Surgeon Survey. Cureus. 2020. In press.
7. Shanmugaraj A, Mahendralingam M, Gohal C, Horner NS, Simunovic N, Ayeni OR. Press-Fit Fixation in Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis. KSSTA. 2020. In Press.
8. Tejpal T, Gupta A, Shanmugaraj A, Horner NS, Simunovic N, Peterson DC, Musahl V, Ayeni OR. Anteromedial Portal Double Bundle Anterior Cruciate Ligament Reconstruction Yields Similar Outcomes to Non-Anteromedial Portal Femoral Drilling Double Bundle Techniques: A Systematic Review of Comparative Studies. 2019.
9. Shanmugaraj A, Tejpal T, Ekthari S, Gohal C, Horner NS, Khan M, Bhandari M. Horizontal Cleavage Tears: A Systematic Review of Surgical Techniques, Outcomes and Complications. KSSTA. 2019. In press.
10. Bhullar R, Habib A, Zhang K, de Sa D, Horner NS, Duong A, Simunovic N, Espregueira-Mendes J, Ayeni OR. Tunnel osteolysis post-ACL reconstruction: a systematic review examining select diagnostic modalities, treatment options and rehabilitation protocols. Knee Surg Sports Traumatol Arthrosc. 2019;27(2):524-533.
11. Gupta A, Tejpal T, Shanmugaraj A, Horner NS, Simunovic N, Duong A, Ayeni OR. Surgical Techniques, Outcomes, Indications, and Complications of Simultaneous High Tibial Osteotomy and Anterior Cruciate Ligament Revision Surgery: A Systematic Review. HSS J. 2019;15(2):176-184.
12. Stride D, Wang J, Horner NS, Alolabi B, Khanna V, Khan M. Indications and outcomes of simultaneous high tibial osteotomy and ACL reconstruction. Knee Surg Sports Traumatol Arthrosc. 2019;27(4):1320-1331.
13. Gohal C, Shanmugaraj A, Tate P, Horner NS, Bedi A, Adili A, Khan M. The Effectiveness of Valgus Offloading Knee Braces in the Treatment of Medial Compartment Knee Osteoarthritis: A Systematic Review. Sports Health. 2018;10(6):500-514.
14. Moroz PA, Quick EE, Horner NS, Duong A, Simunovic N, Ayeni OR. What Is the State of the Evidence in Anterolateral Ligament Research? Clin Sports Med. 2018;37:137-159.
15. Quinn R, Horner NS, Pazionis T, Katsios CM. Is Knee Arthroscopy for Degenerative Meniscal Tears an Unnecessary Procedure? Ortho & Rheum Open Access. 2017;7(3):555715.
16. Ekhtiari S, Horner NS, de SA D, Simunovic N, Hirschmann MT, Ogilvie RA, Beradelli RL, Whelan DB, Ayeni OR. Arthrofibrosis after ACL reconstruction is best treated in a step-wise approach with early recognition and intervention: a systematic review. Knee Surg Sports Traumatol Arthrosc. 2017;25(12):3929-3937.
17. Horner NS, Ekhtiari S, Simunovic N, Bedi A, Glyn-Jones S, Ayeni OR. Early evidence reports positive outcomes after osteochondral grafts and chondrocyte transplantation in the hip: a systematic review. JISAKOS. 2016. DOI: 10.1136/jisakos-2016-000059.