Arthroscopic knee surgery may be a treatment option for certain types of knee pain. Arthroscopic surgery is a procedure that involves inserting a small camera inside the joint. Through other small incisions, instruments can be inserted to repair or remove damaged structures. Arthroscopic knee surgery is often called “scoping the knee” or knee arthroscopy.
What is Knee Arthroscopy?
Arthroscopy is one of the most common procedures used to diagnose and treat joint problems. Knee arthroscopy is a procedure through wich the doctor diagnoses and treats knee problems. The procedure uses small incisions. An arthroscope is a tiny device having a camera attached to the end of it. The arthroscope will be inserted to the knee through the incision. The arthroscope inside the knee joint sends images of the inside structures to the monitor outside. An arthroscopy can be used to diagnose, repair or remove the damaged tissues of the knee joint.
How is the surgery performed?
The surgery will be done on an outpatient basis. The first step of the procedure is the administration of anesthesia. The surgeon may administer a local, regional or general anesthesia based on various factors. After administering anesthesia, he/she will make a few incisions in the surgical area, the knee. Through the incision, the surgeon will insert an arthroscope and analyse the condition very well. After the analysis, if the doctor thinks surgery is necessary, he/she will proceed with the surgery. For the surgery, the surgeon will insert tiny surgical instruments through the incision. The surgery may take around 30 minutes to 1 hour. Length of the procedure may vary according to the condition to be treated.
Why knee arthroscopy is suggested?
A knee arthroscopy is suggested for the following:
- To remove or repair the torn meniscal cartilage
- To reconstruct the torn ACL
- To trim the torn pieces of articular cartilage
- To remove loose fragments of the cartilage or bone
- To remove inflammed synovial tissue
What are the risks and complications of a knee arthroscopy?
Arthroscopy is best known for minimal complications and risks. However, there can be minimal risks and complications as with any other surgery. Some of the common complications include:
- Blood clots
- Blood accumulation in the knee
If the patient has fever, chills or any other strange complications after the surgery, it should be brought under immediate notice of the surgeon.
How about the recovery?
Except those who had ligament reconstruction, a patient after knee arthroscopy will be able to return to normal physical activities after 6-8 weeks. Intense physical activities will not be suggested until the patient recovers completely after the procedure. The final result may vary according to the severity of knee damage the patient had.
Reasons to Perform Arthroscopic Knee Surgery
Not all causes of knee pain can be effectively treated with an arthroscopic procedure. Some of the reasons to perform a Knee Arthroscopy include:
- Torn Cartilage/Meniscus Surgery: Meniscectomy is a surgery that involves the removal of a portion of the meniscus cartilage from the knee joint. The meniscus is a shock-absorbing wedge of cartilage that sits between the bone ends to provide cushioning and support. Smaller meniscus tears can usually be trimmed to relieve the symptoms of a torn meniscus.
- Meniscus Repair: A meniscus repair is a surgical procedure done to repair the damaged meniscus. The meniscus repair can restore the normal anatomy of the knee, and has a better long-term prognosis when successful. However, the meniscus repair is a more significant surgery. The recovery is longer, and, because of limited blood supply to the meniscus, repair of the meniscus is not always possible.
- ACL Reconstruction: The anterior cruciate ligament, or ACL, is one of four major knee ligaments. The ACL is critical to knee stability, and people who injure their ACL often complain of their knee giving out from under them. Therefore, many patients who sustain an ACL tear opt to have surgical treatment of this injury. A majority of the ACL surgery is performed arthroscopically.
- Plica Excision: A plica is a remnant of tissue leftover from fetal development. In early development, your knee was divided into separate compartments. The dividers of the compartments are gradually lost over time, but some remnant remains. When this remnant tissue is more prominent, it is called a plica. When the plica is irritated, it is called plica syndrome. A plica resection is performed to remove this irritated tissue.
- Lateral Release: The kneecap moves up and down the end of the thigh bone in a groove of cartilage. The kneecap can be pulled to the outside of this groove, or may even dislocate from the groove, causing pain with bending of the knee joint. A lateral release is performed to loosen the ligaments that pull the kneecap toward the outside of the groove.
- Microfracture: Microfracture is a treatment used to stimulate the body to grow new cartilage in an area of damaged cartilage. In a microfracture procedure, the firm outer layer of bone is penetrated, to expose the inner layers of bone where marrow cells exist. These cells can then access the damaged area and fill in the gap of cartilage.
- Autologous Chondrocyte Implantation: Cartilage transfer involves moving cartilage from healthy parts of the joint to damaged areas. Small plugs of cartilage are removed, with a portion of underlying bone, and transferred to the area of damage. The plugs are taken from areas of the joint where the cartilage surface is not needed.
- Cartilage Transfer/OATS: Cartilage transfer involves moving cartilage from healthy parts of the joint to damaged areas. Small plugs of cartilage are removed, with a portion of underlying bone, and transferred to the area of damage. The plugs are taken from areas of the joint where the cartilage surface is not needed.
Performing Arthroscopic Knee Surgery
Knee arthroscopy can be done under general, regional, or local anesthesia. After adequate anesthesia, your surgeon will create ‘portals’ to gain access to the knee joint. The portals are placed in specific locations to minimize the potential for injury to surrounding nerves, blood vessels, and tendons. Through one portal, a camera is placed into the joint, and through others, small instruments can be used to address the problem. Patients who have Knee Arthroscopy surgery under a regional or local anesthesia can often watch their surgery on a monitor to see what is causing their problem.
The length of the knee arthroscopy procedure varies depending on what your doctor needs to accomplish. After surgery, your knee will be wrapped in a soft bandage. Depending on the type of surgery performed, your doctor may or may not allow you to place weight on the affected leg. Most patients will work with a physical therapist to regain motion and strength of the joint. The length of rehabilitation will also vary depending on what procedure is performed at the time of surgery.
Complications of Arthroscopic Knee Surgery
Complications of Knee Arthroscopy include infection, swelling, and blood clots in the leg. Complications are unusual after knee arthroscopy, and while they are cause for concern, knee arthroscopy is considered a low-risk surgical procedure.
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