Arthroscopy "Key Hole Surgery" - Cartilage tears
Vidoe below of James Lewis Consultant Orthopaedic Surgeon performing Arthroscopy Key Hole Cartilage Surgery on a patient.
What is Knee Arthroscopy?
Knee arthroscopy is an operation routinely performed by Orthopaedic surgeons, that uses a specially designed telescope called an arthroscope.
Knee arthroscopy is oftentimes refereed to as “arthroscopic knee surgery”.
With arthroscopic knee surgery the arthoscope is inserted into your knee through a small incision (“key-hole” surgery).
The arthroscope utilizes a digital camera through which the inside of your knee can be thoroughly inspected. If needed, any necessary procedures (e.g. removing torn cartilage, ligament reconstructions) can be carried out at this time through separate small incisions.
Arthroscopy is a surgical procedure to visualize, diagnose and treat problems inside a joint.
Arthroscopy is useful in evaluating and treating the following conditions:
Torn floating cartilage (meniscus): The cartilage is trimmed to a stable rim or occasionally repaired
Torn surface (articular) cartilage
Removal of loose bodies (cartilage or bone that has broken off) and cysts
Reconstruction of the Anterior Cruciate ligament (ACL)
Patello-femoral (knee-cap) disorders
Diagnostic knee purposes
A routine X-Ray of the knee, which includes a standing weight-bearing view is often required by the Arthoscopic Knee Surgeon.
An MRI scan which looks at the cartilages and soft tissues may be needed if the diagnosis is unclear to your Orthopaedic surgeon.
Knee Arthroscopy for Meniscal Cartilage Tears
Following a twisting type of injury the medial (or lateral) meniscus can tear.
Meniscal cartilage tears usually results either from a sporting injury or may occur from a simple twisting injury. Cartilages become a little brittle as we get older and therefore can tear a little easier.
The symptoms of a torn cartilage include: pain over the torn area, knee swelling, reduced motion, knee buckling or locking if the cartilage gets caught between the femur a tibia .
Knee Arthroscopy for Cartilage Tears
Once a meniscal cartilage has torn it will not heal unless it is a very small tear that is near the capsule of the joint.
Once the cartilage has torn it predisposes the knee to develop osteoarthritis.
It is advised by Orthopaedic surgeons to remove torn pieces from the knee if the knee is symptomatic.
Torn cartilages in general continue to cause symptoms of discomfort, pain and swelling until the loose, ragged pieces are removed.
Only the torn section is removed and the knee should recover and become symptom free.
If the entire meniscus is removed, the knee will develop osteoarthritis.
It is standard practice by Sussex Knee Orthopaedic Surgeons to remove only the torn section of cartilage this will delay / prevent the onset of long-term wear and tear osteoarthritis.
Knee Arthroscopy for Articular Cartilage (Surface) Injury
If the surface cartilage is torn large pieces of articular cartilage can float in the knee (sometimes with bone attached) and this causes locking of the joint and can cause further deterioration due to the loose bodies floating around the knee causing further wear and tear.
Most surface cartilage wear will ultimately lead to osteoarthritis.
Mechanical symptoms of pain and swelling due to cartilage peeling off can be helped with arthroscopic surgery. Knee arthroscopy for articular cartilage (surface) injuries smooths the edges of the surface cartilage and removes loose bodies.
Knee Arthroscopy for Anterior Cruciate Ligament Injuries
Rupture of the Anterior (rarely the posterior) Cruciate Ligament (ACL) is a common sporting injury.
Once ruptured the ACL does not heal and usually causes knee instability and the inability to return to normal sporting activities.
An ACL reconstruction is required and a new ligament is fashioned to replace the ruptured ligament. This procedure is performed using the arthroscope.
Patella (knee-cap) Disorders
The arthroscope can be used to treat problems relating to kneecap disorders, particularly mal-tracking and significant surface cartilage tears. The majority of common kneecap problems can be treated with physical therapy and rehabilitation.
Inflammatory Arthritis
Occasionally arthroscopy is used in inflammatory conditions (e.g. Rheumatoid Arthritis) to help reduce the amount of inflamed synovium (joint lining) that is producing excess joint fluid. This procedure is called a synovectomy.
Arthroscopy of the Knee: Patient Information
The Arthroscope is introduced through a small (size of a pen) incision on the outer side of the knee. A second incision on the inner side of the knee is made to introduce the instruments that allow examination of the joint and treatment of the problem.
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