The knee joint is one of the most complex joints of the body. The lower end of the thighbone (femur) meets the upper end of the shinbone (tibia) at the knee joint. A small bone called the patella (kneecap) rests on a groove on the front of the femoral end. Another bone of the lower leg (fibula) forms a joint with the shinbone.
To allow smooth and painless motion of the knee joint, articular surfaces of these bones are covered with a shiny white slippery articular cartilage. Two C-shaped cartilaginous menisci are present in between the femoral end and the tibial end.
Menisci act as shock absorbers, providing cushion to the joints. They also play an important role in providing stability and load-bearing to the knee joint.
Bands of tissue, including the cruciate and collateral ligaments, keep the different bones of the knee joint together and provide stabilization to the joint. Surrounding muscles are connected to the knee bones by tendons. The bones work together with the muscles and tendons to provide mobility to the knee joint. The whole knee joint is covered by a ligamentous capsule, which further stabilizes the joint. This ligamentous capsule is also lined with a synovial membrane that secretes synovial fluid for lubrication.
What is Knee Arthroscopy?
Knee arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to diagnose or treat a knee problem. It is a relatively safe procedure and you will usually be discharged from the hospital on the same day of surgery.
Indications for Knee Arthroscopy
The knee joint is vulnerable to a variety of injuries. The most common knee problems where knee arthroscopy may be recommended for diagnosis and treatment are:
- Torn meniscus
- Torn ACL (Anterior Cruciate Ligament) or PCL (Posterior Cruciate Ligament)
- Torn pieces of articular cartilage
- Inflamed synovial tissue
- Malalignment of the patella
- Certain fractures of the knee bones
Knee Arthroscopy Procedure
Knee arthroscopy is performed under sedation anesthesia, much like twilight sedation used with a colonoscopy. Your surgeon will then infiltrate the joint with local anesthetic.
- Your surgeon makes two small incisions around the knee.
- Next, a sterile saline solution is injected into the knee to push apart the various internal structures, and provide a clear view and more room for your surgeon to work.
- An arthroscope, a narrow tube with a tiny video camera on the end, is inserted through one of the incisions to view the knee joint. The structures inside the knee are visible to your surgeon on a video monitor in the operating room.
- Your surgeon first examines the structures inside the knee joint to assess the cause of the problem.
- Once a diagnosis is made, surgical instruments such as biters, motorized shavers, and repair devices are inserted through another small incision, and the repair is perfomed based on the diagnosis.
The procedure may include any of the following:
- Removal or repair of a torn meniscus
- Reconstruction or repair of a torn cruciate ligament
- Removal of small torn pieces of articular cartilage
- Removal of loose fragments of bones
- Removal of inflamed synovial tissue
- Removal of Baker’s cyst
- Realignment of the patella
- Making small holes or microfractures near damaged cartilage to stimulate cartilage growth
After the repair, the knee joint is carefully examined for bleeding or any other damage. The saline is then drained from the knee joint. Finally, the incisions are closed with sutures and steri-strips, and the knee is covered with a sterile dressing.
Postoperative Care Following Knee Arthroscopy
You are most often discharged on the same day of your knee arthroscopy. Pain medicines are prescribed to manage pain. Crutches or a knee brace may be recommended for several weeks. A rehabilitation program may also be advised for a successful recovery. Therapeutic exercises aim to restore motion and strengthen the muscles of the leg and knee.
Recovery after Knee Arthroscopy
Recovery after the surgery depends on the type of procedure performed. Recovery from simple procedures is often fast. Recovery from knee arthroscopy is much faster than that from an open knee surgery.
Risks and Complications of Knee Arthroscopy
Knee arthroscopy is a safe procedure; complications are very rare. Complications specific to knee arthroscopy include infection, bleeding, nerve damage, stiffness, persistent pain, retear of a meniscus, progression of arthritis, blood clots, hardware and instrument complications, and need for further surgery.
- Partial Arthroscopic Meniscectomy
- Intraarticluar Knee Injection
- Combined Hyaluronic Therapy for the Knee
- Arthroscopic Debridement
- Failed Meniscus Repair
- Meniscal Transplantation
- Physical Therapy for Knee
- Knee Arthroscopy
- Joint Preserving Osteotomy
- Multiligament Reconstruction of the Knee
- Arthroscopic Reconstruction of the Knee for Ligament Injuries
- PCL Reconstruction
- LCL Reconstruction
- ACL Reconstruction
- ACL Reconstruction of Patellar Tendon
- ACL Reconstruction Procedure of Hamstring Tendon
- MCL Reconstruction
- Cartilage Replacement
- Autologous Chondrocyte Implantation
- Partial Meniscectomy
- Meniscal Surgery
- Revision ACL reconstruction
- Patellar Realignment