Knee arthroscopy is a minimally invasive surgical procedure that allows surgeons to view the knee joint. Small incisions are made around the knee and using an arthroscope, a small camera, surgeons can view the knee joint to diagnose and treat a variety of knee conditions. This procedure can be used to remove or repair a torn meniscus, reconstruction of a torn anterior cruciate ligament (ACL), trimming damaged cartilage, removal of loose bone or cartilage fragments, and to treat infections. Some advantages to this technique are shorter recovery times, less pain, smaller scars, and less joint stiffness.
The meniscus is a rubbery disk that absorbs impact between the femur and tibia, thus cushioning and stabilizing the knee joint.
A meniscus tear is a common acute knee injury experienced during a sudden twist or turn during an athletic activity.
Typical symptoms experienced with a torn meniscus are: pain at the knee joint where the meniscus is torn, swelling in the knee, and pain on the top or back of the knee.
Conservative Options (non-surgical)
Depending on the severity and symptoms of the meniscus tear, activity management and physical therapy are treatment options
If the tear is significant, surgery may be the recommended treatment option. Arthroscopy is the common surgical technique used to trim the torn portion of the meniscus and to stabilize the base to prevent further pain.
The anterior cruciate ligament(ACL) is one of four ligaments in your knee and provides rotational stability to the knee and prevents the tibia from sliding in front of the femur. ACL tears are commonly seen in athletes or those participating in athletic activities.
The most common cause for an ACL tear comes from an athlete rapidly changing direction, starting and stopping suddenly while running, landing incorrectly after jumping, and from contact or a collision.
Typical symptoms of a torn ACL include pain, a large amount of swelling, loss of full range of motion, and a feeling of instability in the knee. Often patients will report the audible sound of a “pop” when they experienced the injury.
ACL reconstruction is a surgical procedure that uses either an autograft, taken from the patient’s patella, hamstring, or quadriceps, or an allograft , taken from a cadaver, to replace the torn ACL. This procedure is typically performed arthroscopically and can address any other injuries to the knee such as a meniscus tear associated with the torn ACL.
The patella (knee cap) can dislocate from direct contact with the knee (collision) or if the knee is turned in such a way that the patella dislocates (most commonly on the lateral side of the knee). This dislocation commonly tears a ligament (the MPFL) on the inner side of the knee, which keeps the patella in place.
A patella dislocation will cause pain, swelling, lack of stability in the knee, and can be felt or seen shifted to the side of the knee joint.
Conservative Options (non-surgical)
There are a variety of non surgical options that may potentially be utilized for a patella dislocation. Immobilization (bracing), non-weight bearing, and physical therapy are all tools that can be used to treat patella dislocations. These options will be offered depending on the number of dislocations the patient has had and the severity of the dislocation.
Surgery to fix a patella dislocation will involve reattaching the MPFL and possibly a tibial tubercle osteotomy to realign the patella over the knee.
Quadriceps and Patella Tendon Ruptures
A quadriceps or patellar tendon rupture occurs from a strong extension force at the knee occurring from a trauma or landing after jumping. Individuals over 40 years old are at a higher risk of a quadricep tendon rupture.
When your quadricep tendon tears, you may hear a popping sound and will experience pain and swelling. You may have a hard time straightening your leg, have difficulty walking, and have tenderness and bruising.
Due to the nature of the injury, surgery is performed to repair a ruptured quadricep tendon by using a strong suture to secure the tendon to the patella. If the patella tendon has also torn, surgery will include attaching the patella tendon back to the patella.
Unicompartmental (Partial) Knee Replacement
Partial knee replacement is a minimally invasive surgery where only a portion of the knee is resurfaced and replaced with metal and plastic components. This surgery is performed to treat osteoarthritis of the knee that is contained to just one compartment of the knee.
Total Knee Replacement (arthroplasty)
Total knee replacement is a surgical procedure performed to treat a severely arthritic knee. This procedure replaces the damaged ends of the femur and tibia with metal implants. A plastic spacer is then inserted between the two metal implants to produce a smooth surface for the implants to glide along creating a functional knee. This procedure will reduce knee pain and restore the function of your knee.
Revision Knee Replacement
Someone that has had total knee replacement may experience their artificial knee failing due to various reasons. Some of these reasons include: a trauma to the knee, chronic joint disease, worn out prosthesis, loosening of the prosthesis, and infection. When an initial knee replacement fails, a second surgery is required. Revision knee replacement surgery involves replacing all or part of your previous knee replacement components with new implants. The damaged implants will be removed and the bones will be prepared to receive a new implant. New components will be inserted into the femur and tibia to restore function to the knee.
Robotic Knee Replacement
Some patients may be candidates for robotic knee replacement surgery. Robotic systems can be used to assist surgeons to more precisely place knee implants based on the patient’s unique knee anatomy. These robotic systems generate a 3D image and by using a camera, will adjust the positioning of the implant based on the position of the leg ensuring the surgical plan is carried out to the highest degree of accuracy. These robotic systems provide the surgeon real time feedback of implant positioning, accommodating for any change in leg positioning to ensure the most accurate placement of implants.