Knee Arthroscopic Surgery
Arthroscopic surgery, also known as key-hole surgery, is a minimally invasive surgical procedure used to diagnose and treat problems involving the knee joint. It involves making small incisions (portals) to insert a thin telescope and other miniaturized instruments into the joint, allowing the surgeon to visualise the inside of the joint on a video monitor and perform necessary repairs or reconstruction.
It is a minimally invasive technique since it involves using very small incisions without having to open the joint. It helps to minimise the surgical pain and allows for faster recovery times and early return to function.
Common Knee Conditions Treated with Arthroscopy
- Meniscal Tears: The meniscus is crucial for cushioning the bones of the knee and distributing the body weight evenly. Tears in the meniscus can cause pain, swelling, locking and limitation of movement in the knee. Arthroscopic surgery can be used repair or trim the damaged meniscus, relieving symptoms and improving knee function.
- Anterior Cruciate Ligament (ACL) Injuries: The ACL is one of the main ligaments that provides stability to the knee. Injuries to the ACL are usually caused by sports injuries or sudden movements, and can lead to pain, swelling, and instability (feeling of giving way). Arthroscopic surgery can be used to reconstruct (replace) or repair the torn ACL, restoring knee stability and function.
- Posterior Cruciate Ligament (PCL) Injuries: The PCL helps maintain stability by preventing the tibia from moving too far backwards. Injuries to the PCL are caused by serious road traffic accidents or a bad fall. They can cause knee pain and instability. Arthroscopic techniques can be used to repair or reconstruct the PCL, helping to stabilise the knee and alleviate pain.
- Patellar (knee cap) Instability: Patellar instability occurs when the knee cap moves out of its normal position, often causing pain and difficulty with movement. Arthroscopic surgery can address the underlying issues, such as damaged cartilage or misalignment, to restore proper knee function and stability. Some cases may also require additional open surgical procedures like tibial tubercle osteotomy and ligament reconstruction.
- Articular Cartilage Injuries: These occur due to a sudden twisting injury or due to repetitive injury to the knee. It can sometimes be caused due to a condition called osteochondritis dissecans (OCD) or due to degenerative changes in the knee. It causes pain, catching or locking, and stiffness. Treatment usually involves arthroscopic surgery, which can be used to perform various procedures like debridement (cleaning up), fixing or removing the loose fragment, bone marrow stimulation (BMS) techniques, mosaicplasty and autologous cartilage implantation (ACI).
- Synovitis: Synovitis is the inflammation of the synovial lining of the knee, often causing swelling, pain, and stiffness. Arthroscopy allows for direct examination and treatment of the inflamed tissue, providing relief from symptoms and improving joint function.
Why Choose Knee Arthroscopy?
Knee arthroscopy is a minimally invasive technique that uses small incisions (portals) and a tiny telescope (arthroscope) attached to a camera to diagnose and treat knee conditions. This approach offers several benefits:
Reduced Recovery Time: Smaller incisions lead to faster healing and less postoperative pain.
Less Scarring: Minimal incisions mean less visible scarring compared to traditional open surgery.
Effective Pain Relief: Arthroscopy addresses the underlying issues directly, providing significant pain relief and improved knee function.
Open Surgery for Certain Knee Conditions
Some knee injuries or knee conditions may require an open surgery or a combination of arthroscopic and open surgery:
1. Multi-ligament Injuries of the Knee
The knee joint has ligaments which are inside the knee (the ACL and PCL) as well on the outer aspect of the knee (mainly the collateral ligaments – MCL and LCL). Multi-ligament injuries involve injury to more than one ligament. These are usually caused by bad vehicular accidents or severe sports injuries.
The collateral ligament injuries usually require open surgery to repair or reconstruct torn ligaments, in conjunction with arthroscopic surgery to treat other associated injuries.
2. Corrective Osteotomies (Knee Preservation Surgeries)
These are usually necessary for correcting knee deformities that may arise due to knee injury, arthritis, or developmental conditions in children or adolescents. Surgery aims to correct deformity and restore alignment and thereby improve weight transmission across the knee.
It usually involves doing a high tibial osteotomy (HTO) or a distal femoral osteotomy (DFO), or both.