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    Arthroscopic knee surgery

    What are the parts of the knee?

    Arthroscopic knee surgery

    The knee is the largest and one of the most important joints in the body. It is a strong but flexible hinge joint, playing an essential role in movement related to carrying the body weight in horizontal (running and walking) and vertical (jumping) directions.

    Between the femur (upper leg bone) and tibia (lower leg bone) is the meniscus, a layer of tough fibrocartilage that acts as a shock absorber. The knee joint is vulnerable to injuries, that most often occur during sports or recreational activities, work-related tasks, or home projects.

    What are the common types of knee disorders?

    • Tear of meniscus – meniscus resection and in severe cases meniscus refixationThe meniscus can be torn and damaged because of trauma caused by forceful twisting or hyper-flexing of the knee joint, or it can gradually wear out because of age and overuse.
    • Knee ligament tear (ACL) – arthroscopic ACL reconstruction

    The ACL helps stabilize and support the joint. Injuries to the ACL is common, particularly in athletes. The ACL can be injured if the joint of your knee is bent backward, rotated, or quickly shifted laterally or if any of these things occurred simultaneously.

    • Displaced patella (kneecap) – arthroscopic lateral release of patella, or in severe disfunction tuberositas tibiae medialisatio

    The patella (kneecap) is balanced in the front of the knee on the femur (thigh bone). In the painful knee there is a tendency for the patella to tilt toward the outside of the knee. This occurs because of the chronic pull of the knee cap to the outside by the thigh muscles, creating a strain on the medical or inside tissues (the retinaculum).

    • Pieces of bone, cartilage or tissue that are loose in the knee joint – arthroscopic debridement knee surgery or arthroscopic loose-body removal

    Loose bodies are another name for small free floating pieces of debris in the joint. The loose bodies can cause pain, swelling, and locking, and catching of the joint. Causes include fractures, trauma, bone and cartilage inflammation, and benign tumors of the synovial membrane.

    • Condropathy or osteochondral lesion is an injury to the smooth surface on the end of bones, e.g the wear of articular cartilage (chondro) and the bone (osteo) of tibia or femur in the knee joint – arthroscopic knee cartilage shaving surgery and in severe cases arthroscopic shaving with mosaicplasty

    Our surgeons perform the most advanced treatments for cartilage defect. Depending on the severity and overall size of the damage multiple plugs or dowels may be required to adequately repair the joint. Mosaicplasty, a form of chondral grafting, is a surgery designed to replace cartilage on the surface of the knee joint that has been damaged by trauma or arthritis by implanting osteochondral plugs.

    Why is knee surgery needed?

    An arthroscopic knee surgery is a useful way for surgeons to confirm the source of knee pain and treat the problem.

    Arthroscopy may be recommended for these knee problems:

    • Torn meniscus
    • Torn or damaged anterior cruciate ligament (ACL)
    • Torn or damaged collateral ligament
    • Swollen (inflamed) or damaged lining of the joint
    • Kneecap (patella) that is out of position (misalignment)
    • Small pieces of broken cartilage in the knee joint
    • Removal of Baker’s cyst. This is a swelling behind the knee that is filled with fluid. Sometimes the problem occurs when there is swelling and pain (inflammation) from other causes, like arthritis.
    • Repair of defect in cartilage
    • Some fractures of the bones of the knee

    How does knee arthroscopy work?

    Knee arthroscopy is one of the most frequently used procedures for the diagnosis and treatment of knee injuries. This minor surgical procedure is done using a small instrument about the size of a pencil, called an arthroscope. Arthroscopy is done through small incisions. During the procedure, your orthopaedic surgeon inserts the arthroscope into your knee joint and can use it to feel, repair or remove damaged parts.

    What are the surgical procedures we provide?

    Meniscus repair

    Arthroscopic meniscectomy is a minimally invasive surgery used to treat a torn meniscus cartilage in the knee, when the torn segment of the meniscus is removed.

    Meniscus repair
    Meniscus repair
    Meniscus repair

    ACL reconstruction

    Arthroscopic ACL surgery takes place only after the immediate post-injury swelling and inflammation has diminished. When the ACL sustains a complete tear, the surgeon must replace it with a graft, usually obtained from the patient’s own knee (termed an autograft).

    ACL reconstruction
    ACL reconstruction
    ACL reconstruction

    Arthroscopic lateral release of patella (kneecap)

    The procedure incises the lateral stabilizing structures of the patella, in particular, the lateral retinaculum. The lateral retinaculum attaches the lateral patella to the lateral femoral epicondyle, the iliotibial band, and the anterolateral tibia. Arthroscopic lateral release is generally performed in combination with medially based stabilization procedures to more effectively allow for medial realignment

     

    Arthroscopic loose-body removal

    The gold standard today is to remove possibly all loose bodies by arthroscopy, popularly known as “clean out “arthroscopies. This minimally invasive procedure allows surgeon to thoroughly examine the knee for loose body and allows to asses any damage to cartilage and treat the condition

     

    Arthroscopic knee cartilage shaving surgery

    This common treatment intended for patients where the cartilage defect has not worn all the way down to the bone. Inserting a pencil-thin arthroscope into the knee through a small incision, the surgeon shaves and smooths shredded or frayed cartilage. Ideally, the smoothing and shaving away of the damaged cartilage helps to ultimately decrease friction and irritation, thus reducing the symptoms of swelling, noise, and pain.

     

    Arthroscopic mosaicplasty

    Mosaicplasty is the technique of harvesting small circular (4-8 mm) autogenous grafts from the knee from non-weight bearing regions of the knee, and transplanting the grafts in a mosaic pattern until the osteochondral defect is filled.

    What are the benefits and risks of knee surgeries?

    Benefits

    Knee arthroscopy is a safe procedure for the treatment of knee injuries and isn’t very invasive. The advantage of arthroscopy over traditional open surgery is that the joint does not have to be opened up fully. Only two sometimes three small incisions are made — one for the arthroscope and one for the surgical instruments to be used in the knee cavity. This reduces recovery time and may increase the rate of surgical success due to less trauma to the connective tissue. For most people, the procedure takes only an hour or two. There is also less scarring, because of the smaller incisions.

    Knee arthroscopy is an effective tool in diagnosing your joint condition and for confirming treatment for knee problems such as meniscus tears and cartilage wear. An arthroscopy can ultimately provide relief from knee pain and improve mobility. Maintaining a normal and active lifestyle with greater comfort is a key benefit of this procedure.

    Risks

    There are risks associated with any type of surgery, though they occur infrequently and are minor and treatable.

    Potential postoperative problems with knee arthroscopy include:

    • Infection inside the joint
    • Blood clots
    • Accumulation of blood in the knee
    • Deep vein thrombosis/embolism
    • Bleeding inside the knee joint
    • Stiffness in the knee
    • Injury or damage to the cartilage, ligaments, meniscus, blood vessels, or nerves of the knee

    Am I a good candidate for knee operation?

    The number of knee operations has nearly doubled in less than 10 years. If you experience pain in your knee, you should consult a surgeon in order to preserve your own knee joint and delaying, or possibly even preventing the start of a cycle of more serious knee problems. Your surgeon will advise you the best action to take, because there is a number of factors before deciding to undergo a knee surgery, not even mention the variety of their types.

    How should I prepare for the surgery?

    If you decide to have knee arthroscopy, you may need a complete physical examination before surgery to assess your health and identify any problems that could interfere with your surgery.

    Before surgery, tell your orthopaedic surgeon about any medications or supplements that you take. He or she will tell you which medicines you must stop taking before surgery.

    During the 2 weeks before your surgery:

    • You may be told to stop taking medicines that make it harder for your blood to clot.
    • Ask which medicines you should still take on the day of your surgery.
    • Tell your surgeon if you have been drinking a lot of alcohol (more than 1 or 2 drinks a day).
    • If you smoke, try to stop. Smoking can slow down wound and bone healing.
    • Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you have before your surgery.

    On the day of your surgery:

    • You will most often be asked not to drink or eat anything for 6 to 12 hours before the procedure.
    • Take the medicines you been told you to take with a small sip of water.
    • You will be told when to arrive at the Medicover Hospital.

    What shall I do after knee surgery?

    Recovery from knee arthroscopy is much faster than recovery from traditional open knee surgery. Still, it is important to follow your orthopaedic surgeon’s instructions carefully after you return home. Feeling some pain is a natural part of the healing process. Your doctor and nurses will work to reduce your pain, which can help you recover from surgery faster. Medications are often prescribed for short-term pain relief after surgery. In order to relieve swelling and pain, the surgeon may recommend to apply ice. It is important to keep your incisions clean and dry. Your surgeon will tell you when and how you can shower or bathe. Most patients need crutches or other assistance after arthroscopic surgery. Your surgeon will tell you when it is safe to put weight on your leg.

    Therapeutic exercise will play an important role in how well you recover. You should exercise your knee regularly for several weeks after surgery to restore motion and strengthen the important muscles. Unless you have had a ligament reconstruction, you should be able to return to most physical activities after 6 to 8 weeks, or sometimes much sooner.

    Why is regular check-up important after the surgery?

    During your healing period, you will need some check-ups before returning to intense physical activities:

      1. ACL post-operative recommended check-ups: 6 weeks, 12 weeks and 6 months after the surgery

    After you get home, apply ice to your knee for 15-20 minutes out of every hour for the next few days, but keep the bandages dry. Ice helps to reduce pain and swelling. For the first 1-2 weeks after surgery, the most important goal is to regain the ability to fully straighten the knee. It is much more important initially than being able to walk long distances. Too much walking will cause the knee to swell and hurt, which will
    prevent the knee from getting straight. Keep the bandages on until you have your first post-operative check-up.

      1. Arthroscopy post-operative recommended check-up: 6 weeks after the surgery

    Immediately after surgery, if your pain is minimal when walking, then the use of crutches or a walker is not required. If necessary due to pain, patients may opt to use crutches or a walker for a few days after surgery. Once more comfortable, most people are able to walk with a minimal limp within one or two weeks after surgery. Most patients realize a benefit from arthroscopic knee surgery within 4 to 6 weeks. Reduction of pain and swelling, and improvement in knee strength, motion, and coordination may continue for three to four months after surgery. Follow-up appointment should be made 6 weeks after the surgery.

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