Knee Arthroscopy

Knee Arthroscopy

Knee-Arthroscopy

What Is a Knee Arthroscopy?

Arthroscopy of the knee is a minimally invasive procedure that is conducted using only small incisions. It is one of the most commonly utilized procedures for diagnosing and treating knee injuries. The knee is a complex joint and made up of a number of smaller structures that are vulnerable to injury. According to a survey conducted in 2010 by the Centers for Disease Control, nearly 10.4 million outpatient office visits can be attributed to knee injuries.

Arthroscopy procedures are preferred for diagnosing and treating these injuries because they are associated with a reduced recovery time, as well as higher rates of success given the minimized risk of damage to surrounding connective tissue. Recent estimates by the American Orthopedic Society for Sports Medicine have suggested that nearly four million arthroscopic procedures are performed on the knee annually worldwide.

Recognized as one of the largest joints found within the body, the knee joint is quite complex. As noted above, the knee is comprised of several smaller structures that are all vulnerable to injury. These structures fall into four main categories:

  • Bone: Three leg bones come together to form the joint of the knee. These bones include the femur, or the thighbone; the tibia, or the shinbone; and the patella, or the kneecap.
  • Ligaments: Ligaments are responsible for holding together the bones that comprise the knee joint, like sturdy rope. Collateral ligaments are found along the sides of the knee. Their function is to control sideways motion and aid in bracing the knee against unusual movement. Cruciate ligaments are found inside the knee joint. Their function is to control the back and forth movements of the knee.
  • Cartilage: A slippery coating of articular cartilage protects the back of the patella and the ends of both the tibia and the femur. Additionally, two pieces of protective cartilage known as menisci are found between the tibia and femur.
  • Tendon: The muscles of the legs are connected at the knee joint by tendons.

Should you and your doctor decide that a knee arthroscopy procedure is appropriate, either to assist with diagnosing your precise cause for knee pain or to aid in surgical repair of connective tissue within the knee, you will first need to undergo a complete physical exam. Your doctor will want to check for certain risk factors, as well as gather an accurate assessment of your current health status. Some tests may be done prior to undergoing the surgical procedure, including blood counts or an electrocardiogram (EKG).

How Is A Knee Arthroscopy Performed?

In most instances, knee arthroscopy is performed on an outpatient basis. This means that patients are generally released to go home the same day that they undergo the procedure. Prior to the surgery, patients should not eat or drink anything. In general, knee arthroscopy is performed using local (numbs only the knee area) or regional (numbs everything from the waist down) anesthesia, though general (patient is put to sleep during the procedure) anesthesia is required in some cases.

Once the proper anesthesia has been administered, the orthopedic surgeon will make two small incisions on the knee. By using only small incisions, as opposed to opening the whole knee joint, this procedure is regarded as a “closed” procedure. In order to get a clear picture of the internal structures of the knee joint, the orthopedic surgeon will fill the knee with a clear fluid. This rinses away any cloudy fluid within the area that may be making it difficult to see.

Next, the orthopedic surgeon will insert an arthroscopic device, which is equipped with a tiny camera that projects images of the internal structures onto a screen. In instances where knee arthroscopy is used for diagnostic purposes, the orthopedic surgeon will use this image to search for the injury. In instances where the arthroscopic procedure is being used to aid in surgical repair, the image is used to help guide the orthopedic surgeon in the use of other instruments. The incisions made for the procedure are closed using a small stitch or steri-strips, which are small Band-Aids.

Knee arthroscopy is preferred to other “open” procedures, as this technique reduces the required recovery time. Further, it minimizes the risk for possible damage to surrounding tissue. Similar to other surgical procedures though, there is some risk associated with knee arthroscopy. These risks tend to be relatively rare, however, and are generally not very serious. Individuals who have just undergone a knee arthroscopy may be at risk for blood clots, infection, or even fluid build-up within the knee.

Though quite uncommon, patients are encouraged to seek immediate medical attention should they experience chills, fever, sensations of warmth in the area, knee redness, severe swelling of the area, persistent or unremitting pain, or pain that increases in severity within the calf muscle.

For most knee arthroscopic procedures, the patient will be able to resume regular physical activity within six to eight weeks of the procedure. In many cases, patients are able to fully recover even more quickly, though high impact activities must be avoided longer to avoid additional injury.

The actual outcome following a knee arthroscopic procedure does depend upon the degree of damage sustained by the knee. A portion of knee pain patients may even have to make lifestyle alterations following a knee arthroscopic procedure in order to prevent re-injury.

Conditions Related to Knee Arthroscopy

Arthroscopy can be used to treat the following:

  • Repair or removal of damaged or torn meniscal cartilage
  • Trimming torn pieces of articular cartilage
  • Reconstructing a torn or damaged anterior cruciate ligament
  • Removing loose pieces of cartilage or bone from within the joint
  • Removing inflamed synovial tissue from within the joint

Conclusion

Known as one of the largest joints within the body, the knee is highly susceptible to a number of injuries. The injuries typically occur as the result of blunt force trauma, such as motor vehicle accidents, falls, or even sports-related contact. The knee arthroscopic procedure is one of the most commonly utilized techniques for diagnosing and treating common conditions affecting the knee joint. This procedure is preferred given that it reduces recovery time and minimizes the risk for damage to surrounding tissue. Individuals are encouraged to speak with their physician about the risks and benefits associated with this procedure.

References

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  3. Hohlweck J, Quack V, Arbab D, Spreckelsen C, Tingart M, Luring C, Rath B (2013) Diagnostic and therapeutic management of primary and recurrent patellar dislocations – analysis of a nationwide survey and the current literature. Z Orthop Unfall 151:380-388.
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