Arthroscopic knee surgery has generally become the standard knee surgical procedure, replacing previously more traditional open knee surgery. That’s because the success rate and recovery time for knee arthroscopy surgery is often much higher.
Knee arthroscopy surgery uses small incisions in the knee to insert an arthroscope, which is a narrow tube with a video camera on the end. This camera provides a clear view inside the knee, enabling the surgeon to accurately diagnose the knee condition.
The surgeon can inject tiny surgical tools, lasers, or scissors via one of the other tiny incisions in the knee to heal the knee damage. To see if the knee damage has been correctly and totally treated, an arthroscopic camera might be inserted through additional incisions in the knee.
REASONS :
Not all causes of knee pain can be effectively treated with an arthroscopic procedure. Some of the reasons to perform an arthroscopic knee surgery include:
- Meniscus Repair: A meniscus repair is a surgical operation used to replace a meniscus that has been injured. When successful, the meniscus repair can return the knee’s normal anatomy and has a better long-term outlook. The meniscus repair, however, requires more extensive surgery. The recuperation period is prolonged, and meniscus repair is occasionally not possible due to the meniscus’s poor blood supply.
- ACL and PCL Reconstruction:The anterior cruciate ligament, or ACL, is one of four major knee ligaments. The ACL is critical to knee stability, and people who injure their ACL often complain of their knee giving out from under them. Therefore, many patients who sustain an ACL tear opt to have surgical treatment of this injury. A majority of the ACL surgery is performed arthroscopically.
Another crucial knee ligament is the PCL, or posterior cruciate ligament. It aids in knee joint stabilisation and prevents the tibia’s (shinbone’s) posterior translation. PCL injuries can result in symptoms like discomfort, edoema, and trouble moving the knee. After a PCL injury, the knee may occasionally require surgical reconstruction to regain stability and functionality.
- MCL and LCL Reconstruction: MCL and LCL are two important ligaments in the knee. The medial collateral ligament (MCL) and the lateral collateral ligament (LCL) provide stability to the inner and outer sides of the knee, respectively. When these ligaments are injured, surgical reconstruction may be required to restore stability and function to the knee.Extra articular ligament MCL and LCL can be repaired and reconstructed depending on the time and condition of issue.
- MPFL : Medial patella-femoral ligament (MPFL) reconstruction is a surgical procedure performed to address recurrent kneecap dislocation.The MPFL, which aids in stabilising the kneecap and preserving its correct alignment on the femur, is being rebuilt during this treatment using a tissue graft. The surgical procedure involves rebuilding the ligament in an effort to stabilise the knee joint and stop further bouts of kneecap dislocation.For recurrent dislocation of patella MPFL reconstructions can be done.
- Plica Excision: A plica is a remnant of tissue left over from fetal development. In early development, your knee was divided into separate compartments. The dividers of the compartments are gradually lost over time, but some remnant remains. When this remnant tissue is more prominent, it is called a plica. When the plica is irritated, it is called plica syndrome. A plica resection is performed to remove this irritated tissue.
- Lateral Release: The kneecap, or patella, glides along a cartilage groove on the end of the thigh bone during knee movement. However, sometimes the kneecap can be pulled towards the outer side of the groove or even completely dislocated from it, resulting in pain when bending the knee joint. In such cases, a procedure called a lateral release is performed to release the ligaments responsible for pulling the kneecap towards the outer side of the groove. This helps to alleviate the pain and improve the alignment of the kneecap within the groove.
- Microfracture: Microfracture is a therapeutic approach employed to encourage the body to regenerate new cartilage in areas that have been damaged. During a microfracture procedure, the outer layer of the bone is carefully penetrated, exposing the inner layers where marrow cells are present. These cells can then reach the damaged region and promote the growth of new cartilage, effectively filling the gap. The aim of microfracture is to facilitate the natural healing process and restore the integrity of the damaged cartilage.
- Autologous Chondrocyte Implantation: This procedure involves the use of arthroscopic surgery to identify areas of cartilage damage and collect cartilage cells from the patient. These harvested cells are then cultivated in a laboratory setting to allow for their growth and multiplication. In a subsequent procedure, which is performed as an open surgery rather than arthroscopic, the expanded cells are reimplanted into the affected joint. This two-step process aims to facilitate the regeneration and restoration of damaged cartilage using the individual’s own cultivated cells.
- Cartilage Transfer/OATS: Cartilage transfer involves moving cartilage from healthy parts of the joint to damaged areas. Small plugs of cartilage are removed, with a portion of underlying bone, and transferred to the area of damage. The plugs are taken from areas of the joint where the cartilage surface is not needed.
- Torn Cartilage/Meniscus Surgery: Cartilage transfer is a procedure that entails relocating healthy cartilage from unaffected areas of the joint to regions that have been damaged. Small cartilage plugs, including a portion of the underlying bone, are extracted and transplanted into the damaged area. These plugs are sourced from parts of the joint where the cartilage surface is not crucial, ensuring minimal impact on overall joint function. By transferring healthy cartilage to the damaged site, this procedure aims to promote healing and restore the integrity of the affected joint.
BEFORE THE PROCEDURE:
- Be sure you have someone to take you home. Anaesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
- Understand exactly what surgery is planned, along with the risks, benefits, and other options.
- Tell the doctor all the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery and Surgeon will tell you if you should stop taking any of them before the surgery and how soon to do it.
- If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or may Surgeon tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
- Call your insurance company and go over your coverage with them. Make sure you know what they will pay for and what you will pay for. Also, ask about any special equipment you will need to see if it is covered by your insurance.
- If you have any questions that come up, write them down and ask them at your pre-op visit. For questions about surgery, call your medical team.
AFTER THE PROCEDURE :
You can often anticipate being released the same day as your knee arthroscopy procedure. Your recovery time will be influenced by a number of variables, including the particular treatment done, your general health, and your age. A full recovery from arthroscopic knee surgery usually takes four to six weeks. It’s crucial to remember that recuperation times can differ.
TKnee arthroscopy recovery is frequently faster than open knee surgery. You might need to use crutches or a knee brace during the healing process to support and stabilise the knee joint.
To treat any discomfort experienced throughout the healing phase, the doctor may prescribe painkillers. Physical treatment will also probably be advised to help your knee regain its full range of motion and to bolster the muscles around your leg.
Following the guidance of your healthcare team, participating in recommended physical therapy exercises, and taking prescribed pain medication will help optimize your recovery and regain normal function in your knee. It’s important to follow the specific instructions provided by your healthcare professionals to ensure a successful recovery.
RECOVERY :
Recovering from arthroscopy is usually quicker than recovering from open surgery.Most people leave the hospital on the day of the operation with specific instructions about how to handle recovery.
General recovery tips can include:
- Applying ice packs to the dressing and surrounding area to reduce swelling and pain
- Keeping the leg elevated for several days after surgery
- Resting well and often
- Changing the dressing regularly
- Using crutches and following the doctor’s recommendations about applying weight to the knee
Before a patient leaves the hospital, surgeons will often provide detailed instructions. They might also suggest over-the-counter medicines or write prescriptions for them.
In certain circumstances, doctors might advise taking aspirin to lower the risk of blood clots.Recovery periods can differ. Most other physical activities can be resumed in 6–8 weeks, and a person may be able to resume modest activity in 1–3 weeks.