Knee Arthroscopy

Knee Arthroscopy

Your knees help support your weight and let your legs bend and move. Almost any movement that uses your legs relies on your knees — your knees help when you’re walking, running, and jumping. Neglecting a long-term knee injury increases the likelihood of developing degenerative conditions and causing irreversible joint damage. Conditions like osteoarthritis, characterized by the gradual breakdown of joint cartilage, commonly result from untreated knee injuries. Other conditions such as chronic pain, increased risk of further injury, loss of functionality and mobility, degenerative conditions, and emotional distress are among the potential outcomes. Additionally, your surgery options may become more limited if you wait too long, and more significant damage may be caused to your knee, requiring more extensive treatment. It is crucial to seek prompt medical attention, obtain an accurate diagnosis, and follow appropriate treatment strategies. The place to start and ensure the best outcome is OCC – Advanced Orthopedic and Sports Medicine Specialists in Denver, Parker, or Aurora, Colorado.

OVERVIEW

Knee arthroscopy is a very common minimally invasive surgical procedure. It is one of the most common orthopedic procedures worldwide, with millions performed annually due to its safety and effectiveness. Minimally invasive procedures require smaller incisions (cuts) than traditional surgery. The incisions are about the size of a keyhole. The aim is to confirm exactly what the problem is and for many people, the problem can be treated simultaneously. The benefit of keyhole surgery is less pain afterward and, for some people, a quicker recovery. Knee arthroscopy uses tiny incisions, typically less than a centimeter long, through which a small camera (arthroscope) and instruments are inserted. This reduces trauma to the surrounding tissues compared to open surgery. Arthroscopy can address various knee issues, including meniscus tears, cartilage damage, ligament injuries (e.g., ACL reconstruction), synovitis, and removal of loose bodies or bone spurs. Many athletes undergo knee arthroscopy to quickly diagnose and treat injuries, allowing them to return to sports sooner. High-profile athletes often rely on this procedure to stay competitive. The instruments used in knee arthroscopy are incredibly small but precise, enabling surgeons to perform complex tasks like stitching a torn meniscus or smoothing out cartilage. The arthroscope provides a magnified, high-definition view of the knee joint, allowing surgeons to see structures not visible during open surgery. The term “arthroscopy” comes from the Greek words: arthro (joint) and skopein (to look). It literally means “looking into the joint.” Some joint conditions are not visible on MRIs or X-rays, such as early cartilage wear or subtle meniscal tears. Arthroscopy provides a direct view, making it the gold standard for diagnosing certain knee problems.

ABOUT THE KNEE

The knee is the largest joint in the body. Three bones make up the knee joint:

  • Femur: (thigh bone).
  • Tibia: (shin bone).
  • Patella: (kneecap)

The places these bones meet are called articulations or articulating surfaces. There are two articulations in your knee:

  • Patellofemoral: Where your patella meets your femur.
  • Tibiofemoral: Where your tibia meets your femur.

The knee is a synovial joint. Synovial joints have the most freedom to move. They’re made of a cavity in one bone that another bone fits into. Slippery hyaline cartilage covers the ends of bones that make up a synovial joint. A synovial membrane — a fluid-filled sac that lubricates and protects the joint — lines the space between the bones. This extra cushioning helps synovial joints move with as little friction as possible. Functionally, the knee is a hinge joint.  The knee primarily allows for flexion (bending) and extension (straightening), similar to the motion of a hinge. The knee’s main function is to allow the leg to flex and extend, but it also helps with balance and stabilizing the body. The knee is essential for walking, running, jumping, and other bipedal movements. The knee is one of the most stressed joints in the body, receiving four times the amount of stress for every pound a person weighs. The knees also contain cartilage, like your meniscus and ligaments, including your LCL, MCL, ACL, and PCL.

WHAT IS KNEE ARTHROSCOPY

Knee arthroscopy is a minimally invasive surgical procedure. Healthcare providers use knee arthroscopy to diagnose and treat a range of knee injuries. A surgeon makes a small incision and then inserts a long, thin tool with a camera on the end. The camera shows images of the inside of the knee, which helps the healthcare provider make a diagnosis of the injury. The images appear on a screen in the operating room. The surgeon may put other small surgery tools inside your knee through the other cuts. The surgeon will then fix or remove the problem in your knee.

CAUSES

Below are common causes that might require knee arthroscopy:

  • A Baker Cyst- a cyst filled with fluid at the back of the knee, often due to other knee issues like arthritis or a  meniscal tear
  • Patellar Problems- conditions like patellar chondromalacia (softening of the cartilage under the kneecap)
  • Arthritis-related damage- osteoarthritis or post-traumatic arthritis causing localized cartilage damage or debris in the joint.
  • Infections- septic arthritis or infected synovial tissue requiring debridement.
  • Tumors or cysts- rarely, benign tumors or abnormal growths like synovial hemangioma

SYMPTOMS

The key symptoms that typically lead to consideration of knee arthroscopy include:

Physical Symptoms:

  • Mechanical symptoms like catching, locking, or giving way of the knee
  • Swelling that recurs despite rest and conservative measures
  • Limited range of motion that affects daily activities
  • Clicking or popping sounds accompanied by pain
  • Instability during activities

A pattern of Symptoms:

  • Symptoms that worsen with specific activities (e.g., climbing stairs, squatting)
  • Failed response to conservative treatment over 6-12 weeks
  • Pain that interferes with sleep or daily activities
  • Symptoms that prevent a return to sport or work
  • Acute injury followed by persistent symptoms

NON-SURGICAL TREATMENTS

Before considering knee arthroscopy, several non-surgical treatments can help manage knee pain and improve joint function. These treatments are often effective for addressing conditions such as arthritis, meniscal tears, or ligament issues, depending on the severity of the problem.

  • Medications: Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
  • Cold and Ice Therapy
  • Bracing and Supports—knee braces provide support and reduce strain during activities and orthotic (insoles or shoe modifications and correct gait and reduce knee stress
  • Assistive devices—canes or walking sticks redistribute weight and improve balance
  • Corticosteroid injections reduce inflammation and pain for weeks or months
  • Lifestyle changes– reducing body weight can decrease stress on the knee joint.
  • Activity modification: Avoid high-impact sports and repetitive knee-bending activities.
  • Several types of physical therapy can help—strengthening exercises focusing on muscles around the knee, flexibility exercises like stretching can reduce stiffness and improve range of motion, and low-impact activities such as swimming or walking on a treadmill can strengthen the knee without undue pain.
  • Electrotherapy—TENS (Transcutaneous Electrical Nerve Stimulation) may alleviate knee pain by stimulating nerves

WHEN IS SURGERY INDICATED?

A doctor may recommend undergoing a knee arthroscopy simply when one is experiencing severe, chronic knee pain. A doctor might have already diagnosed the condition causing the pain, or they may order an arthroscopy to help find a diagnosis. In either case, an arthroscopy is a useful way for doctors to confirm the source of knee pain and treat the problem. Surgery may also be an option for:

  • Meniscal Tears: Repair or remove torn meniscal tissue causing pain or mechanical symptoms.Root tears or bucket-handle tears, especially in young, active patients.
  • Ligament Injuries: Reconstruction or repair of torn ligaments, such as the anterior cruciate ligament (ACL) Assessment and management of complex ligamentous injuries.
  • Cartilage Lesions: Microfracture, chondroplasty, or other techniques to repair articular cartilage damage. Osteochondritis dissecans (removal or fixation of loose fragments).
  • Loose Bodies: Removal of loose bone or cartilage fragments causing joint locking or mechanical symptoms.
  • Patellar Disorders: Realignment or debridement for patellar instability, maltracking, or chondromalacia patellae.
  • Synovial Disorders: Biopsy or removal of abnormal synovium in conditions such as synovitis or pigmented villonodular synovitis (PVNS).
  • Knee Stiffness: Arthroscopic release for arthrofibrosis or adhesions causing limited range of motion.
  • Degenerative Joint Disease: Debridement in selected cases for symptomatic osteoarthritis, though its utility is limited and controversial.
  • Post-Traumatic Injuries: Management of intra-articular fractures or soft tissue injuries involving the knee joint.
  • Baker’s Cyst: Removal of a cyst at the back of the knee often due to other knee issues like arthritis or a meniscal tear.

GETTING THE RIGHT DIAGNOSIS.  GETTING THE RIGHT DOCTOR.

This surgery isn’t very invasive. For most people, the procedure takes less than an hour, depending on the specific process. You will likely go home on the same day for recovery. While it isn’t that invasive, you still want to find the best surgeon, one who keeps up with the latest developments in arthroscopic surgery, uses the most advanced techniques, and always considers non-surgical options first. They have extensive specialization and experience, performing a high volume of knee arthroscopies annually, with a strong track record of successful outcomes. The best patient care, however, starts with doctors who listen with compassion, like those at Advanced Orthopedics in Denver, Parker, or Aurora, Colorado. Their commitment to providing personalized and comprehensive care is what sets them apart as a trusted resource for individuals seeking relief from knee pain, whatever the cause.

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