Arthroscopy is used in a wide variety of joint problems, especially in the knee. Learn more about this procedure and the types of knee issues it can treat.
How Your Knee Works
Your knee is a hinged joint that rotates. It carries the greatest amount of your body weight. This may contribute to the reason why the knee is one of the most commonly replaced joints: approximately 700,000 knees are replaced every year.
The bones that make up your knee include your femur, or thigh bone, and your tibia, or shin bone. Between the two sits the meniscus, a cushioning piece of cartilage that functions as a shock absorber. Your knee also has ligaments and tendons that provide strength and stability.
What is Arthroscopy?
Arthroscopy is a surgical procedure that involves tiny instruments inserted into small incisions. This minimally invasive surgery allows your orthopedic surgeon to view inside your joint with a tiny camera called an arthroscope. Then, your surgeon makes a second small incision to perform various procedures such as cutting and removing tissue.
Because the incisions are much smaller in arthroscopy than in traditional open surgery, there is far less damage to the soft tissues around your joints. This means you will experience less pain and a quicker healing time.
Knee Arthroscopy Procedures
Arthroscopy is an effective way for your orthopedic surgeon to see exactly what is causing your knee problems because it allows them to examine your knee thoroughly without invasive surgery. It also provides much more information than can be obtained from an MRI scan or x-rays.
Using arthroscopy, your orthopedic surgeon can locate and identify damage in your cartilage, ligaments, and other parts of your knee, such as your patella (kneecap) and synovium (joint lining).
ACL Reconstruction & Repair
The anterior cruciate ligament (ACL) is a ligament that helps stabilize your knee. It is often torn or damaged from sudden twists, stops, or changes in direction that occur in sports or other high-velocity incidents.
ACL repair is for partial ACL tears: injuries where the ligament has separated from the bone, but is still intact. In an arthroscopic ACL repair, your orthopedic surgeon will reattach the ligament to the bone. If the ligament has a slight tear, your surgeon can also sew it back together arthroscopically.
When the ligament has torn in two, you may require ACL reconstruction. In an arthroscopic ACL reconstruction, the torn ligament is removed completely and replaced with graft tissue. The graft tissue—which typically comes from your knee, your thigh, or from a donor—is secured to the ends of your femur (thigh bone) and tibia (shin bone). As your body heals, the graft tissue will attach fully to the bone, effectively becoming your new ACL.
Meniscus Repair & Removal
The menisci are shock-absorbing cushions of cartilage that distribute weight across your knee. They can become torn due to injury or degeneration. Whether the meniscus tissue can be healed depends on the severity of the tear, where the tear is located, and your age.
If you have a minor tear in your meniscus, your orthopedic surgeon can use arthroscopy to repair it using tacks or sutures. For major tears, your orthopedic surgeon will trim and remove the damaged tissue that cannot be healed. This procedure is called a meniscectomy.
Some kneecap dislocations are caused by a tightening of the ligament in the knee that helps it move. This tightening results in the kneecap being pulled to the side of or even out of the groove it sits in on the end of your femur (thigh bone), making it painful to bend your knee. A lateral release involves arthroscopically cutting through the overly tight ligament, allowing the kneecap to return to its groove.
When the cartilage in your knee is damaged, growing new cartilage is one way to get relief. Microfracture is an arthroscopic procedure that involves penetrating the outer layer of bone with tiny holes to expose marrow cells. The marrow cells stimulate cartilage growth, helping heal the damaged area.
Because microfracture stimulates the growth of scar tissue cartilage (fibrocartilage) instead of the standard cushioning cartilage (hyaline cartilage) found in the knee, it is not recommended for patients with widespread arthritis. Instead, it is used as a short-term pain relief measure to introduce cushioning back into the knee.
Lavage & Debridement
Lavage is the process of “washing out” the cavities of the knee joint with sterile fluid to remove debris like loose pieces of cartilage. This helps reduce pain and inflammation in the knee while restoring some range of motion.
Debridement is the process of smoothing rough surfaces—such as osteophytes or edges of torn menisci—that are causing pain in the knee joint. Both lavage and debridement are commonly performed during other knee arthroscopy procedures.
Living with Knee Pain
Arthroscopy is just one of the few ways Arkansas Surgical Hospital can help relieve your knee pain. To learn more, contact Arkansas Surgical Hospital at (877) 918-7020 for help making an appointment with one of our specialists.