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Knee Arthroscopy and Meniscal Injuries

A knee arthroscopy, also known as arthroscopic knee surgery, is a minimally invasive surgical procedure used to diagnose and treat various problems within the knee joint. It involves the use of a specialized instrument called an arthroscope, which is a thin, tube with a camera and light source at the end. This camera allows the surgeon to see the knee joint's inside on a real-time video monitor.

Here's an overview of what a knee arthroscopy involves:

  1. Preparation: Before the procedure, the patient is typically given anaesthesia, which can be either local (numbing the knee area) or general (putting the patient to sleep). The choice of anaesthesia depends on the specific procedure and the patient's needs.
  2. Incisions: The surgeon makes small incisions, usually about the size of a buttonhole, around the knee joint. These incisions serve as entry points for the arthroscope and other surgical instruments.
  3. Arthroscopy: The arthroscope is inserted through one of the incisions. The camera on the arthroscope provides a clear view of the inside of the knee joint. The surgeon can inspect the joint's structures, including the cartilage, ligaments, tendons, and meniscus, to diagnose any issues.
  4. Treatment: If any problems or abnormalities are identified during the diagnostic phase, the surgeon can use specialized instruments to address them. Common procedures that can be performed during knee arthroscopy include:
    • Trimming or Repairing a Torn Meniscus: The meniscus is a cartilage cushion in the knee joint that can tear due to injury or wear and tear. The surgeon can trim or repair the torn portion.
    • Ligament Repair or Reconstruction: Ligament injuries, such as anterior cruciate ligament (ACL) tears, can be treated by repairing or reconstructing the damaged ligament.
    • Cartilage Procedures: Various techniques can be used to address cartilage damage or defects, such as microfracture, cartilage debridement, or cartilage transplantation.
    • Removal of Loose Bodies: If there are loose pieces of cartilage or bone in the knee joint, they can be removed.
  5. Closure: After the procedure is completed, the surgeon removes the arthroscope and any other instruments from the knee joint. The small incisions are closed with stitches or adhesive strips and covered with bandages.
  6. Recovery: Recovery from knee arthroscopy is generally faster and less painful than with open surgery. Most patients can go home the same day or after a short hospital stay. Physical therapy and rehabilitation are often prescribed to help regain strength and mobility in the knee.

Knee arthroscopy is commonly used to diagnose and treat a range of knee problems, including injuries, cartilage damage, ligament tears, and persistent knee pain. It offers the advantages of smaller incisions, less scarring, reduced post-operative pain, and a shorter recovery period compared to traditional open surgery. However, the suitability of knee arthroscopy depends on the specific condition and the patient's individual circumstances, and it is typically recommended after a thorough evaluation by a healthcare provider.

What is Meniscal Surgery?

Meniscal surgery, also known as meniscus surgery, refers to surgical procedures that are performed to address issues with the meniscus in the knee. The menisci are C-shaped pieces of cartilage that act as shock absorbers between the femur (thigh bone) and tibia (shin bone) in the knee joint. They help distribute weight and provide stability to the knee during movement. Meniscal surgery is often recommended when there is a tear in one or both of the menisci. Meniscal tears can occur due to various reasons, including sports injuries, traumatic events, or degeneration over time. The type of meniscal tear and its location influence the treatment approach, which can range from conservative measures to surgical intervention. There are two primary types of meniscal surgery: Meniscectomy: This is a surgical procedure in which a portion of the torn meniscus is removed. The surgeon trims away the damaged part of the meniscus while preserving as much healthy tissue as possible. A partial meniscectomy involves removing only the damaged section, while a total meniscectomy involves removing the entire meniscus. However, preservation of meniscal tissue is preferred whenever possible, as the meniscus plays an important role in knee joint function and stability. Meniscus Repair: In cases where the tear is located in the vascularized outer edge of the meniscus (also known as the red-red zone), repair may be possible. In a meniscus repair surgery, the torn edges of the meniscus are sutured or stitched together to promote healing. This procedure is often preferred in younger patients, as preserving the meniscus can help maintain long-term knee health and function. Meniscal surgery is commonly performed using arthroscopy, a minimally invasive technique that involves making small incisions and using a tiny camera (arthroscope) to guide the surgical instruments. Arthroscopy allows for better visualization of the internal structures of the knee without the need for large incisions. Recovery after meniscal surgery varies based on the extent of the surgery and the patient's overall health. Physical therapy and rehabilitation play a crucial role in helping patients regain strength, mobility, and function in the affected knee. Patients are typically advised to gradually increase their activity level under the guidance of their physio. It's important to note that not all meniscal tears require surgery. Smaller tears or tears in areas with good blood supply may heal with conservative treatments such as rest, ice, physical therapy, and anti-inflammatory medications. The decision to undergo meniscal surgery is based on a thorough evaluation by a healthcare professional and a discussion of the potential benefits and risks.