Knee Arthroscopy
Arthroscopy represents a significant advancement in orthopedic surgery, offering a less traumatic alternative to traditional open surgery.
What Is Knee Arthroscopy?
Knee arthroscopy is a minimally invasive surgical procedure that involves a surgeon investigating and correcting problems within the knee joint using a small, specialized tool called an arthroscope. Common applications include diagnostic arthroscopy, therapeutic arthroscopy, and procedures like meniscal repair, ligament reconstruction, cartilage debridement, and synovial membrane treatment.
The arthroscope is a thin, flexible tube equipped with a tiny camera and light source that allows the surgeon to visualize the inside of the knee joint on a monitor. Through small incisions (typically 2-3 small portals), surgeons can both diagnose problems and perform corrective procedures with minimal tissue damage.
What Happens During Knee Arthroscopy?
The arthroscopic procedure is typically performed as outpatient surgery, usually taking 30-90 minutes depending on the complexity:
- Anesthesia Administration: The procedure is performed under local, regional, or general anesthesia based on the patient’s condition and procedure complexity.
- Portal Creation: The surgeon makes 2-3 small incisions (about 4-5mm each) around the knee to insert the arthroscope and surgical instruments.
- Joint Visualization: The arthroscope is inserted, and sterile saline solution is used to expand the joint space for better visualization of internal structures.
- Diagnostic Assessment: The surgeon examines the cartilage, meniscus, ligaments, and synovial membrane to identify problems.
- Therapeutic Intervention: Using specialized miniature instruments, the surgeon performs necessary repairs, removals, or corrections.
- Closure: The small incisions are closed with stitches or adhesive strips, and a sterile dressing is applied.
When Arthroscopy Is Recommended
Diagnostic Purposes
- Unexplained knee pain or swelling when other imaging studies are inconclusive
- Joint instability or mechanical symptoms like locking or catching
- Persistent symptoms following conservative treatment failure
Therapeutic Applications
- Meniscal tears: Repair or partial removal of torn meniscus tissue
- Ligament injuries: Reconstruction of torn ACL, PCL, or other ligaments
- Cartilage damage: Debridement of damaged cartilage or microfracture procedures
- Synovial problems: Treatment of inflamed synovial membrane or removal of loose bodies
- Baker’s cyst: Drainage and treatment of fluid-filled cysts
- Osteophyte removal: Elimination of bone spurs causing impingement
- Joint infection: Cleaning and irrigation of infected joint spaces
When Arthroscopy May Not Be Sufficient
While arthroscopy is highly effective for many knee problems, it has certain limitations:
Limited Scope for Arthritis
- Severe cartilage loss may require more comprehensive treatments like regenerative medicine
- Extensive bone-on-bone contact cannot be adequately addressed through arthroscopic means
- Advanced deformity may need corrective osteotomy procedures
Temporary Solution for Some Conditions
- Degenerative meniscal tears in older patients may provide only short-term relief
- Progressive arthritis will continue despite arthroscopic intervention
- May delay definitive treatment in cases where joint replacement is ultimately needed
Not Suitable for All Patients
- Active joint infection may require open drainage and extensive debridement
- Severe joint instability might need open ligament reconstruction
- Complex fractures typically require open reduction and internal fixation
Making the Right Choice
Arthroscopy works best when integrated into a comprehensive treatment plan that includes:
- Accurate diagnosis through proper imaging and clinical evaluation
- Conservative treatment trial when appropriate before surgical intervention
- Realistic expectations about outcomes and recovery timeline
- Commitment to rehabilitation for optimal functional recovery
- Long-term joint health strategies to prevent future problems
For patients with mechanical knee problems, ligament injuries, or meniscal tears, arthroscopy offers an excellent minimally invasive solution with proven outcomes and faster recovery compared to traditional open surgery.