Knee arthroscopy is a surgery where a tiny camera is used to look inside the knee to assess the bone, cartilage and ligaments. Small incisions are made through which the camera and specially designed surgical tools are inserted during the procedure.
- Meniscal tears
- ACL tears
- PCL tears
- Removal of loose bodies
- Synovectomy (removal of diseased synovial tissue) in cases of:
- Rheumatoid arthritis
- Infections (pyogenic arthritis, tuberculous arthritis)
- Pigmented villonodular synovitis
- Synovial chondromatosis (multiple loose bodies)
- Joint debridement & washout for osteoarthritis
- Articular cartilage injuries and defects requiring:
- Abrasion arthroplasty
- Autologous cartilage implantation (ACI)
- Lateral retinacular release for patellar maltracking
- Patellar clunk syndrome following total knee replacement
- Evaluating knee joint prior to doing Unicompartmental knee replacement (UKR) or High tibial osteotomy (HTO)
- Arthroscopic assisted fixation of tibial plateau fractures
- Knee stiffness – Arthrolysis
Being a day care surgery, the pre operative assessment is done prior to admission. Pre operative work up starts with a Consultation with the Orthopaedic Surgeon which lasts for about 30 minutes. It includes a detailed history, general physical examination, knee joint examination, x rays, MRI, blood investigations, ECG, Echo(if required) and patient counseling. You will additionally have to meet the Anaesthetist too. Once you are fit for surgery, you will be admitted for undergoing the procedure.
It is a day care procedure usually done under spinal anaesthesia which numbs the lower limbs below the waist. The procedure consists of making tiny incisions into the joint. Through this incision, a sterile solution is filled into the joint. This ensures that unwanted materials are washed away from the joint. Also, more clarity is attained for images of the joints. The ligaments and menisci are assessed and corrected as required. The worn out cartilage is removed. Wound is closed with a single stitch for each incision.
Once the arthroscopic camera is placed inside the joint, the torn ACL and other structures within the knee are examined. The remnants of the torn ACL are gently shaved off and small tunnels of appropriate size are created in the femur and tibia to accommodate the graft (tendons obtained from the same leg and prepared). The graft is inserted into the tunnel, tensioned and secured on either side with either a suture disk, an endobutton or screws.
It is done in a similar manner to ACL reconstruction.
Meniscal tears are treated according to the type of tear and the zone of injury. Simple tears in the outer aspect (red-red zone with very good blood supply) or the middle (red-white zone) of the meniscus are repaired using special sutures and fastened with a knot within the knee joint. However, complex tears in the innermost part of the meniscus (white-white zone with poor blood supply) are not repaired. They are excised partially and the meniscus is stabilized (Meniscectomy).
After the surgery, the wound is covered with a small dressing and crepe bandage. You are usually discharged in the evening once the anesthetic effect wears out. The doctor and the physiotherapist will suggest the necessary exercises. You will be made to walk with support on the day of surgery itself. You will be required to wear a knee brace while walking for a few weeks. The recovery is dependent upon the disease condition treated.