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Arthroscopic Knee Surgery

Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure in which a physical examination of the interior of a joint is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be done to evaluate and treat many orthopaedic conditions including torn floating cartilage, torn surface cartilage, ACL reconstruction and trimming damaged cartilage.

The advantage of arthroscopy over traditional knee endoscopies is that the joint does not have to be opened up fully. Instead, only two small incisions are made - one for the arthroscope and one for the surgical instruments. This reduces the recovery time of the patient and may increase the rate of surgical success due to less trauma to the connective tissue. It is especially useful for professional athletes, who frequently injure knee joints and require fast healing time. There is also less scarring, because of the smaller incisions.

The surgical instruments used are smaller than traditional instruments. Surgeons view the joint area on a video monitor, and can diagnose and repair broken joint tissue, such as ligaments and menisci).

Since the 1970's, arthroscopic surgery has become increasingly popular as a method of treating and diagnosing joint disorders. Today, knee arthroscopy is the most common procedure performed among orthopaedic surgeons.

Craig H. Bennett, MD., Chief of Sports Medicine at the University of Maryland Department of Orthopaedics, who has performed over a thousand arthroscopic knee procedures, explains that knee arthroscopy is used for the treatment of damage to various parts of the knee. This includes treating the knee's shock absorbing pads called the menisci, smoothing the white gliding surface of the knee called the articular cartilage, and reconstructing damaged ligaments of the knee such as the anterior cruicate ligament (ACL).

There are many advantages of arthroscopic surgery over surgery using large incisions. These include: reduced postoperative pain, improved thoroughness of diagnosis, reduced hospital cost and decreased complication rate. Contrarily, the disadvantages to arthroscopic knee surgery are few.

Meniscal injury is the most common indication for knee arthroscopy. Meniscal injuries result from both athletics and activities of daily living and can result in significant impairment. Indications for arthroscopic treatment of meniscal injury include symptoms that interfere with activities of daily living, positive physical exam findings (such as knee locking, catching and swelling), as well as failure of nonsurgical treatment. Treatment consists of arthroscopically repairing or removing the torn piece of the meniscus. In general, candidates for meniscal repair should be younger than 30 and with tears in the outer one third of the meniscus. Patients over age 30 generally require partial meniscal removal.

Advances in technology have also allowed for surgeons to perform arthroscopically assisted ligament reconstructions, articular cartilage repairs, partial knee replacements, and more recently meniscal transplantations.

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