Dr Kalpit Patel (MS Ortho, FRCS)

(Specialist Joint Replacement Surgeon)

Get to know about YOUR ARTHROSCOPY

Arthroscopy is a minimally invasive surgical procedure that allows an Orthopaedic surgeon to see and operate inside a joint using telescope like device called an arthroscope.

KNEE ARTHROSCOPY

Arthroscopy is a minimally invasive surgical procedure that allows an Orthopaedic surgeon to see and operate inside a joint using telescope like device called an arthroscope. The arthroscope is inserted through very small incisions in the skin. An arthroscope is a pen-shaped instrument to which a tiny video camera and light source is attached.

  • Lenses inside the arthroscope magnify images from inside a joint up to 30 times their normal size.
  • These images are transmitted to a TV monitor, giving the Orthopaedic surgeon an exceptionally clear view of the inside of a joint.
  • From this view, the surgeon can then operate inside the joint using small instruments inserted through separate tiny incisions.

ADVANTAGES

Joint surgery has improved greatly since the arthroscope was introduced. Surgery is less traumatic, healing is faster, scarring is reduced, and recovery is quicker. Only a number of tiny scars remain to show that surgery was ever done


When do we advise Arthroscopy at our Knee & Hip Clinic?

Arthroscopy is able to deal effectively with a number of problems in the knee joint, including:

  • Meniscal injury
  • Ligament injury
  • Loose bodies within the knee
  • Chondromalacia of the patella
  • Osteoarthritis

You will most likely have an MRI (magnetic resonance imaging) scan, which clearly will show the problem affecting your knee.

MRI

Magnetic resonance imaging (MRI) uses magnetic fields and radio waves to create detailed images of the body's soft tissue structures, such as ligaments, tendons, and cartilage, which do not appear on an x-ray image of the same part of the body. A computer converts signals from the MRI scan into frontal, lateral, and cross-sectional images.

In an MRI of the knee, many separate images are produced, each one representing a 'slice' of the knee (like very thin slices of bread but a lot thinner). Each slice is a cross section image of a different section of the knee. The clarity of the images allows the radiologist and Orthopaedic surgeon to easily see any problems in the knee. 
For more information about MRI, go to MRI.

Meniscal Injury

These are the most common knee injuries. The menisci are two pads of C shape fibrocartilage on either side in the knee that act as cushions or shock absorbers. They also help distribute the weight load inside the knee.

Most tears of the meniscus result from a sudden twisting movement of the knee, as

often occurs in sports injuries. As the knee bends and twists, the meniscus may be pinched between the bones. This is often accompanied by a "popping" sensation. The knee is likely to swell a few hours after the injury.

The tear may occur along the inner edge of the meniscus, or, less commonly, along the outer edge. There may be just a small torn "flap" of the meniscus, or a longer so-called "bucket-handle" tear, which is a tear along the length of the meniscus. Such a tear may cause the knee joint to "lock," meaning that the leg cannot be straightened. The menisci may be also become damaged and torn as part of normal wear and tear within the knee joint as we age. 

  • ARTHROSCOPIC DEBRIDEMENT
  • All types of meniscal tears can be treated by arthroscopy. Because the inner part of the meniscus has no blood supply, a tear along the inner part will not heal. Treatment, therefore, involves trimming away the torn piece of the meniscus. This is done with miniature motorized instruments inserted through a tiny incision on the side of the knee.

Ligament Injury

Ligaments are strong bands of tissue that fasten the bone ends together and stabilize the joint.There are two ligaments inside the knee that can be reconstructed with the assistance of the arthroscope:

  • The "anterior cruciate ligament"(ACL).
  • The "posterior cruciate ligament"(PCL), which is less frequently injured.

The cruciate ligaments restrict both the forward and backward motion of the knee and its rotation. They may be torn by sudden twisting motions of the knee beyond its normal range.

Not all cruciate ligament injuries need to be reconstructed; it depends on your age, level of activity, type of activity, and what you expect from your knee. A frank discussion with our specialist knee surgeon Dr Kalpit Patel will help both of you determine whether surgery would be beneficial.

  • If you enjoy active sports, it would be appropriate to have surgery.
  • If you have a sedentary-type job and are not active in your leisure time, you may not require surgery.

Unfortunately, a simple repair by suturing the torn ligament together again is not effective. A successful repair involves completely replacing the torn ligament--Reconstruction

Ligament reconstruction is most commonly performed utilizing the patella tendon graft. The Orthopaedic surgeon takes the central strip of the patella tendon and roots this through the knee through tunnels drilled in the tibia and femur. This creates a new ligament to replace the torn one.