Arthroscopy is a minimally invasive surgical procedure that allows an orthopedic surgeon to see and operate inside a joint using a 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.
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.
The knee is a hinged joint made up of three bones held firmly together by ligaments that stabilize the joint. The bones that meet at the knee are the upper leg bone (the femur), the lower leg bone (the tibia) and the knee cap (the patella). The bones inside the joint are lined by a smooth protective layer called articular cartilage, which allows the bones to glide smoothly upon each other. In arthritis, this smooth lining becomes damaged
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 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 your doctor will help both of you determine whether surgery would be beneficial.
These are the most common knee injuries. The menisci are two pads of fibrocartilage on either side of 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. 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.
Meniscal injuries along the outer edge of the knee may be repaired rather than removed because the blood supply to this part of the meniscus is better, giving an improved chance of healing.