Knee arthroscopy is a minimally invasive procedure by which the knee is examined with an arthroscopic camera, and its inner structures are displayed on a monitor. With the use of arthroscopic instruments, these structures are felt, trimmed and shaved, torn parts can be sutured in place, and damaged tissue, loose fragments of bone and cartilage and foreign bodies can be removed. The main purpose of an arthroscopic procedure on the knee is to improve the patient’s quality of life, and to prevent or slow down the wear of the joint which may occur if a disease or injury is not treated in time. An arthroscopic procedure is not indicated in a patient with advanced wear in the knee joint.
Knee arthroscopy is used mainly in the treatment of a torn meniscus. The knee contains two menisci, one on the inner and one on the outer side of the joint.
The menisci are damaged most frequently during twisting movements combined with bending of the knee. A torn meniscus usually causes a sharp, piercing pain in the knee or even a feeling of catching or locking during movement.
When the torn part of the meniscus becomes impinged in the joint, the knee cannot be extended. Such a patient must undergo an arthroscopy as soon as possible.
During the procedure, the damaged part of the meniscus is removed or, in certain cases, it can also be sutured in place.
In addition to the menisci, an orthopaedic surgeon also assesses the condition of the anterior and posterior cruciate ligaments and inspects the synovial membrane, removing any thickened areas (synovial folds or plicae).
Sometimes surgeon may cut off a piece of inflamed synovial tissue and send it for histological examination. Consultant surgeon has also assessed the condition of the articular cartilage, looking for possible damage and wear.
If the cartilage is flaking off Consultant surgeon smooth it with a special instrument to obtain firm edges. In certain cases surgeon may remove a piece of articular cartilage and send it to the laboratory, where new cells are cultured from it, which are then returned into the knee (autologous chondrocyte transplantation).
A well demarcated and sufficiently small cartilage defect can sometimes be treated by the microfracture technique, which involves making minute holes in the bone surface at the site of the lesion, thus allowing growth factors from the bone to come to the area and form scar cartilage.