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Meniscal Injuries

Knee Arthroscopy and meniscal injuries

Knee arthroscopy is a common procedure that orthopaedic surgeons use to examine and treat the inside of the knee. An arthroscope, a thin fibre-optic telescope about the width of a pencil, is passed into the joint through a small incision at the outer side of the knee. This is done under an anaesthetic.

A camera is attached to the arthroscope, and a clear view of the inside of the joint can be seen on a video monitor. This allows us to examine all areas inside the knee joint. Usually, a diagnosis can be made. Depending on the diagnosis, it is possible to treat a number of abnormalities during the same procedure.

Arthroscopic surgery has become a routine procedure. The incision is much smaller, which assists faster healing and lowers the risk of complications.

Most arthroscopies canbe done as a day procedure. This reduces the problems that can occur with prolonged bed rest and lack of mobillity, such as blood clots and chest infections.

The knee joint can be easily injured, especially during sports or work that requires twisting movements, sudden stopping and starting, changes in direction, and collisions with other players. As cartilage becomes less supple with age, relatively minor trauma in older people may result in significant damage to the knee joint.

Common signs and symptoms of an injured knee are swelling, persistent pain, catching or locking during certain movements, and “giving way” unexpectedly. If these do not improve an arthroscopy is often recommended.

A physical examination of the knee is always performed, usually with imaging studies including an xray and MRI if more information is needed prior to surgery. The full extent of the damage is seen through the arthroscope, and repaired at the time of surgery.

Tears to the lateral or medial menisci:

A tear to the medial or lateral meniscus is usually caused by a twisting injury. Pain is left on the inner or outer side of the knee, and there may be swelling of the joint with difficulty moving it. Sometimes the joint will “lock” if the torn segment becomes caught between the bones. The tears have a variety of names, based on their appearance.

Unless the tear is very small, it is unlikely to heal on its own. It untreated, it will usually continue to catch in the knee, resulting in long-term irritation and damage. This can lead to osteoarthritis over time.

We perform a partial menisectomy with the arthroscope (key hole), removing the torn piece so the knee can return to normal function. The entire meniscus is not removed, carefully preserving as much as possible. In younger people with a specific type of tear it may be possible to repair the damaged meniscus.

Arthroscopic partial medial menisectomy – sequential views from arthroscope demonstrating and exposing the tear. Removal of the tear preserving as much normal meniscus as possible.

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