An ACL (Anterior Cruciate Ligament) injury is the most common ligament injury requiring reconstruction. The anterior cruciate ligament (also called the ACL) is one of four ligaments that are critical to the stability of the knee joint. An ACL injury is usually sustained during contact sport or caused by falling. The procedure is done under general or spinal anesthetic and a one night hospital stay is required. It is an arthroscopic procedure where keyhole surgery allows the surgeon to replace the torn ends of the ACL with grafts from the hamstring tendon or the patella.
This is less common than an ACL injury as the posterior cruciate ligament is the strongest ligament in the knee. Patients normally have a combination of injuries when the PCL is injured. After arthroscopic surgery using grafts from other parts of the knee, the patient will normally be in a brace for 6 weeks and undergo rehabilitation.
This is an inside lateral ligament connecting the femur and tibia and stabilizing the knee against lateral dislocation to the left or to the right. The injury is usually due to external pressure against the inside of the knee. In the case of a grade I or II collateral ligament tear, doctors are likely to brace the knee for four to six weeks. A grade III tear may require arthroscopy to repair ligament tear and is followed by three months of bracing. Physical therapy may be necessary before resuming full activity.
A sprain of the LCL is an injury to the ligament. There are different types of sprains, called "grades". Minor sprains of the collateral ligaments will heal with rest and gradual return to activity. Arthroscopic surgery is usually performed as quickly as possible in grade 2 and 3 sprains to prevent further damage.
Meniscectomy is official name of the surgery that involves the removal of a portion of the meniscus cartilage from the knee joint. The meniscus is a shock-absorbing wedge of cartilage that sits between the bone ends to provide cushioning and support. Smaller meniscus tears can usually be trimmed to relieve the symptoms of a torn meniscus.
A meniscus repair is a surgical procedure done to repair the damaged meniscus. The meniscus repair can restore the normal anatomy of the knee, and has a better long-term prognosis when successful. However, the meniscus repair is a more significant surgery. The recovery is longer, and, because of limited blood supply to the meniscus, repair of the meniscus is not always possible.
Multiple ligament knee injuries are common in athletes involved in contact sports such as soccer, football and basketball. Multi-ligament injuries occur as a result of major trauma such as a direct blow to the knee, or a fall from a height, or motor vehicle trauma. Patients with multi-ligament knee injuries may experience pain, swelling, limited range of motion, injuries to nerves and arteries of the leg, and knee instability. Knee ligament injuries are graded based on the severity of injury. In grade I the ligament is mildly damaged and slightly stretched, but the knee joint is stable. In grade II there is a partial tear of the ligament. In grade III there is a complete tear of the ligament and the ligament is divided into two halves making the knee joint unstable. Most multi-ligament knee injuries require surgery to reconstruct the ligaments. Reconstruction of the torn ligaments using a tissue graft taken from another part of the body, or from a donor is known as complex ligament reconstruction. Surgical reconstruction is usually performed as a minimally invasive surgery where an arthroscopy with a miniature camera is inserted through a tiny incision to enable the surgeon to view the inside of the knee on a large screen. Small surgical instruments are inserted through the other tiny incisions around the knee. The damaged ligament is replaced by the graft and is fixed to the femur and tibia using metallic screws. After complex ligament reconstruction, the graft heals over a period of a few months and most patients are able to return to their high level sport after a period of rehabilitation. As the surgery is done through small incisions, it provides the following benefits: →Less post operative pain →Shorter hospital stay →Quicker recovery
Synovectomy is an operation performed to remove partial or all the synovial membrane of a joint. The procedure is either by classic arthrotomy or arthroscopy.
Arthroscopic synovectomy has many advantages over open synovectomy: including minimal invasive surgery, short hospital stay, diminution of postoperative joint stiffness, and better complete synovectomy. Arthroscopy allows for a more accurate diagnosis and facilitates the ability to ascertain small, localized areas of synovitis.
synovial tumors : Pigmented VilloNodular Synovitis → inflammatory arthritis : Rheumatoïd, chondromatosis, hemophily → septic arthritis →stiffness Synovectomy is indicated before cartilage damage.
The intra-articular suction drain is removed 24 hours after surgery. The patients began physical therapy (passive range of motion and isometric quadriceps contraction exercises) the same day to achieve maximum range of motion, restrengthen the quadriceps and hamstring muscles, and use modalities to decrease the swelling, pain, and inflammation in the acute postoperative period.
The knees are the joints most likely to go bad and the cartilage that cushions them has only a limited natural ability to repair itself. Knee Cartilage procedures are very common in young adults and adolescents. They can also be used for older people with arthritis. Treatments range from a micro fracture technique, cartilage transplantation and mosaicplasty for lesions bigger than 2cm in the knee. Microfracture is a treatment used to stimulate the body to grow new cartilage in an area of damaged cartilage. In a microfracture procedure, the firm outer layer of bone is penetrated, to expose the inner layers of bone where marrow cells exist. These cells can then access the damaged area and fill in the gap of cartilage. Autologous Chondrocyte Implantation Cartilage transfer involves moving cartilage from healthy parts of the joint to damaged areas. Small plugs of cartilage are removed, with a portion of underlying bone, and transferred to the area of damage. The plugs are taken from areas of the joint where the cartilage surface is not needed.
Patellofemoral symptoms of pain, swelling and giving way are extremely common. They can result from a number of problems affecting the muscles, ligaments, joint lining and cartilage surface. Patellofemoral pain and swelling requires expert investigation and diagnosis to avoid inappropriate treatment. Instability of the patellofemoral joint with recurrent dislocation can be a disabling condition in active people. Soft tissue surgical procedures for patellofemoral symptoms can be arthroscopic or open procedures. The arthroscopic procedures are mostly done as day surgery cases or one night stay . In many cases chronic patellofemoral pain involves mainly the synovial structures of the knee such as the plicae, or synovial folds which can be successfully treated arthroscopically. Surgery is reserved for symptomatic patients who have failed conservative management or for initial treatment of patients with an acute dislocation with a concomitant injury, such as osteochondral fracture, meniscal tear, or a loose body. Current emphasis is on anatomic reconstruction of the MPFL although, in the presence of malalignment or articular pathology of the patella, a distal bony realignment may be added.