We offer the most advanced treatment options available including:
- Minimally Invasive (MIS) Total Knee Replacement (TKA)
- Computer Assisted Surgery (CAS) – Navigation
- Partial Knee Replacement (TKR)
- Patient Matched Total Knee Replacement
- Knee Arthritis Surgery
- Total Knee Replacement (TKR)
- Anterior Cruciate Ligament (ACL) Injury Care
- Cartilage Regeneration Surgery
- Knee Arthroscopy
- Fracture Surgery
- Sports Medicine
Phoenix Knee Arthroscopy - Minimally Invasive Knee Surgery, Arthroscopic Knee Surgery
The most common surgical procedure in Orthopedic Surgery is arthroscopy of the knee. The operation is performed at a hospital or outpatient surgical center. The patient is usually administered a general anesthetic. The procedure usually takes 30-45 minutes. A thin telescope less than 12 inches long with a fiber optic light cable attached to a side port and a HD video camera clamped to the optic eye piece is inserted into the knee through 2 or 3 incisions each ¼ inch long. Sterile saline fluid is "pumped" into the knee joint for a clear view inside the knee capsule. Small hand and motorized tools are used to cut off torn flaps of meniscus, smooth rough joint surfaces, and grasp/remove loose tissue. The patient is discharged to home an hour or two later the day of surgery. Patients are on crutches for a day or day, take oral pain medications for less than a week, return to desk work in 2-4 days, and are usually fully recovered in 2-4 weeks (for simple arthroscopic procedures such as menisectomy, chondroplasty, loose body removal and lateral release).
Patient outcomes vary, but can be predicted based on age and diagnosis. As a rule, if the patient is younger than 50 with only one problem (only a torn meniscus, only a loose body, only a small area of joint surface damage) tend to have a higher rate of successful surgical outcomes. Patients over 50 with more than one disease process (most common is torn meniscus with chondral damage – also know as arthritis) have unpredictable outcomes after knee arthroscopy {improved knee outcome in 60% range for these multiple disease process knees}.
Diagnostic Arthroscopy: Even in the age of high resolution 3T MRI scans there is still a role for the surgeon to only look inside the knee for diagnostic purposes. This is done to assess healing of meniscal repair, healing of microfracture, healing of Autologous Chondrocyte Implantation, looking for wearing of Total Knee Replacement, assessment of ligament injury ( or a new injury or after surgical reconstruction of knee ligament), or when knee symptoms are unexplained even after history, physical, Xray and MRI of the knee.
Arthroscopy Menisectomy: Surgical procedure to remove the torn portion of a meniscus and stop mechanical symptoms such as pain with pivoting or squatting, swelling, locking or catching. Medial meniscus tears are much more common than lateral meniscus tears. The age of the patients that have the best outcome after partial menisectomy is 25-55 age group because these knees are the healthiest with respect to joint surface (also known as articular cartilage) and usually have only one knee part diseased - the torn meniscus [above photo shows flap tear of medial meniscus with healthy articular cartilage – this case will result in surgical cure for the patient].
Arthroscopic Meniscal Repair: Instead of removing a portion of the torn meniscus, meniscal sutures or anchors are used to hold the tear in place to allow natural healing of the tear (see above arthroscopic photo). The meniscus only has blood vessels (and thus the ability to heal) in the peripheral 3 millimeters and only this tear pattern is treated with repair techniques. Isolated, repairable lateral menisci are much more common than medial meniscus (usually isolated medial meniscal tears are best treated by removal).
Arthroscopic Chondroplasty/Microfracture: Chondroplasty refers to a technique in which an arthroscopy shaver blade is used to smooth the rough edges and remove the loose articular cartilage (joint surface) around a defect in the articular cartilage. Results are highly variable. Microfracture (see above knee cartoon) describes a technique in which the surgeon uses an ice pick-like tool to penetrate the bone surface just under the articular cartilage in a defect where articular cartilage has died and flaked off the underlying bone. The principle is based on the idea that the marrow element cells released by this "micro fracturing" will fill the joint surface defect and mature into tissue to replace the lost cells. This works best when the defect is less than 2 centimeters in diameter and the patient is less than 30 years of age. Special post op care is mandatory for a good outcome and return to sports can be many months.
Arthroscopic Lateral Release: This is an arthroscopic treatment of patellar tracking abnormalities, specifically lateral patellofemoral compression syndrome, with or without associated patellar joint surface injury. The surgeon will use thermal or cautery to arthroscopically cut through the lateral retinaculum (depicted in black in the above diagram, red line is the cut in the retinaculum) in order to release the tension on the tissue. In theory this will allow your patella to return to a normal position. Success is 50 %.
Arthroscopic Loose Body Removal: Loose pieces of bone or articular cartilage or composite of both can break loose and float in the knee, causing symptoms of pain, locking and catching. Most commonly loose bodies are seen in older patients when bone spurs break off the margins of the knee joint. In younger patients loose bodies are the result of patellar (knee cap) dislocation, shear or direct blow injury, and osteochondritis dissecans. Arthroscopic loose body removal is a predictable and helpful procedure for patients. Recovery is usually quick.
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Last Modified: June 18, 2009