The Knee Joint

The knee is the largest joint in the body and is quite complex. The knee joint is stabilized with multiple ligaments, and may be injured with cutting, twisting or pivoting movements or trauma. The knee joint is also prone to wear and tear, including degenerative arthritis and meniscus tears.

The knee joint has three compartments, or areas: the patellofemoral compartment under and around the kneecap; the medial compartment on the inside of the knee; and the lateral (outside) compartment. Pain in these areas could signify damage or injury to the structures inside the knee.

Knee Arthroscopy

Knee arthroscopy is a surgery in which a camera, or arthroscope, is inserted into the knee joint through small incisions around the knee. Sterile fluid is then inserted into the knee joint, which expands the joint and makes it easier to see and work in your knee. Knee arthroscopy allows Dr. Burns to look directly into your knee joint and treat damage in the knee.

Knee arthroscopy can be done with you reclining on your back and your surgical leg supported in a brace or holder.  Special instruments have been designed to help your surgeon accomplish knee surgery through small incisions. Most of these instruments are long and thin, like a pencil, to fit through the portals. Special arthroscopic devices can be used to perform the same procedures that previously required incisions, including meniscal repair and ligament repair or reconstruction.

The advantage of having knee operations done through the scope is more than cosmetic. Depending on the type of procedure, post-operative pain and recovery time can be faster. This type of surgery is usually done on an outpatient basis, so that you can go home the same day. However, in knee surgery sometimes it can be necessary to make a small additional incision to get the work done properly, such as to harvest tendons for ACL or other ligament reconstruction, or to secure devices outside of the knee joint, as for meniscal root repair.

Common Knee Arthroscopy Procedures

Meniscus removal or repair. Dr. Burns may remove or repair damaged meniscus (a shock absorbing cushion in the knee), depending on the quality of the tissue and the location of the tear. Torn tissue on the inner portion of the meniscus is usually removed, while tears on the outer edge or at the root attachment can be repaired because those areas have enough blood supply for healing.

Articular cartilage shaving or removal. Arthritis is a process in which damage occurs to the articular cartilage (the shiny white and smooth ends of the bones). Dr. Burns may use instruments to smooth or remove unstable cartilage flaps, or she may drill the bone to stimulate cartilage growth (microfracture). Other procedures to repair or replace cartilage can also be performed, including cultured chondrocyte (cartilage cell) implants, or allograft implants of cartilage.

Ligament repair or reconstruction. Common ligament injuries include tears or damage to the ACL and PCL. Less common surgeries include stabilization of the MCL or LCL, or for the MPFL, which stabilizes the kneecap.