Arthroscopic, or minimally invasive, surgery has become more common as advances in technology allow doctors to see inside your body without making large incisions. This results in smaller scars for you, less post-operative pain, and a faster return to the physical activities you love.
The most common knee injuries that are applicable to Arthroscopic Surgery are meniscus tears and ACL restructuring. The knee is composed of menisci, the ACL, the PCL, and other muscles and ligaments that act as stabilizers. The ACL limits forward movement of the tibia while the PCL limits its backward movement, for example. Both act in tandem to stabilize the knee from front to back.
A meniscus tear occurs during twisting or pivoting of the knee with the foot placed firm on the ground, like with tennis or while squatting in a garden. Heavy lifting can also be a cause. There is no specific age range for meniscus tears – they are uncommon in younger children, however.
Pain associated with meniscus tears is usually minimal. Menisci themselves have no nerve endings, so most pain is associated with swelling and damage to surrounding tissue. Smaller meniscus tears may heal on their own with the help of a brace and rest. Symptoms you may have a meniscus tear include tenderness of the knee, popping or clicking noises from the knee. Outer edge meniscus tears may heal on their own easier as there is a good blood supply going to them. If the tear is in the inner two-thirds, however, there is not a good blood supply and arthroscopic surgery is recommended.
The ACL, along with the PCL, are involved in knee stabilization.
A sprain or a rupture may occur when the foot is planted and the knee twists to change direction. Generally, a “pop” in the knee is a common characteristic of such damage, followed by immediate swelling. Loss of stability and a limited range of motion are also symptoms of ACL damage.
If the damage is not severe, immobilization and RICE (rest, ice, compress, elevate) may be enough to prevent further injury. However, should the ACL tear completely, surgery may be the only option to returning to an active lifestyle.
Damage to the anterior cruciate ligament, or ACL, is common amongst athletes and especially women. Damage to this part of the knee will make it instable, prone to arthritis and even cartilage tears. Non-surgical alternatives are available,
but require personal sacrifice of more demanding physical activities. If you are willing to limit yourself to low-impact sports like cycling or swimming, a brace and rehab may be all you need to repair your ACL. However, if you enjoy sports
like soccer, tennis, or skiing, arthroscopic surgery is recommended.
In ACL reconstruction arthroscopic surgery, the torn ligament is cut and replaced with graft tissue either from your own body or from a suitable donor. Screws are placed to anchor the graft down.
This injury, where the cartilage under the kneecap becomes soft or damaged, is due to wear and tear or arthritis as we age for the most part. In younger athletes, a fall, overuse, knee misalignment, or muscle weakness may lead to chondromalacia as well.
Runners, skiers, soccer players, and cyclists are at risk for this injury. As for treatment, minor cases can be resolved by avoiding high-impact exercises and trying more low-impact activities like swimming. In extreme cases, arthroscopic surgery may be recommended.Dislocated Knee Cap / Patella
When the triangle-shaped bone covering the knee slides out of place, it is called a kneecap dislocation. It occurs most often in women and is usually a result of sudden direction changes while running.
Kneecap dislocation damages your knee joint, so medical treatment should be sought even if pain is minimal, as is often the case with patients who have repeated dislocations and no medical treatment. Unless a bone has broken, the knee will be placed in a cast for around 3 weeks.Iliotibial, or IT Band Pain
Knee pain felt on the outside of the knee or lower thigh is referred to as IT Band Pain. Inflammation of the iliotibial band, running along the outside of the thigh, generally occurs due to overuse and is most common in runners. Other causes include training errors like running only on one side of an uneven road, or biomechanical abnormalities like overpronation of the foot or bowed legs.
Treatment begins with the RICE method, followed by physical therapy. Anti-inflammatory medication and rest are also common treatment options.Meniscus Tears / Injuries
Menisci are small pieces of cartilage acting as cushions in the knee joint. They are on the outside (lateral) and inside (medial) of the joint.
Forcefully rotating the knee while bearing weight is a common way these menisci can be injured or torn. Sports like soccer or football are activities where meniscus injury is common.
An injured or torn meniscus can cause moderate to severe pain when the leg is extended and the knee is straight; sometimes pain can be very severe should a torn meniscus fragment catch between the femur and tibia.
Swelling at the time of injury is common though it may delay a few hours as the joints become inflamed. The meniscus may click or pop, the knee may lock or feel weak as further symptoms of injury.Osgood-Schlatter Disease (Knee Pain)
This is an overuse injury found amongst adolescents, centralized at the knees. Inflammation of the tendon below the kneecap will cause pain, swelling, and tenderness below the kneecap.
Treatments focus on reducing the pain and swelling. This means anti-inflammatory medication and the wrapping of the knee until the adolescent can return to physical activities without discomfort. Sometimes, symptoms may worsen and several months of rest will be recommended, followed by a conditioning program. Usually, symptoms disappear on their own once the child completes their growth spurt, around age 14 and 16 for girls and boys, respectively.Osteoarthritis
Osteoarthritis is the most common form of arthritis and is known as “wear and tear” arthritis, as cartilage in joints becomes damaged and worn away with time, resulting in stiffness of joints and infrequent inflammation/swelling.
Exercise is the recommended course of treatment to control the symptoms and keep the joints strong and flexible.Osteochondritis Dissecans
A disruption of the joint, usually the knee, where the affected bone and cartilage loosen and cause pain. Eventually, this may turn into osteoarthritis. Osteochondritis Dissecans is most common in active adolescents and young adults.
Treatment options vary according to the severity of each case. If cartilage fragments have not broken loose, they may be fixed in place with pins and screws through surgery. If the fragments have broken loose, a bone graft may be necessary to fix the fragments into position.Patella Tendonitis
The patellar tendon joint the kneecap to the shin bone. Should this tendon come under a large amount of stress or strain, micro-tears and collagen degeneration may occur. This is common in sports involving rapid changes of direction or jumping movements, giving this injury the alternate title of Jumper’s Knee.
Symptoms of Jumper’s Knee include pain at the bottom and front of the kneecap, aching and stiffness after training, pain in contracting the quadriceps muscles, and possible calf weakness.
Treating patella tendonitis is different based on the level of injury. Icing the injury is good when pain is only present after training. If pain is continuous or even chronic, decreasing the stress placed on the tendon is necessary and in bad cases, ceasing activity completely. Rehab may be required for serious cases.Plica Syndrome
Occurs when bands of remaining synovial tissue are irritated by overuse or injury. Normally, synovial plicae combine to form one large synovial cavity, but if the process is incomplete, plicae remain as folds or bands of tissue within the knee.Prepatellar (Kneecap) Bursitis
People who spend a lot of time on their knees are at risk for prepatellar bursitis – swelling in the front of the knee due to the inflammation of the bursa, a small lubricating sac located in front of the kneecap. Jobs requiring constant kneeling, like carpet layers, plumbers, roofers, or gardeners, or athletics where falls on the knee are common such as football or wrestling, heighten the risk for this injury. Those with rheumatoid arthritis or those who have been in an automobile accident are also at higher risk.
Generally, pain is felt during the activity but not at night. The kneecap is tender and warm to the touch. There is also swelling on the kneecap’s front. Treating these symptoms is a matter of rest, icing the injury, elevating the affected leg(s), and taking appropriate anti-inflammatory medications. Significant swelling may prompt your physician to drain the bursa with a needle.Runner’s Knee (Patellofemoral Pain)
Despite its name, patellofemoral pain is not attributed solely to runners. Any athletic activity placing heavy stress on the knee carries the risk for patellofemoral pain. A number of conditions cause pain around the front of the knee and are placed under this umbrella terminology: anterior knee pain syndrome, patellofemoral malalignment, and chondromalacia patella.
Runner’s knee generally follows a few common symptoms: a dull, aching pain near the kneecap, pain walking up or down stairs, while kneeling or squatting, or while sitting with bent knees for a long period of time. A few causes include kneecap malalignment, dislocation, excessive training, tightness or weakness of thigh muscles, or flat feet.
Should you be diagnosed with Runner’s knee, utilize the RICE formula before seeking any more extreme treatment options. Reconditioning may be necessary and in extreme cases, arthroscopy or realignment surgery.Arthritis in the Knee
A sweeping term for over 200 conditions. The most common forms are rheumatoid arthritis and osteoarthritis. The former is a reaction of the nervous system, attacking joints and other parts of the body when no threat is present, causing inflammation and damage to the bursae of joints. Osteoarthritis is the most common and is known as “wear and tear” arthritis, as cartilage in joints becomes damaged and worn away.
There is no cure for rheumatoid arthritis; exercise is recommended for both common forms.Bursitis in the Knee
This is the term used for the inflammation of the bursa, a sac that decreases friction between joints moving in different directions. When the bursa becomes enflamed, any further use of it causes increased irritation. This condition arises from overuse of a repetitive movement or continuous and excessive pressure, like resting your elbows on a desktop for long periods of time.
There are many types of bursitis (elbow, knee, shoulder, hip, etc), but most diagnoses are consistent in that each show tenderness and swelling over the bursa along with pain during movement. Inflamed bursas carry a small chance of getting infected. If you experience open wounds around the area of bursitis, redness, or a fever/chills, contact a doctor immediately.
Treating bursitis is a matter of resting and protecting the affected area. Ice it down, take anti-inflammatory medicines to control swelling, with physical therapy & cortisone injections available for persistent cases. Physical rehab may be recommended for serious cases.Tendonitis in the Knee
Tendons connect muscles to bones. Tendonitis occurs when any of these tendons become inflamed and using the muscles becomes irritating and painful.
Overuse is the most common reason tendonitis may develop. Another cause is aging, as tendons lose their ability to stretch as you age. Tenderness over the tendon, pain and swelling of the tendon are common symptoms of tendonitis; different kinds of tendonitis (wrist, Achilles, knee, shoulder) need different treatments, but most require RICE therapy and in some cases, physical therapy.