The knee is a hinge joint held together with ligaments. Any one of these ligaments, either the central ligaments (Cruciates) or the peripheral ligaments (collaterals) can be torn. Sometimes one or more of these ligaments can be torn at the same time. The most common ligament torn is the Anterior Cruciate Ligament which often requires a reconstruction to make the knee stable again.
The bones that make up the knee joint, femur (thigh bone), tibia (shin bone) and patella (knee cap) are covered with a very highly specialised tissue called Articular Cartilage. The damage to or wearing away of this articular cartilage is called arthritis. The most common form of arthritis is Osteoarthritis
As well as this specialised articular cartilage there exists within the knee two “rubber doughnut shock absorbers” called menisci or sports cartilage. From the age of twenty seven onward these menisci become more and more brittle, easier and easier to tear.
Lastly, one of the other common pathologies affecting the knee joint is an inflammation or irritation of the tendons around the knee such as patella (knee cap) tendonitis.
Knee Arthroscopy- See the video here
A knee arthroscopy can be done to solve a number of problems arising within the knee joint.
Under a general anaesthetic a scope is introduced into the knee joint via a small (keyhole) portal. Through another portal the instruments are introduced to either repair or resect a tear in the meniscus for example. Indications for arthroscopic sugery include pain, locking, giving way, articular cartilage damage and a wealth of others.
The surgery is undertaken as a day case (in and out the same day).
Anterior Cruciate Ligament Reconstruction
Patients that have sustained an anterior cruciate ligament tear and who wish to pursue twisting activities eg skiing, football, hockey, netball will probably require a reconstruction of their ruptured ligament.
Again this surgery is undertaken under general anaesthetic as a day case. The surgery involves a lot of keyhole surgery to prepare the bone and drill the tunnels into which the new graft acl is introduced and fixed with screws. The new Anterior Cruciate Ligament is made from the hamstring tendons which are removed for this purpose ( though they will grow back!).
Knee Replacement Surgery
When the articular cartilage that lines the joints has become damaged and worn away this can be an extremely painful condition that severely limits function and quality of life. In these circumstances a joint replacement may be the most predictable method to alleviate these symptoms.
In knee replacement surgery the whole knee may be replaced (Total Knee Replacement) or only the specific part of the knee that is worn out (Partial knee Replacement). Knee replacement surgery is a highly successful (but quite invasive) technique to relieve arthritic pain.