Knees

Operations & Procedures

 Knee arthroscopy :: Cruciate reconstruction :: Total Knee Replacement

Knee arthroscopy

Knee arthroscopy is a day surgical procedure performed under a general anaesthetic. This is a type of keyhole surgery where instruments are inserted through small skin incisions to the knee. These cuts are less than a centimetre long. One of the incisions allows the insertion of a telescope and video camera and a light source in a tube of approximately 7mm diameter. Image of the inside of your knee is projected on to a television screen and may be recorded on a video cassette. Through a second incision, surgical instruments that include scissors and electronic and manual tissue resecting devices may be inserted as well as surgical suturing devices. These instruments are then used to correct the pathology within the knee without resorting to a formal opening of the knee joint. Usually with these three incisions no surgical sutures are required.

Procedures such as cruciate ligament reconstruction require more incisions, slightly larger incisions in order to obtain a graft and accurately place the graft within the knee.

Following your knee arthroscopy, you will be brought into recovery and the doctor will discuss his findings with you. As soon as you have recovered from the anaesthetic you will be fit to return home. You should not stay by yourself the night following the anaesthetic and should have someone in the same house with you. The knee is usually pain free for the first 24 hours as the last stage of the operation involves placing 10-15mls of local anaesthetic within the joint. This acts to numb the joint for approximately the first one day. Following this it is quite normal for a patient to commence experiencing some pain. The surgical wounds must be kept clean and dry until they are well healed by day twelve. For the first three days the dressing must remain in place but after this the heavy dressings may be taken down and waterproof Steri Strips may be placed over the three wounds. For further information on the post-operative management, please see the clinical pathway.

Following knee arthroscopy, a physiotherapy programme is usually required in order to strengthen specific muscle groups and protect the knee from damage in the early stages. Included here are some of the exercises that you may be required to do. However, your physiotherapist should guide you specifically through these exercises and supervise this programme.

Cruciate ligament injuries

As previously stated approximate ninety-five percent of cruciate ligament tears involve the anterior cruciate. Operative reconstruction of the anterior cruciate ligament is often required when conservative means and physiotherapy have failed. The most commonly used techniques of operative reconstruction involve the substitution of the torn cruciate ligament with another equivalent piece of ligament from the knee. Both the patella tendon and hamstring tendons are successfully used in cruciate ligament reconstructions. They both involve the drilling of some tunnels within the proximal tibia and distal femur around the knee joint and anatomically substituting a new tendon for the old or damaged tendon. The new or reconstructed cruciate ligament usually requires one to two metal screws or other fixation devices to hold it in place while the bony and other soft tissue structures heal.

Total knee replacement

Coming Soon

Visit http://www.brisbaneorthopaedics.com.au/knees.html to find out more about
knee surgery.