Arthroscopic Knee Procedures

Due to the minimally invasive nature of this surgery it can provide a quick recovery to treat your knee problem. My philosophy is always to try and repair and preserve tissue if at all possible. Knee arthroscopy is not a good option in isolation for the treatment of osteoarthritis - other more reliable options are available.

Knee Arthroscopy

The meniscus is a 'c'-shaped piece of specialised cartilage, which is attached to the top of your shin bone (tibia). It lies in the middle of your joint, in between the articular cartilage that is on the end of your bones. It has a protective role, acting as a shock absorber, to help protect the joint. There is a meniscus on both the inside (medial) and outside (lateral) of your knee. If they are torn they can become painful, and you can get mechanical symptoms such as locking and catching.

Meniscal tears are either acute traumatic, or degenerative in nature. In my practice, I will aim to repair an acute traumatic tear if it is a suitable tear type. Acutely locked knees require prompt surgical intervention. Generally degenerative tears are managed with non-operative techniques. This may include referral to the radiology department for a para-meniscal injection. I would advise that you should complete at least 3 months of non-surgical treatment (such as structured physiotherapy) before surgery is considered. Surgery is primarily indicated to treat mechanical symptoms of locking and catching, provided there is an appropriate target on the MRI scan. In degenerative knees the pain following surgery may persist or deteriorate if it is primarily osteoarthritic in nature.

If you do require arthroscopic meniscal surgery the procedure is relatively low risk and generally provides good outcomes. The operation is generally performed as a daycase procedure under general anaesthetic. Depending on the procedure performed it takes around 2-3 weeks until you are walking comfortably and 2-3 months until you are back to full function. With a meniscal repair this is closer to 5-6 months.

If your meniscus tear is repairable I will use a combination of sutures to achieve a stable construct. You will be placed into a brace post-operatively and will need to engage in physiotherapy rehabilitation.

If I do surgery to repair the meniscal root, which is where the meniscus attaches to the bone, you will need to be non-weight bearing in a brace post-operatively. This procedure may be combined with a high tibial osteotomy (HTO).

If you tear is not repairable then I will remove the damaged tissue. There is a chance this may lead to ongoing symptoms, and further surgery may be indicated at a later date.

Meniscal Surgery

Articular cartilage is a specialised part of your knee joint that lines the ends of the bone. It allows the joint to move smoothly and helps absorb forces when you walk, run, or play sport. The cartilage can be injured either acutely secondary to trauma, or as part of a degenerative process within the knee joint. The blood supply to the cartilage is poor and therefore significant lesions do not heal very well. If you have an acute injury, or are getting significant symptoms of pain and mechanical locking, you may be a suitable candidate for surgery.

I have experience in performing a variety of techniques to treat damaged cartilage within the knee, ranging from fixation of traumatic osteochondral lesions or microfracture combined with a chondral scaffold, to focal resurfacing procedures using Osteochondral Autograft Transfer System (OATS) or the EPISEALER® KNEE implant.

Cartilage regeneration is generally considered most suitable for carefully selected patients with focal cartilage defects, particularly when the surrounding knee is otherwise reasonably healthy.

Depending on the procedure that has been performed you may be in a brace post-operatively, and typically you will not be able to fully weight bear through your knee. The operation is generally performed as a daycase procedure under general anaesthetic, with a nerve block to help with pain. Recovery requires active engagement in physiotherapy to effectively rehabilitate your knee function. Cartilage surgery may be performed concomitantly with ACL reconstruction, or osteotomy surgery.

Cartilage Restoration

It is vitally important that with any cartilage surgery you do not smoke, or vape, as this can impair blood supply and subsequent healing potential.

info@ahearnknee.co.uk

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