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Arthroscopy Of The Knee

What Is Arthroscopy of the Knee?

Last modified: 
15/04/2013 - 12:48

Contributing Author: Guy Slowik FRCS

Arthroscopy is a minimally invasive surgical procedure that allows an orthopedic surgeon to see and operate inside a joint using a device called an arthroscope. The arthroscope is inserted through very small incisions in the skin.

An arthroscope is a pen-shaped instrument to which a tiny video camera and light source is attached.

  • Lenses inside the arthroscope magnify images from inside a joint up to 30 times their normal size.
  • These images are transmitted to a TV monitor, giving the orthopedic surgeon an exceptionally clear view of the inside of a joint.
  • From this view, the surgeon can then operate inside the joint using small instruments inserted through separate tiny incisions.

Joint surgery has improved greatly since the arthroscope was introduced. Surgery is less traumatic, healing is faster, scarring is reduced, and recovery is quicker. Only a number of tiny scars remain to show that surgery was ever done.

Facts about arthroscopy of the knee:

  • More than 1.5 million knee arthroscopies are performed in the U.S. each year.
  • In the U.S., more than 11.2 million visits are made to physicians' offices because of a knee problem.
  • Arthroscopy is one of the most common orthopedic procedures in the U.S.
  • Millions of people have recovered and returned to work following a knee injury much sooner thanks to arthroscopy.
  • Modern or contemporary arthroscopy of the knee was first performed in the late 1960s.

Understanding The Knee

The knee is a hinged joint made up of three bones held firmly together by ligaments that stabilize the joint.

The bones that meet at the knee are the upper leg bone (the femur), the lower leg bone (the tibia) and the knee cap (the patella). The bones inside the joint are lined by a smooth protective layer called articular cartilage, which allows the bones to glide smoothly upon each other. In arthritis, this smooth lining becomes damaged.

Ligaments

Ligaments are dense structures of connective tissue that fasten bone to bone and stabilize the knee.

Inside the knee joint are two major ligaments.

  • The anterior cruciate ligament (ACL)
  • The posterior cruciate ligament (PCL)

These cross in the center of the knee (that's why they're called cruciate ligaments) and control the backward and forward motion of the knee. The ACL is frequently injured in severe twisting injuries of the knee.

Two other major ligaments are actually located outside the knee joint, on the outer and inner side of the leg. They act to stabilize the knee's sideways motion. The ligament on the inner side of the knee is called the medial collateral ligament or MCL (medial means inner side). The ligament on the outer side of the knee is the lateral collateral ligament or LCL (lateral means outer side).

The patellar ligament (the ligament of the knee cap) connects the lower part of the patella to the upper part of the tibia, specifically to the bony prominence one can feel on the lower leg bone (the tibia). The central one-third of this ligament is the most commonly used graft source in reconstructing a torn ACL.

Meniscus

The meniscus is a half moon-shaped structure placed between the weight-bearing bone ends in the knee. There are two menisci in each knee, one on the inner side called the "medial meniscus" and one on the outer side called the "lateral meniscus."

The two menisci act as shock absorbers within the knee and also help spread the weight load.

The meniscus is a type of cartilage, though it is different than the cartilage that lines the bones.

The menisci may be torn during twisting movements of the knee.

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Arthroscopy Of The Knee

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From Andrew Maynard - Chair of the University of Michigan Department of Environmental Health Sciences, with help from David Faulkner - 2013 Master of Public Health graduate.