Knee joint imaging or knee arthroscopic surgery is a minimally invasive procedure for the surgical treatment of meniscus and cruciate ligament injuries. Small incisions are made through which instruments are inserted into the knee joint. This allows gentle treatment of meniscus and cruciate ligament tears. In cases of infection or inflammation, the knee joint can be cleaned and irrigated with antibiotics.
Knee joint imaging, medically referred to as knee arthroscopic surgery, is used in the diagnosis and treatment of diseases and injuries in the knee joint. This minimally invasive procedure is most commonly used in meniscus and cruciate ligament injury. However, knee arthroscopic surgery may also be used in the diagnosis and treatment of inflammation and infections of the knee.
What preparations are carried out before the procedure?
The knee joint is thoroughly examined prior to knee arthroscopic surgery and the extent of the injury of disease determined using x-ray images or MRI scans.
Patients should be fasting for the procedure. This means they should not consume any food or drink at least six hours and three hours, respectively prior to the procedure. Agents used to arrest bleeding are discontinued a few days beforehand. As is usual prior to surgery, blood tests and an ECG are performed and blood pressure taken as required.
How is the operation performed?
Knee imaging is often carried out on an outpatient basis. In most cases, the procedure is performed under local anaesthesia of the spinal cord (spinal anaesthesia). In some cases, general anaesthesia may be the preferred option, depending on the patient’s situation. A pencil-thick optical instrument with a camera is inserted into the knee joint via a small incision. A second incision is then made through which surgical instruments are inserted into the joint. The joint is rinsed with a special fluid throughout the operation. This widens the joint cavity and gives the camera a better view.
A damaged meniscus is either stitched or partially removed. In cases of very extensive meniscus damage, it may be necessary to remove the entire meniscus. If this is the case, a meniscus replacement is implanted, commonly known as a collagen meniscus implant. Cartilage or bone fragments may also be removed in arthroscopic surgery.
Cruciate ligament surgery
Damaged cruciate ligaments can also be stitched or replaced in knee arthroscopic surgery. Damaged, anterior cruciate ligaments are usually replaced with a tendon from the patient’s own body. Parts of the patellar tendon or quadriceps tendon make suitable replacements. Sometimes, the ligament is replaced with a tendon removed from the other knee in arthroscopic surgery.
Chronic inflammation of the joint capsule, or of the joint lining sometimes requires the removal of the inflamed joint lining. This surgical procedure is referred to as a synovectomy and can also be performed during knee joint imaging.
Following knee arthroscopic surgery, knee joint function is checked, any liquid suctioned from the joint cavity and the incisions closed.
What is the success rate of this procedure?
Knee joint imaging is a gentle, minimally invasive procedure. The stress placed on the knee joint is markedly less than in open surgery. Knee arthroscopic surgery is considered a standard procedure with good outcomes for the treatment of meniscus and cruciate ligament tears.
What are the possible complications and risks of this procedure?
Knee arthroscopic surgery is a low-risk routine procedure. As with all surgery, the operation may occasionally lead to infections, nerve damage, post-operative haemorrhaging or blood clots. Sometimes, effusions arise in the joint following surgery which must then be aspirated. In rare cases, dysregulation of the nerves and arteries may occur, known as Sudeck’s syndrome.
What happens after the operation?
Follow-up treatment depends on the type of injury and the surgical treatment used. After minor procedures, the knee joint can soon support the patient’s full weight again. Following cruciate ligament surgery or if the meniscus is partially removed, it may take longer until patients can put their full weight on the joint. In such cases, it may take up to three months for the joint to heal completely. The healing process is regularly checked in follow-up examinations.