Up until about 1975, the majority of knee operations were done through large, open incisions. Patients usually stayed in the hospital for a few days and the recovery period was long and painful. In the late 1970’s, arthroscopic knee surgery started to become the new standard.
The invention of and improvement upon Arthroscopic surgery techniques has revolutionized the way that I do most knee surgeries. Knee Arthroscopy uses a scope (a tiny fiber optic camera), inserted into the knee joint, to help the surgeon visualize mechanical problems that can be fixed surgically or other problems that may be causing pain or loss of function.
The scope provides an amazing level of acuity and great magnification of the area being examined. This scope, as well as the other surgical instruments, has been specially designed to be inserted through small incisions in the skin and to work in the small compartments of the knee joint. In this article, I will discuss why people have problems with their knees, how they can be treated surgically by using the Arthroscope and what to expect when having this type of surgery on the knee, including the benefits and risks.
In my role as an Orthopaedic Surgeon, I see patients of all ages who complain of a painful knee. As the knees are arguably some of the most actively used and abused joints in the body, it makes sense that they might give us trouble from time to time.
Knee pain can be caused by a variety of different problems, and are usually in one of two categories, Acute or Chronic. Acute Knee problems are those that usually have a sudden onset, and that resolve and heal after some time, such as sports or work related injuries or an infection. Some of these types of injury will require surgery for the best outcome. Examples of Acute types of knee problems include:
- Tears to the ACL (Anterior Cruciate Ligament) or any of the other knee ligaments
- Meniscal Tears
- General Sprains and Strains of the Knee Ligaments and Tendons
- Knee Cap Dislocations or Fractures
- Knee Joint Dislocations
- Knee joint infections
Chronic Knee Problems
Chronic knee problems can be defined as those which occur gradually and may worsen over a period of time. These are typically problems that do not resolve non-surgically and must be dealt with over a long-period of time, such as in arthritis of the knee. Examples of Chronic types of knee problems include:
- Baker’s Cyst
- Inflammatory Disease, such as Lupus, Rheumatoid Arthritis or Gout
Some types of knee pain can be caused by overuse or repeated activities over time. Some examples of overuse injuries are:
- ITB (Iliotibial Band Syndrome)
- Patellofemoral Pain Syndrome (this is pain of the knee cap – the patella is the medical term for the knee cap)
Although this is not a complete list of every possible knee disorder, you can see from the above discourse that the knee can be affected in many ways, causing pain and discomfort to the human who owns and uses it. In my next post, I will discuss diagnosis and treatment of common issues.
Robert J. Snyder is an Orthopaedic Surgeon who specializes in the treatment of knees, hips and shoulders. A graduate of and former Chief-of-Surgery at the United States Military Academy at West Point, Dr. Snyder’s specialty focus is Total Joint Replacement and the treatment of Sport Injuries.
Dr. Snyder currently practices at Orthopaedic & Spine Center in Newport News, VA.