Treatment Options for Knee Injuries
If you've injured your knee, what are your treatment options? Naturally, the treatment course for each patient is different.
In general, John C. Lincoln's knee surgeons in Phoenix explore conservative, nonoperative treatment options before pursuing surgical intervention. The conservative treatment program consists of conditioning exercises and physical therapy — as pain decreases — to gradually improve motion, strength and agility.
See how John C. Hospitals provide advanced orthopedic care, from diagnosis to post-surgical rehabilitation.
The second option is arthroscopic knee surgery, which is performed on an outpatient basis. In arthroscopy, a miniaturized camera affords the surgeon an exact view of a meniscus tear or damaged articular cartilage (cartilage that covers bones, bears weight and reduces friction).
Meniscus Knee Surgery
The lower portion of the knee (the tibia) is covered by two highly resilient cartilage structures — the medial meniscus and lateral meniscus. They distribute weight, provide lubrication to the knee joint and stabilize the knee.
Unfortunately, about only 10 percent of meniscus tears are suitable for meniscus knee surgery, which involves a tack- or suture-repair of the cartilage.
If meniscus knee surgery is not feasible, a knee surgeon can remove unstable fragments of meniscus and recontour the meniscus. This procedure is called a partial menisectomy. Here, the goal is to preserve as much cartilage as possible, not remove the complete meniscus.
Procedures Available for Articular Cartilage Damage
If the thickness of the cartilage is damaged partially, it can be smoothed down using a treatment called debridement, to relieve knee pain and minimize future arthritis.
If the thickness of the articular cartilage is thoroughly defective, several techniques are available to John C. Lincoln's knee surgeons in Phoenix:
- Microfracture: Small holes are placed in the exposed bone, to stimulate a healing response from marrow.
- Osteochondral grafting: Plugs of bone and cartilage are transferred from a nonweight-bearing portion of the knee to resurface the articular cartilage.
- Autologous condrocyte implantation: For resurfacing large cartilage defects, this relatively new technique involves a biopsy of the patient's articular cartilage. Twelve million cells that make up articular cartilage, called chondrocytes, are "cloned" into the defect, under a patch of periosteum (bone lining tissue).
After Arthroscopic Knee Surgery
Arthroscopic knee surgery has a 90-percent success rate. Yet, the exact probability of success depends upon many factors. These include:
- The complexity of the injury.
- The patient's age.
- Time since injury.
- Presence of arthritis.
- The patient's participation in rehabilitation.
Risks of surgery include anesthesia-related complications, infection, chronic stiffness and need to re-operate. Before surgery, knee surgeons help patients gain a realistic understanding of surgical risks and potential complications.
After arthroscopic knee surgery, the knee surgeon will review findings and photos with patients so they fully understand surgical outcomes. Patients also begin exercise and physical therapy as soon as possible.