Overview
Arthroscopy is a minimally invasive surgical technique used to diagnose and treat knee injuries, including those involving ligaments, cartilage, and the meniscus. This technique has become the standard of care for managing knee trauma due to its ability to reduce recovery times, minimize complications, and provide accurate visualization of the joint structures.
Traumatic Ligament Injuries
Traumatic ligament injuries commonly affect the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). These injuries often result from high-impact trauma, such as during sports activities.
ACL Injuries
ACL tears are one of the most common traumatic knee injuries. Arthroscopy allows for the assessment of the injury's extent and guides the decision for reconstructive surgery. ACL reconstruction is typically performed using grafts (e.g., hamstring tendon, patellar tendon, or allograft).
PCL Injuries
Arthroscopic procedures can help diagnose and manage PCL injuries, which are less common but may result from direct trauma to the knee. Arthroscopy aids in ligament repair or reconstruction.
MCL and LCL Injuries
Minor MCL injuries may be managed conservatively with physiotherapy, while severe injuries or combined injuries with ACL tears may require arthroscopic intervention, including repair or reconstruction.
Arthroscopic ligament reconstruction typically involves the use of specialized equipment for graft fixation and precise tunnel placement in the femur and tibia. This allows for faster recovery and less scarring compared to open surgery.
Cartilage Injuries
Traumatic cartilage injuries are often a result of direct blows, twisting motions, or long-term wear and tear. The cartilage in the knee can be damaged, leading to pain, swelling, and functional impairment.
Chondral Lesions
These injuries affect the articular cartilage of the femur, tibia, and patella. Arthroscopic techniques like microfracture, autologous chondrocyte implantation (ACI), or osteochondral allograft transplantation can be used to treat these defects.
Microfracture
Microfracture involves creating small holes in the bone beneath the damaged cartilage to promote the growth of new fibrocartilage.
Autologous Chondrocyte Implantation (ACI)
Autologous Chondrocyte Implantation (ACI) involves harvesting healthy cartilage cells from the patient, culturing them, and then implanting them into the defect site.
Osteochondral Allograft Transplantation
Osteochondral Allograft Transplantation involves transplanting healthy cartilage and bone from a donor to replace damaged areas.
Osteoarthritis
In cases where traumatic injury leads to early-onset osteoarthritis, arthroscopic debridement can remove damaged tissue, alleviate pain, and improve joint function. In more advanced cases, joint preservation techniques or even knee replacement may be considered.