Knee problems are one of the most common health issues for people across the world. From athletes to office workers, from young adults to the elderly, knee pain is a common ailment that can affect anyone, regardless of age or lifestyle. Chronic knee pain can be debilitating, affecting everyday activities and significantly reducing the quality of life. It impairs knee function, limits mobility, and can even lead to chronic pain in other parts of the body.
As a leading orthopaedic surgeon with years of experience, Dr. Brian Kelly is committed to helping individuals regain their mobility and live a life free from chronic knee pain. In this blog, we'll delve into the common types of knee surgeries performed by orthopaedic surgeons like Dr. Kelly and discuss when these procedures might be necessary. Whether you're suffering from chronic knee pain, struggling with decreased knee function, or simply curious about the field of orthopaedics, read on for more details.
Understanding Knee Problems
Knee problems can range from minor aches and pains to severe, debilitating pain that requires surgical intervention. Some of the most common knee issues that may end up requiring surgery include:
- Meniscus Tears: The menisci are dense pieces of cartilage that cushion between the thigh bone (femur) and shin bone (tibia) on either side of the knee. There is a medial meniscus (inner side of the knee) and lateral meniscus (outer part of the knee) in each knee. The meniscus can be injured either through gradual wear-and-tear over time (most common) or by a sudden, usually twisting injury to the knee.
- Ligament Injuries: The knee joint is stabilized by four main ligaments: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). These ligaments can be injured during sports or other activities or due to accidents. A torn ligament in the knee can cause pain, instability, and difficulty in walking or other activities. Depending on the severity of the injury and the specific ligament that is injured, surgery might be required to repair or reconstruct the ligament and restore knee function.
- Cartilage Injuries: Injuries to the cartilage (cushioning material) of the knee can occur from traumatic injuries where a piece of cartilage breaks off from the end of the bone or from a condition called osteochondritis dissecans (OCD), where the cause is not completely understood. Damaged areas of cartilage can sometimes become asymptomatic if they are small enough, but larger injuries can require surgical treatment. Sometimes OCD lesions can heal on their own, especially in children or teenagers, but sometimes they can progress and become unstable, which can lead to surgery.
- Knee Osteoarthritis: Osteoarthritis of the knee is a common condition where the cartilage in the knee joint deteriorates over time. This degenerative disease is often referred to as 'wear and tear' arthritis and is characterized by the progressive loss of articular cartilage, the smooth tissue that cushions the ends of the bones in your joints. As the cartilage wears away, the bones rub together, causing pain, swelling, and stiffness.
Understanding these common knee problems can help individuals make informed decisions about their health and treatment options. If you're experiencing knee pain or other symptoms, it is crucial to consult with an orthopaedic surgeon like Dr. Kelly to determine the best course of action.
1. Arthroscopic Procedures
Arthroscopy is a minimally invasive surgical procedure that orthopaedic surgeons use to diagnose and treat conditions inside a joint. The term arthroscopy comes from two Greek words: 'arthro' (joint) and 'skopein' (to look) - literally meaning 'to look within the joint'.
Unlike traditional open surgery, an arthroscope (a small, pencil-sized instrument fitted with a camera and light) is inserted through tiny incisions in the knee. This allows the surgeon to visualize the internal structures of the knee on a video screen, identifying and repairing any issues without the need for larger incisions.
Typically, arthroscopy is used when non-surgical treatments like rest, medications, or physical therapy fail to alleviate chronic knee pain or enhance knee function. It can also be used to treat injuries that do not heal on their own. Arthroscopic surgery can be an effective way to address a variety of knee conditions, including ligament tears:
- Meniscus Tears: When these pieces of cartilage tear and do not respond to non-surgical treatment, arthroscopy can be very effective. Depending on the type of tear and the age of the patient, the torn portion can either be removed or repaired. Meniscus surgery can be less effective in patients that already have changes of arthritis starting within the knee.
- ACL (Anterior Cruciate Ligament) Tears: The ACL is one of the key ligaments that help stabilize your knee joint. Athletes who participate in high-demand sports like soccer, football, and basketball often tear their ACL. It often occurs during a hyperextension injury. If an ACL tear occurs, you might hear a 'pop' in your knee and feel it giving out from under you. Arthroscopy can be used to reconstruct the torn ligament to make the knee stable again.
- PCL (Posterior Cruciate Ligament) Tears: PCL tears are not as common as ACL tears, and they are also less likely to require surgical treatment. They typically occur due to a blow to the front of the knee while it is bent. Symptoms include pain, swelling, and difficulty walking due to an unstable feeling. If necessary, arthroscopic surgery can reconstruct the PCL and restore stability to the knee.
Through the use of arthroscopy, orthopaedic surgeons can effectively treat these conditions, helping patients regain mobility and stability to resume their regular activities faster compared to traditional open surgery.
2. Knee Cartilage Restoration
Cartilage is a vital component of our knee joints, providing a smooth surface that facilitates movement and acts as a cushion to absorb shock. However, different types of localized cartilage lesions can occur as mentioned above. These lesions can cause pain, swelling, mechanical symptoms like catching and clicking, or reduced mobility. Fortunately, there are several treatment methods available for knee cartilage restoration:
- Microfracture: Microfracture is a minimally invasive procedure where tiny holes are made in the bone under the cartilage, called the subchondral bone. This process stimulates the body's natural healing response, encouraging the growth of new cartilage-like tissue.
- Osteochondral Autograft Transplantation (OATS): Also known as mosaicplasty, this procedure involves taking healthy cartilage from a non-weight bearing area of the knee and transplanting it to the damaged, weight bearing area. This method is generally used for smaller cartilage lesions.
- Osteochondral Allograft Transplantation: For larger lesions, osteochondral allograft transplantation may be utilized. This procedure uses cartilage from an undamaged donor knee, which is then transplanted into the same damaged area of the patient's knee.
- MACI (Matrix-Induced Autologous Chondrocyte Implantation): MACI is a two-step process. First, a small biopsy of the patient's cartilage is harvested arthroscopically and then grown in a laboratory. These cells are then implanted into a collagen membrane matrix. In the second step, this matrix is surgically implanted into the damaged area of the knee and secured into place. Over time, the damaged area is repaired with the patient’s own cartilage tissue.
Each of these methods has its own advantages and disadvantages, and the best treatment choice depends on various factors like the patient's age, activity level, and the size and location of the lesion, as well as the presence of other conditions such as ligament or meniscus damage or more generalized knee arthritis. Dr. Kelly can help determine the best course of action for your individual needs.
3. Total Knee Replacement
Total knee replacement (arthroplasty) involves removing the damaged or diseased parts of the knee joint and replacing them with artificial parts made from metal and plastic components.
The goal of total knee replacement is to relieve chronic knee pain and restore knee function that has been lost due to severe arthritis or a serious knee injury. It is typically recommended when non-surgical treatments like activity modifications, medications, injections, or physical therapy are no longer effective, or when the knee pain becomes so severe that it interferes with daily activities.
Knee replacements have been performed for decades, and advancements in surgical techniques and technology have made this procedure highly successful in improving mobility and quality of life for many years. In fact, according to the American Academy of Orthopaedic Surgeons, more than 90% of people who have had a knee replacement report that their replacements are still functioning well more than 15 years after the surgery.
In conclusion, total knee replacement is a proven and effective surgery that can help individuals suffering from severe knee problems regain their mobility, improve their quality of life, and return to a more active lifestyle. However, timing is crucial, and delaying surgery can potentially lead to further health complications.
Do you think you need knee surgery? Ask Dr. Kelly!
If you're struggling with knee pain, it may be challenging to know whether surgery is the right option for you. That is why consulting with a medical professional like Dr. Brian Kelly can make all the difference.
Dr. Kelly brings a wealth of experience and expertise in diagnosing and treating various knee conditions. He will thoroughly assess your situation, considering your lifestyle, activity level, and overall health before making any recommendations. If surgery is necessary, he will guide you through the process, explaining the procedure, potential risks, and expected recovery timeline in detail. His patient-centric approach ensures that all of your concerns will be addressed and that the most effective treatment plan is developed specifically for you.
Remember, when it comes to your health, it is essential not to leave anything to chance. Knee problems, if left untreated, can significantly impact your quality of life. If you think that knee surgery may be an option for you, don't hesitate to contact Dr. Kelly today and schedule a consultation!
Dr. Brian Kelly, MD is an orthopaedic surgeon and sports medicine doctor experienced in treating a variety of injuries and conditions. Dr. Kelly and his expert team will make sure that you get the treatment you need to get back in the game. Schedule an appointment at the offices of Dr. Brian Kelly today.
