There are three main types of knee surgery that are used to treat injuries and illnesses such as arthritis. Arthroscopy, which is minimally invasive, allows surgeons to work with a knee scope inserted through a small incision. Partial knee replacement is more serious and involves replacing one of the three components of the knee joint with an implant. Total knee replacement is major surgery that doctors generally hope to postpone as long as possible because it involves replacing the entire knee joint with a prosthesis.
Surgeons use knee arthroscopy to investigate knee problems and repair damage from injuries and arthritis. This type of surgery is generally used to repair torn meniscus, treat mild arthritis, or remove loose pieces of broken knee cartilage. Knee scope surgery may also be performed to repair torn or damaged ligaments, treat inflamed or damaged synovium, or repair misaligned knee caps.
In this type of procedure, surgeons begin by a small incision in the knee, and then pump in salt water to expand the knee joint and control bleeding. The doctor inserts a knee scope through the small incision and uses a video monitor to see the problem better. From there, one or several more small incisions may be made. These incisions will be used to insert surgical instruments, including hooks and shavers, to repair the problem. To finish, the surgical team will drain the fluid from the knee and close the incisions.
Partial-replacement knee surgery is a more serious procedure and is generally used to treat patients in whom arthritis has damaged one portion or compartment of the knee, causing debilitating pain. The knee has three compartments — the medial, the lateral and the patello-femoral. A partial knee replacement involves replacing either the medial or the lateral compartments with an implant.
Total-replacement knee surgery is major surgery that doctors use to treat patients with advanced arthritis and debilitating pain. It involves replacing the entire knee joint with a prosthesis, and as a result, recovery can be a long process. A patient can be discharged from the hospital once he can walk on crutches, maneuver short flights of stairs and bend his knee 90 degrees. Once home, rehabilitation involves using a cane and participating in therapy to gain strength and flexibility.
Doctors generally prefer to postpone total-replacement knee surgery for as long as possible and will usually try more conservative treatments first. These include lifestyle modification such as losing weight or avoiding running and twisting that aggravate an injured knee; physical therapy exercises to improve the strength and flexibility of a painful knee; joint fluid therapy to inject the knee with fluids that reduce pain and improve lubrication; or medicines including anti-inflammatory drugs or glucosamine.
