Arthroscopic Knee Surgery

Arthroscopy is a safe method of examining and treating conditions affecting the joints. Most arthroscopic procedures are carried out upon the knee joint, which because of its complexity and design, is the most commonly injured large joint in the body.

The procedure is safe and reliable in expert hands and is commonly known as minimal access surgery or keyhole surgery.

The advantages for the patient include extremely small incisions and ease of mobilisation after the procedure. This means most arthroscopic procedures can be carried out as day case and patients are able to regain a fully functioning knee fairly rapidly.

A lot of knee procedures are made possible through arthroscopy surgery. I am able to inspect all the joint surfaces and the two menisci in the joint.

Using specifically designed arthroscopic instruments and micro tools I am able to carry out complex procedures down the arthroscope. The majority of operations I perform this way are on the meniscal cartilages within the joint. Additionally, surgery to the anterior cruciate ligament, which is situated in the central part of the knee joint, and repair or smoothing down of articular cartilage (which lines the surfaces of the knee) is also possible as well as complimentary cartilage repair techniques.

The menisci (popularly known as cartilages) are the structures on which most of the work is carried out upon in arthroscopy. The menisci are crucial to knee function both in bending and flexing and in twisting or pivoting, acting as a washer or shock absorber within the joint to allow smooth movement of the femur upon the tibia.

The menisci can be injured by sudden trauma such as a sporting accident or a twisting injury or alternatively the menisci may tear as a result of minor repetitive injury especially in an older patient. Once a meniscus is torn, the damaged edge causes pain, particularly when you try to carry out a deep knee bend or twisting movement. As well as pain, some long term damage can occur as a result of the torn cartilage damaging the bearing surface of the joint.

Meniscal surgery to a damaged articular cartilage is carried out by removing the area which is torn, whilst leaving the vast majority of undamaged meniscus intact. This lessens the chance of developing premature osteoarthritic degeneration of the knee. Meniscal damage that involves a large surface area of the structure can easily be repaired.

Articular cartilage (the white lining tissue of the bone) forms a vital function within our knee joints, coating the bearing surfaces of the knee, allowing them to move effortlessly across each other.

However, the smooth lining of the joint may be damaged by injury leading to painful symptoms as parts of the underlining bone are exposed, giving rise to grating and crunching along with pain and aching. This is the beginning of osteoarthritis. Once damaged, articular cartilage does not regenerate and there is the possibility that damage to the articular cartilage can progress leading to arthritis of the joint.

Arthroscopic surgery is aimed at containing and smoothing these areas, promoting the growth of repair tissue and helping to prevent further damage to existing articular tissue.

I have a particular interest in the prevention of joint damage and employ other specialist techniques such as coblation, microfracture and cartilage grafting to restore the function of the joint. I am also involved in the newest techniques of regeneration using biological scaffolds.

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