Wednesday, 27 July 2016

Arthroscopy Knee

Patients with certain types of meniscal tears and cartilage damage are prime candidates for the minimally invasive surgical intervention called Arthroscopy Knee diseased by osteoarthritis, rheumatoid or psoriatic arthritis can also be treated using arthroscopy.

The following covers the different types of treatments for meniscal tears and cartilage damage with a partial focus on arthroscopy assisted procedures.

Meniscal Tears

The most common non-surgical treatments of meniscal tears are:
  • Rest, Ice, Compression, Elevation, (RICE)
  • Non-Steroidal anti-inflammatory medicines
The outer third of the meniscus has a healthy supply of blood so can heal successfully without the trimming of smaller tears using arthroscopy. Though the inner two thirds of meniscus plates have a much reduced blood supply meaning tears in the region are more likely to require arthroscopic intervention.

For surgical treatment of meniscal tears there is:
  • Arthroscopy: a miniature camera is inserted through a small incision to provide a view of the inside of the knee. Miniature surgical instruments are then inserted in separate incisions to trim or repair the tear.

Cartilage damage

As cartilage does not heal easily of its own accord, surgical techniques have been developed to assist cartilage regrowth. Cartilage restoration can relieve pain and delay the onset of arthritis. Arthroscopy has many different applications in treating cartilage damage, such as:

  • Microfracture: A small pointed tool called an awl is used to create small holes in the subchondral bone. This stimulates new blood supply and cell growth in the cartilage.
  • Drilling: stimulates the production of healthy cartilage. Multiple holes are made in the subchondral bone using drills or wires to initiate a healing response. Though the tools used are less precise than microfracture. Arthroscopy.
  • Abrasion Arthroplasty: instead of using drills or wires, high-speed burrs remove the damaged cartilage and reach the subchondral bone. Arthroscopy.
  • Autologous Chondrocyte Implantation: using arthroscopy of the knee this procedure extracts healthy cartilage tissue, then grows the cells in a laboratory over 4-5 weeks. Using open knee surgery, the cells are the re-implanted in the site of the damaged cartilage. Arthroscopy and arthrotomy, (open surgery).
  • Osteochondral Autograft Transplantation: healthy cartilage is lifted using a cylindrical plug from a non-weight-bearing area of the knee joint, then transferred to the defective area and pressed into place. A single plug or multiple plugs can be used. Arthroscopy and open surgery.
  • Osteochondral Allograft Transplantation: when the defect is larger, instead of autografts, allografts use tissue grafts taken from cadaver donors. Allografts usually use open knee surgery.

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