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Knee Procedures

Knee Fracture Surgery

Knee Fracture Surgery

A knee fracture is a broken bone or a crack in or around the joint of the knee. This can involve the tibia (shin bone), the kneecap (patella), or femur (thighbone) where they connect with the knee. Knee fracture surgery is a surgical procedure performed to correct the cracked or broken bones in or around the knee to restore normal anatomical function, stability, and motion.

Meniscal Transplantation

Meniscal Transplantation

Meniscal transplantation is a surgical procedure to replace the damaged meniscus of the knee with healthy cartilage. The meniscus is a C-shaped cartilage ring that acts as a cushion between the shinbone and the thighbone. Each of your knees has two menisci - one on the inside (medial aspect) and the other on the outside (lateral aspect)of your knee. Apart from the cushioning effect, the menisci also provide stability to the knee.

Mosaicplasty

Mosaicplasty

Weight-bearing joints, such as the knee, may develop defects in the articular cartilage (spongy tissue that lines and cushions joints during movement) due to stress, trauma or degenerative disease. This can lead to pain, swelling or locking at the joint. Mosaicplasty is a surgical technique to repair the defect by transplanting healthy bone and cartilage from non-weight bearing areas of the knee. It is indicated to treat small cartilage defects of less than 2 cm in young active adults less than 45 years of age.

Posterolateral Corner Reconstruction

Posterolateral Corner Reconstruction

Posterolateral corner injury is damage or injury to the structures of the posterolateral corner. The structures of the posterolateral corner include the lateral collateral ligament, the popliteus tendon, and the popliteo-fibular ligament. Injuries to the posterolateral corner most often occur with athletic trauma, motor-vehicle accidents, and falls. An isolated injury to the posterolateral corner is rare but often occurs with injuries to the cruciate ligaments, the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL).

Chondroplasty

Chondroplasty

Chondroplasty is a surgical procedure to repair and reshape damaged cartilage in a joint. The procedure involves smoothing degenerative cartilage and trimming any unstable flaps of cartilage.

Viscosupplementation

Viscosupplementation

Viscosupplementation refers to the injection of a hyaluronan preparation into the joint. Hyaluronan is a natural substance present in the joint fluid that assists in lubrication. It allows the smooth movement of the cartilage-covered articulating surfaces of the joint.

Knee Arthroscopy

Knee Arthroscopy

Knee arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to diagnose or treat a knee problem. It is a relatively safe procedure and you will usually be discharged from the hospital on the same day of surgery.

High Tibial Osteotomy

High Tibial Osteotomy

High tibial osteotomy is a surgical procedure performed to relieve pressure on the damaged site of an arthritic knee joint. It is usually performed in arthritic conditions affecting only one side of your knee and the aim is to take pressure off the damaged area and shift it to the other side of your knee with healthy cartilage. During the surgery, your surgeon will remove or add a wedge of bone either below or above the knee joint depending on the site of arthritic damage.

Medial Patellofemoral Ligament Reconstruction

Medial Patellofemoral Ligament Reconstruction

The medial patellofemoral ligament is a band of tissue that extends from the femoral medial epicondyle to the superior aspect of the patella. It is a major ligament that stabilizes the patella and helps in preventing patellar subluxation (partial dislocation) or dislocation.

Arthroscopic Reconstruction of the Knee for Ligament Injuries

Arthroscopic Reconstruction of the Knee for Ligament Injuries

Arthroscopic reconstruction of the knee ligament is a minimally invasive surgery performed through a few tiny incisions. An arthroscope is inserted into the knee joint through one of the small incisions to provide clear images of the surgical area (inside the knee) to your surgeon on a television monitor. Guided by these images your surgeon performs the surgery using small surgical instruments inserted through the other small incisions around the knee.

PCL Reconstruction

PCL Reconstruction

The posterior cruciate ligament (PCL), one of four major ligaments of the knee, is situated at the back of the knee. It connects the thighbone (femur) to the shinbone (tibia). The PCL limits the backward motion of the shinbone.

ACL Reconstruction

ACL Reconstruction

ACL reconstruction is a commonly performed surgical procedure. With recent advances in arthroscopic surgery, it can now be performed with minimal incision and low complication rates. The advancements in arthroscopic surgery make it easy for surgeons to view and work on knee structures through small incisions. The repair of the torn ligament can be performed at the same time as the diagnostic arthroscopy with fewer surgical risks.

ACL Reconstruction of Patellar Tendon

ACL Reconstruction of Patellar Tendon

Anterior cruciate ligament reconstruction patellar tendon is a surgical procedure to replace the torn ACL with part of the patellar tendon taken from your leg. The new ACL is harvested from the patellar tendon that connects the bottom of the kneecap (patella) to the top of the shinbone (tibia). The procedure is performed under general anesthesia. Your surgeon will make two small cuts about ¼ inch around your knee. An arthroscope, a tube with a small video camera on the end is inserted through one incision to see the inside of the knee joint. Along with the arthroscope, a sterile solution is pumped into the knee to expand it, providing your surgeon with a clear view of the inside of the joint.

ACL Reconstruction Procedure of Hamstring Tendon

ACL Reconstruction Procedure of Hamstring Tendon

The goal of ACL reconstruction surgery is to tighten your knee and restore its stability. Anterior cruciate ligament reconstruction hamstring method is a surgical procedure to replace the torn ACL with part of the hamstring tendon taken from your leg. The Hamstring is the muscle located on the back of your thigh. The procedure is performed under general anesthesia.

Subchondroplasty

Subchondroplasty

Subchondroplasty is a minimally invasive procedure that is performed to specifically repair chronic BMLs by filling them with a bone substitute material. The bone substitute is then slowly resorbed and replaced with healthy bone, repairing the bone defect. Subchondroplasty also resolves the associated edema. Subchondroplasty may be performed alone or along with other arthroscopic procedures.

Partial Meniscectomy

Partial Meniscectomy

Partial meniscectomy is a surgical procedure to remove the torn portion of the meniscus from the knee joint.

Meniscal Surgery

Meniscal Surgery

A meniscus tear is the commonest knee injury in athletes, especially those involved in contact sports. A sudden bend or twist in your knee can cause the meniscus to tear. This is a traumatic meniscal tear. The elderly are more prone to degenerative meniscal tears as the cartilage wears out and weakens with age.

Transphyseal Surgery

Transphyseal Surgery

Surgery may be necessary to reconstruct an irreparable anterior cruciate ligament (torn ACL). It usually involves the use of a soft tissue graft which is passed through tunnels drilled into the shin and thigh bones and secured to these bones. In a child or adolescent, a transphyseal surgery may be performed where the tunnels pass through the growth plate or physis (area near the end of a long bone where growth is still occurring). Injury to this area could potentially affect growth and result in deformity. An appropriate surgical technique is used to minimize these effects.

Partial Transphyseal Surgery

Partial Transphyseal Surgery

Partial transphyseal surgery is an arthroscopically assisted operative procedure to reconstruct the anterior cruciate ligament (ACL) in the knee of a child or adolescent with growth plates or physis (areas near the ends of long bones where growth is still occurring). Reconstruction of the ACL is performed using a soft tissue graft which is passed through tunnels drilled into the shinbone (tibia) and thighbone (femur) and secured to these bones. Partial transphyseal surgery is performed to minimize injury to the physis which could potentially affect growth and result in deformity. The tunnel is created such that it passes centrally through the physis of the tibia while sparing the physis of the femur.

Physeal Sparing Surgery (Anderson's Technique)

Physeal Sparing Surgery (Anderson's Technique)

Surgery may be necessary to reconstruct an irreparable anterior cruciate ligament (torn ACL). In adults, reconstruction of the ACL involves passing a soft tissue graft through tunnels drilled into the shinbone (tibia) and thighbone (femur). In a child or adolescent, such tunnels may damage the physes or growth plates (areas at the ends of long bones where growth is still occurring). A physeal-sparing technique may be recommended where the physes in the tibia and femur are left undisturbed avoiding complications such as growth disturbance or angular deformity.

Partial Arthroscopic Meniscectomy

Partial Arthroscopic Meniscectomy

Partial arthroscopic meniscectomy is a procedure to remove the damaged part of a meniscus in the knee joint with the help an arthroscope. The meniscus is a C-shaped disc of cartilage between your thighbone and shinbone. There are 2 menisci in each knee. They act as shock absorbers and provide stability to the joint.

Autologous Chondrocyte Implantation

Autologous Chondrocyte Implantation

Autologous chondrocyte implantation (ACI) is a procedure to treat the articular cartilage defects of the knee. This procedure is effective for treating small areas of cartilage damage that causes pain and swelling and restricts range of motion. Autologous chondrocyte implantation is not indicated if you have advanced arthritis of the knee.

Saucerization

Saucerization

Saucerization is a surgical procedure performed to treat a discoid (disc-shaped) meniscus in the knee joint which is more prone to injury. The normal meniscus is crescent-shaped cartilage cushioning the ends of the femur (thighbone) and tibia (shinbone) in the knee. There are two menisci in each knee, one on either side. During saucerization, the abnormally thick discoid meniscus is cut and re-shaped into a crescent.

Matrix Induced Autologous Chondrocyte Implantation (MACI)

Matrix Induced Autologous Chondrocyte Implantation (MACI)

Matrix-Induced autologous chondrocyte implantation is an innovative, FDA-approved cartilage restoration procedure that uses your own cells to repair cartilage defects in your knee. It can alleviate knee pain, help you regain function and may even delay or prevent arthritis.

Arthroscopic Debridement

Arthroscopic Debridement

Arthroscopic debridement or a clean-up is a surgical procedure performed using an arthroscope. In this procedure, the cartilage or the bone that is damaged is removed using surgical instruments and the edges of the articular cartilage that are rough will be smoothened. A washout or joint lavage is done using a special tool to spray jets of fluid to wash and suck out to remove the remaining debris around the joint.

Tibial Tubercle Osteotomy

Tibial Tubercle Osteotomy

Tibial tubercle osteotomy is a surgical procedure that is performed along with other procedures to treat patellar instability, patellofemoral pain, and osteoarthritis. The tibial tubercle transfer technique involves realignment of the tibial tubercle (a bump in the front of the shinbone) such that the kneecap (patella) traverses in the center of the femoral groove. The patellar maltracking is corrected by moving the tibial tubercle medially, towards the inside of the leg. This removes the load off the painful portions of the kneecap and reduces pain.

Multiligament Reconstruction of the Knee

Multiligament Reconstruction of the Knee

Multiligament knee reconstruction is a surgical procedure to repair or replace two or more damaged ligaments of the knee joint. The surgery can be performed using minimally invasive techniques.

Patellar Tendon Repair

Patellar Tendon Repair

The goal of the surgery is to reattach the torn tendon to the kneecap and to restore normal function in the affected leg. The procedure is performed under regional or general anesthesia and an incision is made on the front of the knee to expose the tendon rupture. Holes are made in the patella, strong sutures are tied to the tendon and then threaded through these holes. These sutures pull the torn edge of the tendon back to its normal position on the kneecap.

Failed Anterior Cruciate Ligament (ACL) Reconstruction

Failed Anterior Cruciate Ligament (ACL) Reconstruction

The knee joint is stabilized by four strong ligaments. The anterior cruciate ligament (ACL) passes diagonally in the middle of the knee, ensuring that the thigh and shin bone do not slide out of alignment during movement. ACL injury is one of the most common sports injuries of the knee joint and is generally repaired with ACL reconstruction surgery, where the torn ligament is replaced with a graft tendon. While this process is a very common and highly successful procedure, some may fail to achieve stability.

Failed Meniscus Repair

Failed Meniscus Repair

Meniscal repair may be performed either by open surgery under direct vision or minimally invasively using an arthroscope, which is a thin tube fitted with a camera that can be inserted into the knee through a very small incision to locate and repair the damaged meniscus.

Meniscectomy

Meniscectomy

Meniscectomy is a surgical procedure indicated in individuals with torn meniscus where the conservative treatments are a failure to relieve the pain and other symptoms. Meniscectomy is recommended based on the ability of meniscus to heal, patient’s age, health status, and activity level. The meniscus is the C-shaped two pieces of cartilage located between thighbone and shin bone that act as shock absorbers and cushion the joints. Meniscus distributes the body weight uniformly across the joint and avoids the pressure on any one part of the joint and development of arthritis.

Prior Meniscectomy

Prior Meniscectomy

The menisci are two C-shaped cartilages that act as shock absorbers between the thigh and shin bones that articulate at the knee joint. They provide stability and lubrication to the joint as well as nutrition for the articular cartilage. Tears in the meniscus may occur as a result of acute injury or chronic degeneration with age. Symptoms may include pain, swelling, and catching or locking of the joint. Meniscus tears can be surgically treated by meniscectomy.

Quadriceps Tendon Repair

Quadriceps Tendon Repair

Quadriceps tendon is a thick tissue located at the top of the kneecap. The quadriceps tendon works together with the quadriceps muscles to allow us to straighten our leg. The quadriceps muscles are the muscles located in front of the thigh.

Tibial Eminence Fracture

Tibial Eminence Fracture

The tibia or shin bone is a major bone of the leg which connects the knee to the ankle. A fracture or break in the upper part of the tibia is known as a proximal tibial fracture and commonly occurs just below the knee joint. The knee joint is the largest weight-bearing joint of the body, where the lower end of the femur or thigh bone articulates with the tibial plateau.

ORIF of the Knee Fracture

ORIF of the Knee Fracture

ORIF refers to open reduction and internal fixation. It is a surgical procedure employed for the treatment of a fracture not amenable to non-surgical conservative treatment.

Distal Femoral Osteotomy

Distal Femoral Osteotomy

An osteotomy is a surgical procedure that involves cutting of bone. The distal femur is part of the femur (thighbone) just above the knee joint. Distal femoral osteotomy is performed to correct knee alignment which can lead to excessive loading and degeneration of one side of the knee joint. The procedure involves cutting of the distal femur, repositioning the bones and securing them in the proper alignment.

Physeal Sparing Reconstruction of the Anterior Cruciate Ligament

Physeal Sparing Reconstruction of the Anterior Cruciate Ligament

Physeal sparing reconstruction of the anterior cruciate ligament is a surgery to replace a torn anterior cruciate ligament or ACL, a major ligament of the knee, while minimizing damage to the growth plate (physis) present near the end of the bone. Ligaments are powerful bands of tissue that attach one bone to another, and the anterior cruciate ligament attaches the thighbone (femur) to the shinbone (tibia) to help stabilize the knee joint.

Pharmacological Interventions for Knee Injuries

Pharmacological Interventions for Knee Injuries

The knee is a complex joint that consists of bone, cartilage, ligaments, and tendons, which help in joint movements. Knee problems may arise if any of these structures get injured by overuse, trauma or during sports activities. These may impair your mobility as well as your quality of life.

Knee Osteotomy

Knee Osteotomy

Knee osteotomy is a surgical procedure in which the upper shinbone (tibia) or lower thighbone (femur) is cut and realigned. It is usually performed in arthritic conditions affecting only one side of your knee. The aim is to take pressure off the damaged area and shift it to the other side of your knee with healthy cartilage. During the surgery, your surgeon will remove or add a wedge of bone either below or above the knee joint, depending on the site of arthritic damage.

Distal Realignment Procedures

Distal Realignment Procedures

Distal realignment procedures, also known as tibial tubercle transfer (TTT) procedures, are performed to reposition the kneecap after subluxation or dislocation by realigning the tendon under the kneecap to the underlying tibial tubercle.

LCL Reconstruction

LCL Reconstruction

The knee is the largest joint of the body and is stabilized by a set of ligaments. In the knee, there are four primary ligaments viz. anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament. The lateral collateral ligament (LCL) is a thin set of tissues present on the outer side of the knee, connecting the thighbone (femur) to the fibula (bone of the lower leg). It provides stability as well as limits the sidewise rotation of the knee.

MCL Reconstruction

MCL Reconstruction

The medial collateral ligament (MCL) is one of four major ligaments of the knee that connects the femur (thighbone) to the tibia (shinbone). It is present on the inside of the knee joint and helps stabilize the knee.

Others

Nonoperative Treatments for ACL Injuries

Nonoperative Treatments for ACL Injuries

The ACL (anterior cruciate ligament) is one of the four major ligaments located within the knee joint. It connects the femur (thighbone) to the tibia (shinbone). It plays a key role in holding the two bones within the knee and keeping the joint stable while your knee moves back and forth. An ACL injury is a sprain or a tear (total or partial) to the ligament. Young people involved in sports such as basketball, football, soccer and gymnastics are more prone to ACL injuries due to sudden changes in direction, acceleration, deceleration and repetitive movements.

Non-Surgical Knee Treatments

Non-Surgical Knee Treatments

The knee is a complex joint which consists of bone, cartilage, ligaments, and tendons that make joint movements easy and at the same time it is more susceptible to various kinds of injuries. Knee problems may arise if any of these structures get injured by overuse or suddenly during sports activities. Injuries to the knee can be caused by degenerative diseases such as arthritis, traumatic injuries, and sports injuries. These conditions may affect the bones & joints and impair the mobility as well as the quality of life of the patients. All these conditions require appropriate treatment, may be surgical or non-surgical to restore to normal activities. The non-operative orthopedic treatment options include non-pharmacological and pharmacological interventions. They are aimed at providing symptomatic relief and improving the quality of life of the patients. They can be used as a treatment option to treat certain conditions or to decrease pain as well as promoting functioning and quality of life after the surgical treatment.

Physical Examination of the Knee

Physical Examination of the Knee

A complete physical examination of the knee is performed when you present to your doctor with a knee complaint. Both of your knees are examined and the results of the injured knee are compared to those of the healthy knee.

Pre-op and Post-op Knee Guidelines

Pre-op and Post-op Knee Guidelines

Planning for your knee surgery prepares you for the operation and helps to ensure a smooth surgery and easier recovery. Here are certain pre-operative and post-operative guidelines which will help you prepare for knee surgery.

Am I a Candidate for Knee Surgery?

Am I a Candidate for Knee Surgery?

Arthritis of the knee can cause pain and stiffness, making regular activities such as walking and bending difficult. As arthritis progresses, conservative treatments tend to lose their efficacy and more definitive treatment should be considered. Knee replacement surgery involves replacing worn or damaged joints with implants to reduce pain and improve movement. It provides excellent results for many and is usually performed on those above 60 but may also benefit young patients with certain conditions.

  • ASES
  • American Orthopaedic Society for Sports Medicine
  • Arthroscopy Association of North America
  • American Academy of Orthopaedic Surgeons
  • Alpha Omega Alpha - Honor Medical Society
  • UNC Charlotte
  • American Athletic Conference
  • National Collegiate Athletic Association
  • Stumptown Athletic
  • National Independent Soccer Association