Knee injuries are one of the most common complications that people deal with throughout their lives. Your knees can be damaged by twisting and overextending. They're often susceptible to sports injuries and arthritis as well.
Knees have a number of moving parts, including tendons, ligaments, and the bones that make up the knee joint. Tendons are strong tissues that connect muscles and bones. Ligaments are flexible, stretchy bands that connect bones with other bones.
Most knee pain surgery is arthroscopic
Most knee surgeries are done by making a few small cuts in the knee. The surgeon inserts tools and a small camera into these cuts to observe what needs to be done. This method of looking at joints, like the knee joint, is called arthroscopy.
The most common types of knee pain surgery include:
Knee replacement surgery
Knee replacement surgery is also called arthroplasty. Your doctor will recommend this surgery if you have severe arthritis or were seriously injured.
Both full and partial knee replacement surgeries are available. In partial replacement surgeries, only the damaged parts of your knee joint are removed and replaced with artificial parts made of plastic or metal.
In a full replacement surgery, all parts of your knee joint and cap are replaced with metal and plastic parts. The goal of this surgery is to create new surfaces so your knee no longer hurts when its different parts touch. Recovery time is different for each person. Your doctor will order physical therapy until you have regained muscle strength and acceptable range of motion.
Revision knee replacements are another version of this surgery. Knee replacement surgeries usually wear out after 15 to 20 years. In this case, you’ll have to repeat the surgery — but this time your original replacement parts will be replaced.
ACL injuries are very common — particularly in sports. Surgery is not needed for slight tears, only when your entire ligament needs to be replaced. The replacement is woven through the knee joint and attached to the upper and lower leg bones.
Real tissue is used for the replacement. Sometimes this will come from another part of your body, which will make the surgery take more time. At other times a donated tissue is used.
It can take up to six months for you to recover enough to resume normal activities, such as playing sports.
The meniscus is cartilage that acts as a shock absorber in your knee. You can easily tear it by twisting your knee. Smaller tears to the outer parts of the meniscus will heal on their own and don’t always require surgery. When you damage your meniscus symptoms can include:
- Problems moving your joint from stuck pieces of cartilage
Your surgeons will decide the exact type of surgery that you need when they see the damage inside of your knee using a small camera. Meniscus repair is the best option, but can only be done when the damage is in a part of the meniscus that has a lot of blood flow. The portion of the meniscus that has torn will be reattached. Sutures, a type of stitch, or specialized meniscus repair devices are used to reattach the piece.
A meniscectomy is a related surgery, but, in this case, the damaged pieces of the meniscus are completely removed. Your surgeon will only choose this option when repair is not possible. Patients who have removal surgeries have much greater rates of arthritis than those who have their meniscus repaired.
You may need a specialized knee surgery that's less common than the ones discussed above. Some examples include knee osteotomies and knee plica surgeries.
Knee osteotomies are sometimes done when only one side of your knee is affected by arthritis. In this surgery, your bones are rearranged in order to shift the way that your weight lands on your knee. Your surgeon will add or remove pieces to your upper and lower leg bones in a way that suits your body.
Knee plica surgeries
Knee plica surgeries are most often performed alongside other knee surgeries. The plica is a smooth, elastic tissue that slides around on the end of the upper leg bone — on top of the knee. When this plica is irritated, you’ll experience symptoms that are similar to those from a torn meniscus.
Your doctor won't typically diagnose this until they've been able to look inside your knee with a camera. The plica can either be removed entirely or divided into parts and only partially removed. It's not replaced. Most patients don't experience any negative symptoms after the plica is removed.
Knee Surgery and Related Research: "Arthroscopic Excision of Medial Knee Plica: A Meta-Analysis of Outcomes."
Orthopedic Associates: "Types of Knee Surgery (Arthroscopic Knee Surgery) in Sports Medicine."
OrthoInfo: "Anterior Cruciate Ligament (ACL) Surgeries," "Osteotomy of the Knee," "Total versus partial joint replacement: what are the differences?"
UCSF Health: "ACL Reconstruction Surgery."
UW Medicine: "Arthroscopic Meniscus Repair."
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