KNEE ARTHROSCOPY
Please see the menu below to learn more about the details of a procedure, its related diagnosis, and what to expect following surgery.
ACL Reconstruction
ACL
knee cap
Reconstructed ACL
The ACL, or Anterior Cruciate Ligament, is a ligament deep in the middle of the knee serving to provide stability to the knee joint. This ligament, in conjunction with the PCL (Posterior Cruciate Ligament), prevents the tibia and femur bones of the knee from gliding back and forth on one another. When the ACL is torn and there is increased movement of the tibia and femur in relation to one another, the knee becomes unstable. This leads to symptoms of locking, giving out, buckling, and swelling of the knee. The ACL can be torn in a variety of ways: a plant-and-twist (pivot) injury, or a fall or trauma. An examination in the office as well as MRI imaging will confirm the presence of a torn ACL.
When the ACL tears, the vessel supplying blood to the ligament also tears. This leads to devitalized, unrepairable tissue. For this reason, if you have an ACL tear, Dr. Bedford will recommend a surgical ACL reconstruction. Dr. Bedford performs arthroscopically assisted ACL reconstruction surgery, allowing it to be minimally invasive. A graft is used to recreate the ACL, either from a donor or using a piece of your own tissue. This graft is reinserted into the knee through tunnels and anchored into place.
Following ACL reconstruction surgery, your leg will be in a long leg hinged knee brace keeping your knee in extension (all the way straight). You are able to bear weight and walk while in this brace to your level of comfort. You will be in this brace for an estimated four weeks. Physical therapy should begin within two days of your surgery to minimize pain and swelling and improve range of motion and strength of the knee. Overall recovery to your pre-surgery level of activity is estimated to be 6-9 months; however, you will begin lighter levels of physical activity such as jogging as soon as three months post operative.
Chondroplasty
irregular cartilage
after chondroplasty
An arthroscopic chondroplasty is a procedure in which roughed or degenerated articular cartilage, or the cartilage coating the ends of the bones, is touched up and smoothed out. Dr. Bedford may recommend an arthroscopic chondroplasty if you have mild to moderate osteoarthritis causing a swollen, painful knee. An examination in the office as well as MRI imaging will confirm the presence of mild to moderate osteoarthritis. Keep in mind that not all osteoarthritis is suited for arthroscopic debridement, and a discussion in the office with Dr. Bedford will help determine if this is right for you.
Following arthroscopic chondroplasty, you are able to bear weight and walk on the knee right away to your level of comfort. Physical therapy is advised within two days of your surgery to minimize swelling and pain and improve range of motion and strength of the knee. Overall recovery to your pre-surgery level of activity is estimated to be about six weeks. It is important to know that arthroscopic chondroplasty does not “cure” osteoarthritis - it serves to lessen its symptoms. For patients with persistent aching pain and swelling greater than six weeks, further treatment for osteoarthritis such as postoperative lubricant or cortisone injections can be discussed.
Meniscus Repair
meniscus tear
meniscus repair
An arthroscopic meniscus repair is a common treatment for a meniscus tear in the knee. The meniscus is the soft cartilage cushion for the knee joint which provides stability and shock absorption. This soft cartilage can easily be torn in a variety of ways: a fall or trauma, a plant-and-twist (pivot) injury, or through wear-and-tear. An examination in the office as well as MRI imaging will confirm the presence of a meniscus tear, and of which morphology. Depending on the size, shape, and location of your meniscus tear, Dr. Bedford may recommend a meniscus repair. A meniscus repair is when the meniscal tissue is stitched together and anchored down to its attachment point in the knee.
The blood supply to the meniscus varies by location, and when tissue with sufficient blood supply is torn, it is repairable. This is when a meniscus repair may be recommended. Following arthroscopic meniscus repair, your leg will be in a long leg hinged knee brace keeping your knee in extension (all the way straight). You are able to bear weight and walk while in this brace to your level of comfort. You will be in this brace for an estimated six weeks. Physical therapy should begin within two days of your surgery to minimize pain and swelling and improve range of motion and strength of the knee. Overall recovery to your pre-surgery level of activity is estimated to be about three months.
MPFL Reconstruction (Kneecap Stabilization)
The MPFL, or Medial Patellofemoral Ligament, is the ligament keeping the kneecap (patella) from dislocating. The MPFL stabilizes the kneecap, and when a kneecap dislocation occurs, the MPFL may tear or become stretched out. Without a competent MPFL, the kneecap can recurrently dislocate. Kneecap dislocations cause a swollen, painful knee often with the feeling of a clunk or pop. In addition to causing knee pain, kneecap dislocations can cause damage to the cartilage on the underside of the kneecap. This can occur for a variety of reasons: a plant-and-twist (pivot) injury, or a fall or trauma. An examination in the office as well as MRI imaging will confirm the presence of a torn MPFL or any cartilage injuries to the underside of the kneecap.
If you have a torn MPFL, a recurrently unstable kneecap, or a large cartilage injury to the underside of your kneecap, Dr. Bedford may recommend surgical reconstruction of the MPFL and treatment of the cartilage lesions. Dr. Bedford performs arthroscopically assisted MPFL reconstruction surgery, allowing it to be minimally invasive. A graft is used to recreate the MPFL. This graft is inserted in the position of the narrative MPFL through tunnels and anchored into place. If a cartilage injury to the kneecap is present, this will be addressed separately at the time of surgery.
Following MPFL reconstruction surgery, your leg will be in a long leg hinged knee brace keeping your knee in extension (all the way straight). You are able to bear weight and walk while in this brace to your level of comfort. You will be in this brace for an estimated four weeks. Physical therapy should begin within two days of your surgery to minimize pain and swelling and improve range of motion and strength of the knee. Overall recovery to your pre-surgery level of activity is estimated to be 6-9 months; however, you will begin lighter levels of physical activity such as jogging as soon as three months post operative.
Partial Meniscectomy
meniscus tear
after partial meniscectomy
A partial meniscectomy is the most common treatment for a meniscus tear in the knee. The meniscus is the soft cartilage cushion for the knee joint which provides stability and shock absorption. This soft cartilage can easily be torn in a variety of ways: a fall or trauma, a plant-and-twist (pivot) injury, or through wear-and-tear. An examination in the office as well as MRI imaging will confirm the presence of a meniscus tear, and of which morphology. Depending on the size, shape, and location of your meniscus tear, Dr. Bedford may recommend a partial meniscectomy. A partial meniscectomy is when the torn portion of the meniscus is gently debrided and removed through arthroscopic portals.
The blood supply to the meniscus varies by location, and when tissue with poor blood supply is torn, it is not repairable. This is when a meniscectomy may be recommended. Following arthroscopic partial meniscectomy, you are able to bear weight and walk on the knee right away to your level of comfort without a brace or crutches. Physical therapy should begin within two days of your surgery to minimize swelling and pain and improve range of motion and strength of the knee. Overall recovery to your pre-surgery level of activity is estimated to be about six weeks.
Removal of Loose Body
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loose body in knee joint
A loose body is when a piece of cartilage or other tissue is floating loosely in the joint. This can cause damage to the joint surfaces, buckling, giving out, locking, and recurrent swelling of the knee. Loose bodies can arise even without prior trauma, fall, or injury. An examination in the office as well as MRI imaging will confirm the presence of a loose body. If a loose body is identified, Dr. Bedford will recommend an arthroscopic removal of loose body. Through small portals, the loose body will be identified and grasped and removed from the knee.
Following arthroscopic loose body removal, you are able to bear weight and walk on the knee right away to your level of comfort without a brace or crutches. Physical therapy should begin within two days of your surgery to minimize pain and swelling and improve range of motion and strength of the knee. Overall recovery to your pre-surgery level of activity is estimated to be about 4-6 weeks.
loose body after removal