Normal Anatomy of the Knee Joint
The knee joint is one of the most structurally complex joints of the human body. Functionally, the knee joins the femur to the tibia and fibula, or shin bones. The patella (kneecap) is the other primary component of the human knee. The knee is supported by a complex set of tendons, tissue and cartilage, which allow it to provide the leg with its full range of motion, strength and flexibility.
Arthritis is an umbrella term that refers to the damage and deterioration of cartilage within a synovial joint. In other words, arthritic joints experience a wearing down of the tissues that allow for smooth, pain-free movement. Arthritic diseases tend to be very painful, sometimes debilitatingly so, and progressive. There are many underlying causes for developing arthritis, including natural ageing, auto-immune reactions, overexertion, poor diet, etc.
A knee fracture occurs when one of the many bones that comprise the knee joint break or shatter. Knee fractures are typically seen in people who have experienced some type of fall, accident, or trauma; particularly those who participate in high-impact physical activity. Symptoms of a knee fracture include an inability to place weight on the knee, difficulty bending the joint, prominent swelling, a marked deformity of the knee, and intense pain.
Anterior Cruciate Ligament (ACL) Tears
The bones within the knee joint are connected to each other through various ligaments. There are four primary ligaments located inside the knee and they control the extension and flexion movement of the knee. One of the most common knee injuries is a sprain or tear of the Anterior Cruciate Ligament, also known as the ACL. Anyone can suffer these types of injury but athletes are especially susceptible. It is important to note that many times the ACL will tear in conjunction with damage to the other structures of the knee and, as such, it is slow to heal.
When most people talk about a torn knee ligament, they are referring to a torn meniscus. The menisci of the knee are strong and highly elastic cartilaginous tissues that provide the knee support as it is stretches and extends. Knee meniscus tears are common, especially in athletes.
The knee sits between the bottom of the thighbone (femur) and the top of the shinbone (tibia) and can be broken into three compartments (medial, lateral and patella). The stability of the patellofemoral joint depends on the strength and stability of the other two compartments of the knee joint, as well as the other surrounding bones, tendons and tissue. Therefore, any alteration of the knee joint’s functional integrity may result in patellofemoral instability. Conservative treatment of physical rehabilitation can help improve overall joint health, and surgery can be used to provide further stability by removing damaged tissue and providing supportive fixtures such as artificial bone, pins and plates.
Arthroscopy of the Knee Joint
Knee arthroscopy is a minimally invasive surgical technique that utilizes a miniature camera, inserted through small incisions on the knee joint that allows for comprehensive visualization of the entire area. Knee arthroscopy offers advanced visualization for confident maneuverability for complex surgical procedures without the need for more traditional and invasive surgical techniques.
Total Knee Replacement (TKR)
Total knee replacement is a commonly performed surgical procedure in which any damaged tissues inside the joint are removed and replaced by artificial tissue. Total knee replacement surgery is typically only recommended in patients with severe pain and/or total loss of mobility the knee.
Anterior Cruciate Ligament ACL Reconstruction
A rupture of the ACL, or Anterior Cruciate Ligament, will significantly decrease the stability of the knee joint. A torn or ruptured ACL results in severe pain and long-term degeneration of the knees functional capacity. When an ACL is torn, rather than strained, it will likely require reconstruction, rather than conservative rehabilitation. A reconstruction of the Anterior Cruciate Ligament through arthroscopic surgery is extremely successful at restoring stability to the knee.
ACL Reconstruction Hamstring Tendon
One particularly effective method of reconstructing the Anterior Cruciate Ligament is to use the Hamstring Method. In effect, the surgeon completely replaces the torn ligament with a section of the hamstring tendon. Although the hamstring method is relatively new, it has shown significant promise.
ACL Reconstruction Patellar Tendon
Anterior cruciate ligament (ACL) reconstruction patellar tendon will consist of a surgeon removing a section of the Patellar Tendon and binding it to the damaged ACL to improve the stability and overall function of the knee joint. By utilizing tissue from the patient’s own body, the Patellar Tendon approach, similar to the hamstring reconstruction approach, has a great likelihood of the body accepting the new tissue.
Uni Condylar Knee Replacement
For many patients, a total knee replacement is the only surgical procedure that can offer any real, long-term benefits. However, for others, only a section of their knee is impaired. In these cases, surgeons will utilize the minimally invasive approach known as Uni Condylar Knee Replacement (partial knee replacement). Using arthroscopy, the surgeon will identify the damaged tissue and insert a knee implant that will sufficiently support the patient’s remaining knee joint that is otherwise healthy.
The meniscus tissue in a joint plays the role of shock absorption. As joints regularly flex and hinge, they endure consistent pressure. Without healthy meniscus tissue, the joint is subject to severe pain and discomfort. A torn meniscus is a common knee injury that has the ability to significantly reduce the stability of the knee. The severity of a meniscus tear generally determines if surgical repair is a possibility.