Knee arthroscopy has in many cases replaced the classic arthroscopy that was performed in the past. Today knee arthroscopy is commonly performed for treating meniscus injury, reconstruction of the anterior cruciate ligament and for cartilage microfracturing. Arthroscopy can also be performed just for diagnosing and checking of the knee; however, the latter use has been mainly replaced by magnetic resonance imaging.
During an average knee arthroscopy, a small fiberoptic camera (the arthroscope) is inserted into the joint through a small incision, about 4 mm (1/8 inch) long. A special fluid is used to visualize the joint parts. More incisions might be performed in order to check other parts of the knee. Then other miniature instruments are used and the surgery is performed.
Arthroscopic procedures can be performed either to evaluate or to treat many orthopedic conditions including torn floating cartilage, torn surface cartilage, ACL reconstruction, and trimming damaged cartilage.
Anterior cruciate ligament reconstruction (ACL reconstruction) is a surgical tissue graft replacement of the anterior cruciate ligament, located in the knee, to restore its function after anterior cruciate ligament injury. The torn ligament is removed from the knee before the graft is inserted through a hole created by a single hole punch. The surgery is performed arthroscopically.
An ACL reconstruction is sometimes referred to, incorrectly, as an ACL repair. A torn anterior cruciate ligament cannot be “repaired”, and must instead be reconstructed with a tissue graft replacement.
LCL Repair – Repairing Torn Lateral Collateral Ligaments
The lateral collateral ligament is a thin band of tissue along the outer side of the knee. It joins the thighbone (femur) to the fibula. (The fibula is the small bone of the lower leg that runs down the side of the knee to the ankle.) Like the medial collateral ligament, the lateral collateral ligament’s main job is to keep the knee stable as it moves.
Tears to the lateral collateral ligament most often occur from a direct blow to the inside of the knee. This can stretch the ligaments on the outside of the near too far and may cause them to tear. This type of injury occurs in sports that require a lot of quick stops and turns such as soccer, basketball and skiing or ones where there are violent collisions such as football or hockey.
The ligament can also be injured by repeated stress that causes it to lose its normal elasticity. Most knee injuries are to the ligaments that support the knee, not the knee joint itself.
- Surgical Treatment for Lateral Collateral Ligament Tears
If the lateral collateral ligament was torn where it attaches to the thighbone (femur) or shinbone (tibia), the surgeon will re-attach the ligament to the bone using large stitches or a metal bone staple. If the tear happened in the middle of the ligament, the surgeon will sew the torn ends together.
If the damage was severe and cannot be repaired, your surgeon may reconstruct a tendon by using a graft taken from a tendon of your thigh muscles (quadriceps) or your hamstrings. Lateral knee reconstruction is an open-knee procedure, and is not done arthroscopically. The tendon graft is passed through bone tunnels and fixed to the thighbone and lower leg bone (fibula) using screws or posts or with stitches tied around a post.
The medial collateral ligament (MCL) is a wide, thick band of tissue running down the inner knee from the thighbone (femur) to a point on the shinbone (tibia) about four to six inches from the knee.
The MCL’s main function is to prevent the leg from extending too far inward, but it also helps keep the knee stable and allows it to rotate.
- Surgical Treatment for Medial Collateral Ligament Tears
A torn medial collateral ligament is rarely treated with surgery. When surgery is done, it is usually done through a small incision on the inside of your knee. It is not done arthroscopically, since this ligament is not inside the knee joint. If the medial collateral ligament has been torn where it attaches to the thighbone (femur) or shinbone (tibia), the surgeon will re-attach the ligament to the bone using large stitches or a metal screw or bone staple. If the tear was in the middle of the ligament, the surgeon will sew the torn ends together.