Get Relief From Knee Pain

Arthroscopy is a minimally invasive procedure that allows doctors to examine tissues inside the knee. It is often performed when a diagnosis is made after a physical examination and other imaging tests such as MRI, CT or X-rays.

During an arthroscopic procedure, a thin fiberoptic light, magnifying lens and tiny television camera are inserted into the knee, allowing Dr. Lager to examine the joint in great detail.

For some patients, it is then possible to treat the problem using a few additional instruments inserted through small incisions around the joint. Sports injuries are often treatable with arthroscopy. Knee injuries that are frequently treated using arthroscopic techniques include meniscal tears, mild arthritis, loose bone or cartilage, ACL and PCL tears, synovitis (swelling of the joint lining) and patellar (knee cap) misalignment.

Arthroscopy is not appropriate for every patient. Dr. Lager will discuss the options that are best for you.

A tear in the anterior cruciate ligament (ACL) is one of the most common knee injuries. An injury to this ligament causes the knee to become unstable and the joint to slide forward too much. ACL tears occur most often in athletes.

ACL reconstruction is usually not performed until several weeks after the injury, when swelling and inflammation have been reduced. The torn ligament is completely removed and replaced with a new ACL. Simply reconnecting the torn ends will not repair the ACL. Part of another ligament, usually in the knee or hamstring is used to create a graft for the new ACL. Choosing the proper type of graft depends on each patient's individual condition.

ACL surgery requires a few months for full recovery and physical rehabilitation will be needed as well. Surgery is not required for all ACL injuries. In addition to performing traditional ACL reconstruction procedures for adults, Dr. Lager also performs pediatric reconstruction, taking into account the growing and sensitive structures of young children. Special techniques are used to achieve long-term results as the child continues to grow.

Made of cushioning cartilage, the C-shaped meniscus performs many functions in the knee. Athletic injury (trauma) or weakened tissue associated with aging or illness (degeneration) can tear the meniscus. Movements most likely to result in a meniscal tear are twisting the knee, pivoting, cutting and rapidly decelerating.

Symptoms of a meniscal tear include stiffness, swelling, pain, tightness, tenderness, and fluid build-up. If a piece of the meniscus breaks off in the joint, the knee may pop, slip or lock (become stuck at a 45-degree angle until physically moved out of the position).

Treatment for a meniscus tear may involve meniscus repair surgery. Meniscus repair is an arthroscopic procedure in which part or all of the meniscus is removed and the torn edges are sutured together, which allows them to heal properly.

For minor meniscus tears, a partial meniscectomy may be performed as a less invasive alternative to the total procedure. In the partial procedure, Dr. Lager removes as little of the meniscus as possible to preserve the healthy cartilage and allow patients to recover more quickly and efficiently.  Any damaged fragments are removed during this procedure, which can often be performed arthroscopically, before the remaining edges are smoothed.  This procedure may be performed using only regional anesthetic, which further reduces the risks and recovery times of surgery.

The patella, commonly known as the kneecap, is one of three bones that make up the knee joint and serves to increase leverage. Pain in the patella can be a result of overuse or injury, and often results in a fracture. Patella fractures can involve a single crack across the kneecap or a break into several pieces and usually cause intense pain and swelling. Treatment depends on the type and severity of the condition.

Surgery may be required for more severe patella fractures. This procedure repairs the patella by realigning the fractured ends and holding them in place with pins, screws and wires. Part of the bone may just be removed in smaller fractures. Rehabilitation is essential to successfully repairing patella fractures. The knee must be kept straight to allow for initial healing and physical therapy programs are often used to help restore movement.

The kneecap (patella) connects the muscles in the thigh to the shinbone. In a healthy knee, the patella rests in a groove in the thighbone and slides up and down as you bend and straighten your leg. Patellar instability, or unstable kneecap, occurs when the patella slips wholly or partially out of the groove.

If your patella dislocates, you may experience:

For patients with severe pain or recurring dislocations, surgery may be needed to correct a malalignment that may make the knee susceptible to frequent dislocation. This usually involves a lateral release to cut tight ligaments and restore the patella to its normal position. Surgery is performed on an outpatient basis and most patients are able to return to physical activity after several weeks of immobilization and rehabilitation.

The ligaments connect and support the bones and joints in order to allow for movement. There are four main ligaments within the knee joint (anterior cruciate ligament, posterior cruciate ligament, medial collateral ligament and lateral collateral ligament) that all work together to connect the thigh and shin bones together while providing strength and stability to the joint.

Ligaments may become stretched or torn as a result of an abnormal twisting of the knee. Anterior cruciate ligament (ACL) injuries are one of the most common orthopedic injuries and affect millions of people each year. Patients with a cruciate ligament injury often experience a popping sound, swelling, and a feeling that the leg is going to buckle. Those experiencing a collateral ligament injury experience pain, swelling and a popping sensation.

Treatment for a knee ligament injury depends on the severity of the condition and the patient’s age, overall health and medical history, but is usually done through conservative methods such as applying ice, wearing a protective brace and performing strengthening exercises. Surgery may be needed in severe cases in which the ligaments do not heal or symptoms persist.

Unicompartmental knee replacement, or partial knee replacement, is a surgical procedure used to treat osteoarthritis and other degenerative conditions of the knee by removing and replacing only the damaged area. This procedure is most often performed on patients with severe arthritis that has not responded to conservative treatments, but still have healthy areas of cartilage left in the knee. It is preferred by younger patients who wish to maintain their active life and put off total joint replacement surgery, or those who have worn out their artificial joint after their first joint replacement surgery.

In comparison to total knee replacement, this procedure offers patients smaller incisions, less bleeding and shorter recovery times. Its minimally invasive nature offers patients may benefits, but may not be ideal for older or obese patients.

Procedure

During unicompartmental knee replacement, your surgeon will make an incision in the front of the knee in order to access the damaged area. The location of the incision may vary depending on which area of the knee will be replaced. The damaged bone ends are then removed from both the tibia (shin) and femur (thigh) to prepare for the artificial replacement, which is then placed on the smoothed bone ends. The metal replacements may be held in place by cement or by screws. The soft tissue in the area is then replaced and the incision is sutured closed.

Recovery

After surgery, most patients experience significant pain relief from their arthritis, which usually last for quite some time. However, it is still possible for patients to develop arthritis in the other areas of the knee. Total knee replacement may be needed eventually after the unicompartmental procedure, although technology is continually improving to provide patients with the most effective, long-term results.