Common Conditions Treated by Knee Surgeon in Fort Worth

Because the knee is one of the most complex joints in the body, there are a multitude of common conditions treated by knee surgeon in Fort Worth that can affect its functionality. Orthopedic knee surgeons at OSMI utilize knee arthroscopy to treat many of these conditions in a minimally invasive way, using state-of-the-art methodology.

Conditions Treated by Arthroscopic Knee Surgeons

• Arthroscopic Anterior Cruciate Ligament (ACL) Reconstruction
• Arthroscopic Chondroplasty of the Knee
• Arthroscopic Knee Meniscus Repair
• Knee Arthroscopy with Meniscectomy
• Autologous Chondrocyte Transplantation
• Knee Cartilage Repair

 

Arthroscopic Anterior Cruciate Ligament (ACL) Reconstruction

The anterior cruciate ligament (ACL) is one of the four primary ligaments which hold the knee in place. The ACL runs diagonally inside the knee joint, connecting the femur to the tibia. ACL injuries are some of the most common injuries incurred during sports and often occur when the knee is twisted abnormally or hyperextended.

Most ACL tears require reconstruction, as they are typically torn too severely to be repaired. ACL reconstruction involves harvesting a graft from another tendon, usually from within the patient’s own body (autograft).

Once the graft is obtained, tiny incisions around the knee joint are made and the arthroscope is inserted. Damaged ACL tissue is removed, holes are drilled into the tibia and femur, and a pin is used to guide the graft into place. The harvested tissue is then attached to the tibia and femur with special screws.

Arthroscopic Chondroplasty of the Knee

Arthroscopic chondroplasty of the knee is a procedure in which damaged cartilage in the knee is removed in order to allow smooth healthy cartilage to grow in its place. Articular cartilage, which covers the ends of the bones at the knee joint, can become damaged, or rough, by traumatic injury or degenerative disorders, such as osteoarthritis of the knee.

Symptoms of damaged articular cartilage can include:

• Knee joint pain
• Instability of the knee
• Popping or locking of knee joint

Chondroplasty is often used to treat less severe cartilage wear on smaller areas of the knee joint. During arthroscopic chondroplasty, damaged tissue is taken out and the joint surface is smoothed with specialized tools.

Arthroscopic Knee Meniscus Repair

When a meniscus tear of the knee occurs and is not responsive to nonsurgical treatments, arthroscopic meniscus repair may be performed. Meniscus repair involves creating small incisions in the front and back of the knee in order to arthroscopically investigate where the tear is located. Loose fragments are cleared away, and using an arthroscope, your knee surgeon will determine where the meniscus is torn.

If the lateral meniscus is damaged, a repair can be performed. The torn edges of the meniscus will be sutured together rather than removed due to the abundant blood flow to the area allowing for greater healing.

Arthroscopic meniscus repair is typically performed under general anesthesia as an outpatient procedure.

Knee Arthroscopy with Meniscectomy

When the medial meniscus (inner side of the knee) is torn, the tear may not be able to be repaired due to lower blood flow to the affected area. Your knee surgeon will assess the meniscus tear once the arthroscope is inserted. If the tear is located on the medial meniscus, an arthroscopic meniscectomy is often the best treatment.

During a meniscectomy, the loose fragments are removed, as well as any torn or damaged pieces of the meniscus. The surgeon cleans and smooths the area surrounding the meniscus tear and the incisions are closed. The meniscus may be partially or completely removed depending on the severity of damage.

Arthroscopic meniscectomy does not repair the meniscus, but removing the damaged portion of cartilage should alleviate the painful symptoms of the torn meniscus.

Autologous Chondrocyte Transplantation

Autologous chondrocyte transplantation of the4 knee is a two-part surgical procedure in which damaged knee cartilage is replaced with healthy cartilage tissue that is harvested from the patient’s own body, allowed to grow in a laboratory environment, and then placed back into the knee joint. The first portion or phase one of the autologous chondrocyte transplantation is performed arthroscopically. Your surgeon will create 2-5 small incisions to insert the arthroscope and miniature tools. Healthy cartilage cells (chondrocytes) are removed from an area of the knee joint which is non-weight bearing and the incisions are closed.

The cartilage cells are sent to a lab where they regenerate and grow, which takes approximately 4-6 weeks, at which time the patient undergoes the second part of the autologous chondrocyte transplantation. The transplantation procedure involves creating a larger incision and typically requires a 1-2 day hospital stay.

In phase two, your surgeon will make two incisions, one in front of the knee to access the area in need of repair and the other above the tibia. The damaged area is cleaned out and prepared (debrided), and a patch of healthy tissue is harvested from above the tibial bone (periosteal patch).

The periosteal patch is transferred to cover the damaged area and the healthy lab-grown cartilage cells are injected into the knee joint. The incision is closed with staples or sutures and the knee is bandaged. Recovery time after autologous chondrocyte transplantation will vary depending on patient health and the initial severity of cartilage damage, but can take several months to a year to regain full range of motion and functionality.

Knee Cartilage Repair

The cartilage which lines the knee joint can be damaged due to constant stress (wear-and-tear), weight bearing, or injury. When nonsurgical treatments do not sufficiently alleviate pain, your orthopedic knee surgeon may recommend arthroscopic cartilage repair.

Common methods of cartilage repair include:

• Cartilage debridement: The knee joint is cleaned out and loose cartilage is removed to relieve pain and restore mobility. The affected knee may eventually require additional treatment, as debridement is typically not permanent.
• Osteochondral allograft or autograft (bone and cartilage grafts): In some cases, knee cartilage damage exposes the underlying bone and both require replacement. Osteochondral autograft involves using the patient’s own tissue harvested from another part of the knee, while an allograft uses donor tissue. In both grafts, a section of the damaged cartilage and bone is cored out and replacement tissue fitted tightly in its place.
• Autologous chondrocyte implantation (ACI): In this two-step procedure, chondrocytes (healthy cartilage cells) are harvested from the patient’s body and cultured in a laboratory setting. After the cells have grown (usually about 4-6 weeks), they are reimplanted in the knee joint where they regenerate over time, forming new cartilage.
• Marrow stimulation: This procedure involves drilling holes in the damaged cartilage and just into the bone beneath in order to allow a blood clot to form from the bone marrow. The chondrocytes in the marrow then restore the cartilage. In some instances, blood from the veins may also be injected into the knee joint to promote additional cartilage formation.
• OATS cartilage repair (mosaicplasty): Damaged cartilage is removed from the knee creating a socket in which healthy cartilage (which is harvested from a non-weight bearing area of the patient’s knee joint) is placed. The replacement cartilage graft is fitted into the socket and tapped into place, forming a smooth, level surface. Multiple knee grafts may be placed during the same procedure, in which case, allografts may be required. The damaged cartilage may be placed in the donor site or it may be left open for healing.

In addition to knee arthroscopy, the orthopedic knee surgeons at OSMI perform traditional open surgery to repair and replace damaged knee structures. Your surgeon will advise you on the best surgical method for your knee condition. If you are experiencing knee pain or limited mobility in the knee, contact our office for an appointment.

Our goal at OSMI is to provide our patients quality, cutting-edge orthopedic treatments, both surgical and non-surgical. Dr. Michael Boothby, having performed hundreds of successful arthroscopic surgeries, is consistently rated as one of The Top Orthopedic Surgeons in the Fort Worth area. If you have questions or concerns about joint pain, or for more information about arthroscopic surgery, please submit an online appointment request or contact our office at 817-529-1900.