Wednesday, June 3, 2009

Knee Surgery Basics: Surgical Treatment of the Knee

By Dr. Stefan Tarlow

Within the field of Orthopedic Surgery, the most well-known and common surgical procedure is Arthroscopy of the knee. The operation is performed at an outpatient surgical center or major hospital. The patient is usually provided a general anesthetic, and the procedure takes from 30-45 minutes barring complications.

Patients are on crutches for a day or less, need to take oral pain medications for less than a week, return to their normal desk jobs in several days, and are completely recovered in 2-4 weeks (for simple arthroscopic procedures such as loose body removal, chondroplasty, menisectomy, and lateral release).

Knee arthroscopy outcomes vary, but can be predicted based on factors like age and diagnosis. As a rule, if the patient is younger than 55 years with only one problem (like a torn meniscus, a loose body, a small area of joint surface damage) tend to have a higher probability of successful surgical outcomes.

Patients older than 55 years with greater than one disease process (the most common is torn meniscus with chondral damage " commonly known as arthritis) have variable outcomes after knee arthroscopy [improved knee probability in 60% range for multiple disease process knees].

The best surgical outcomes are after Arthroscopic Lateral Meniscal repair, Arthroscopic Medial Menisectomy and Arthroscopic Loose Body removal. The least predictable surgical outcomes are with Arthroscopic Lateral Retinacular Release for patellar tracking problems and Arthroscopic Chondroplasty for arthritis.

An explanation of Diagnostic Arthroscopy: Even with the technology of high resolution 3T MRI scans, there is still a responsibility for the surgeon to look only inside the knee for diagnostic purposes.

This is done to assess healing of meniscal repair, healing of microfracture, healing of Autologous Chondrocyte Implantation, looking for wearing of Total Knee Replacement, assessment of ligament injury ( or a new injury or after surgical reconstruction of knee ligament), or when knee symptoms are unexplained even after history, Xray, physical, and MRI of the knee.

A more detailed report is found the website of Phoenix knee doctor, Dr. Stefan Tarlow.

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