Removal of Loose Bodies

Most loose bodies can be removed arthroscopically via keyhole incisions. The arthroscope is used to localise the loose body and the fragment is then gripped with an arthroscopic tool. It can then be pulled out through the keyhole incision. If the piece is too large, then either the hole is made bigger to retrieve the fragment, or the fragment can be “chewed” into smaller pieces and removed piecemeal.

Plica Removal

Plicas are removed arthroscopically (through “keyholes”) with the use of small tools passed through incisions in the front of the knee. The surgery is performed as a daycase and most people will return to activity and work within 2-6 weeks dependent on their jobs.

Meniscectomy

If a meniscal cartilage is injured, typically during a twisting injury, and the patient suffers from pain or instability then the cartilage will require treatment. If the injury is not fresh the tear may not be repairable and may need removing.

Two keyhole incisions are made in the front of the knee so that a telescope (arthroscope) and tools can be introduced into the knee. The tools may be mechanical, electrical or use high frequency energy to remove tissue and frequently a combination of tools will be required. No stitches are required.

Following surgery the patient goes to physiotherapy and generally returns to work between 2 and 6 weeks later dependent on the nature of the job.

Meniscal Repair

If a tear of the meniscal cartilage is in the periphery of the cartilage and is fresh, that is within 6 weeks of injury, then the cartilage should be repaired rather than removed. Any person with fresh knee injury which may be a cartilage injury should only be arthroscoped by a surgeon who has the expertise and training to perform this type of repair.

This surgery is performed arthroscopically (keyhole). The torn cartilage is put back into the correct place and sutures are passed across the cartilage from inside the knee to out and tied on the outside of the capsule of the knee. The repair is then protected from twisting movements for 6 weeks. The success rate is not 100% but if the result is successful the risk of arthritis following the surgery is much decreased.

Arthroscopic Debridement

Arthroscopic debridement is an operation designed for osteoarthritis of the knee. The idea is to use a keyhole operation to “clean up” ragged surfaces on the joint surfaces and the meniscal cartilages. The joint is also washed out to remove any loose debris. It is a procedure designed to buy time prior to a joint replacement rather than being a cure.

A recently published trial in which arthroscopic debridement was compared to a sham operation in which the patient was anaesthetised and two keyhole scars were made without performing the operation showed no difference in outcome between the groups. However there are many studies that suggest it is an effective treatment and many patients feel an improvement in their symptoms, especially mechanical symptoms such as clicking and locking, following this procedure.