Treatment for knee problems
In general terms, treatment for knee problems can be divided into two main types, non-operative and operative.
Many knee problems do not require surgery and can be cured or at least significantly improved by treatments such as physiotherapy. Such treatments require a lot of responsibility and commitment from the patient to be successful and sometimes patients have difficulty in making this commitment. However surgery is not the alternative to an inability to comply with a course of physio treatment.
Other problems may require even more simple remedies which may be equally unpalatable to a patient. A young person with early osteoarthritis of the knee may just need to alter his activities to see a significant reduction in symptoms but to a person who has played a particular sport for many years, retirement from the sport may be difficult. Another problem is obesity. When coming down stairs, the force on the kneecap is approximately 5 times body weight and therefore for people with arthritis or anterior knee pain simple weight reduction may significantly improve symptoms.
If non-surgical treatments are not appropriate or are not successful, then surgery is required. The chances of surgery being successful are greatly increased by having your surgery performed by someone with a special interest in knee surgery and by complying with the treatment and rehab regime as outlined by your surgeon and therapist.
Arthroscopic procedures are commonly referred to as “keyhole” procedures due to the fact they are performed through two, or occasionally three, small incisions in the skin over the knee. A small microscope is inserted into the knee and the surgeon can then confirm the diagnosis. Usually, but not always, a procedure can be performed that may cure or significantly improve the patient’s problem. Most arthroscopic procedures are performed as day case surgery.
The picture on the left shows a torn meniscal cartilage during an arthroscopy. The instrument is a probe used to define the tear and the tip is only 3mm long. Small tools and radiofrequency probes were used to remove the tear.
Problems outside the knee cavity and more major problems within it are not amenable to arthroscopic surgery. The techniques involved in open knee surgery range from minor day case surgery up to major undertakings such as total joint replacement which may require a stay in hospital for a few days.