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KNEE
Meniscal tears ( cartilage discs in the joint)
Anterior Cruciate Ligament (ACL) tear
Posterior Cruciate Ligament (PCL) tear
Synovitis e.g. rheumatoid arthritis, infections, PVNS etc
Loose bodies
Patellar subluxation or dislocation
Certain intra articular fractures of the knee joint
Meniscal tears
There are two menisci in the knee; medial (inner) and lateral (outer).
These are cartilaginous "C" shaped structures which separate the femoral from the tibial surfaces.
These can get torn as a result of twisting injury to the knee.
Symptomatic meniscal tears are treated with arthroscopy with either a repair ( in certain selected cases ) or a partial menisectomy.
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ACL ( Anterior Cruciate Ligament ) Injury
The ACL is one of the key ligaments situated in the centre of the knee.
It helps in providing rotational stability to the knee.
A twisting injury, where the foot remains stuck on the ground and the rest of the body twists, causing a rotational stress at the knee is the commonest mechanism of injury.
The commonest complaint is that of instability or insecurity of the knee while performing any activity which involves some amount of rotational force. E.g. cutting and running, dancing and so on.
In symptomatic young patients an arthroscopic ACL reconstruction helps restoring stability to the knee allowing patients to resume an active lifestyle.
The hamstring tendon (semitendinosus) or the patellar tendon are the two commonest grafts used.
Recently there has been a trend to advocate an anatomical or a double bundle ACL reconstruction. This technique restores the dual bundle pattern (anteromedial & posterolateral) of the ACL and is thought to provide better rotational stability.
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PCL( Posterior Cruciate Ligament ) Injury
The PCL is a short and strong ligament situated within the knee connecting the femur to the tibia.
Along with the posterior capsule it is a key structure in providing antero posterior stability to the knee.
The commonest mechanism of injury is hyperextension of the knee or a direct impact on the front of the tibia with the knee in flexed position (Dash board injury).
Apart from instability the patient might complain of anterior knee pain due to chronic overload of the patello femoral joint.
In symptomatic cases, an arthroscopic PCL reconstruction with or without posterior capsule or corner repair is recommended.
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Knee Synovitis
Synovium is the membrane lining the inside of the knee. In certain conditions ( rheumatoid arthritis, infections eg TB ) this synovium swells up and the condition is known as Synovitis.
Synovitis over a prolonged period of time can cause damage to the cartilage of the knee joint and precipitate a secondary arthritis.
When the medical management cannot adequately cure or control the synovitis, an arthroscopic synovectomy helps to physically get rid of the inflamed synovium.
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