Arthroscopic surgery is a minimally invasive surgical procedure performed with the aid of a tiny television camera mounted on a flexible pencil-sized tube. Known as an arthroscope, a lighted lens is used as a diagnostic tool as well as the means for a trained surgeon to make necessary orthopaedic repairs through an incision as small as a buttonhole. The camera, in effect, becomes the doctor’s “eyes,” projecting a real-time view of the surgical area onto a monitor, and allowing the surgeon to maneuver instruments appropriately without traditional open site surgery.

It is a state-of-the-art surgical treatment due to the relative simplicity of the procedure, its generally short duration and faster patient recovery.

Modern arthroscopic procedures are used commonly on knees, shoulders, wrists and elbows to repair joint injuries and treat a variety of illnesses and chronic conditions.

Struan Coleman, MD, PhD, is a highly respected orthopaedic surgeon and an expert in arthroscopic procedures. With practices in three separate locations, including New York City; Locust Valley, New York; and Philadelphia, Pennsylvania, Dr. Coleman also serves as head team physician for the New York Mets, so he has vast experience treating joints in need of rehabilitation.

The five most common reasons for knee arthroscopy include:

Torn meniscus

The meniscus is a piece of cartilage in the knee, made up of collagen fibers that run in opposite directions. Each knee has two meniscal pads that are shaped like crescents, surrounded by tendons and soft tissues. When the meniscus is torn, the ability to easily repair the damage depends to a large extent on the location and the shape of the tear. Small tears sometimes heal without intervention; at other times, the repair can be challenging, particularly when caused by degenerative conditions. Arthroscopic surgery has revolutionized meniscal tear treatment. Typically performed on an outpatient basis and under local anesthesia, post-operative pain is lessened and patients generally are able to resume normal activity within a few weeks, even though rehabilitative therapy is usually a part of the recovery process.

Removal of bone or cartilage fragments

Arthroscopic surgery is often the treatment of choice to clear a joint of bone, cartilage and tissue fragments that accumulate as a result of injuries, inflammation and tissue tears. With a trained orthopaedic specialist, the procedure is a simple one. Debris left floating free in the joint area can result in pain, swelling and locking.

Swollen synovium

The synovium is a membrane that functions to lubricate and nourish knee and shoulder joints. It creates synovial fluid, but the membrane itself is distinguished by irregular folds and it can become painfully inflamed. When this happens, the surgeon can insert an arthroscope to facilitate removal of the tissue that is causing the pain and swelling. It is a minimally invasive procedure that promises fast relief and requires little recovery time.

Torn anterior cruciate ligament (ACL)

During this procedure, the damaged portion of ligament is removed and replaced with tendon from another part of the patient’s knee or from a donor. According to the Mayo Clinic, the need for ACL reconstruction is commonly a result of repeated injury due to participation in sports that require fast starts, stops and changes of direction, such as basketball or downhill slalom racing. Although less severe ACL injuries can sometimes be improved with physical therapy, arthroscopic surgery is the primary choice for athletes and extremely active patients. The surgery itself is typically an outpatient procedure, and recovery is relatively swift.

Popliteal cyst

Sometimes known as a Baker’s cyst, this condition is characterized by fluid-filled lumps that appear at the back of the knee. Sometimes popliteal cysts disappear with treatment of the underlying cause, which might include arthritis, injury to surrounding cartilage or other inflammation. However, similar swelling can also be caused by a blood clot or a tumor, so the doctor may order non-invasive imaging tests to determine the exact cause prior to considering surgery of any kind.

As common as arthroscopic knee surgery has become, it is still a surgical procedure that must be performed by a skilled orthopaedic surgeon. For more information about symptoms that might warrant such surgery, contact Dr. Coleman by phone at your preferred treatment location, or complete the online form to schedule a consultation.