Scar Tissue In Knee After Meniscus Surgery – Knee arthroscopy is a surgical procedure that places a small joint camera (arthroscope) and small instruments and tools (arthroscopic razors, burrs, punches, knives, scissors, sutures, sutures with bone anchors) into the knee joint using very small incisions. look at all three compartments of the knee and treat injuries or remove tissue in the knee.

The arthroscope is a metal tube with a camera and light at the tip that goes into the knee, and a control module at the end of the hand piece where focus, camera angle and image capture are controlled. The arthroscope is connected via a cable from the handpiece to a display monitor and image capture device where images can be stored and digitally printed to be shared with the patient. The arthroscope is about the diameter of a pencil and about a foot long.

Scar Tissue In Knee After Meniscus Surgery

Patients who are considering undergoing knee arthroscopy can do several things to prepare for surgery. Some are required, others can optimize your results.

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All patients must be medically examined by a family physician or physician to clear you for surgery and provide medical recommendations.

If you have a specific medical condition, a specialist may need to examine you and make recommendations for management before, and after surgery. Specialists who can participate in your surgery preparation may include:

Knee arthroscopy procedures treat a variety of knee conditions and problems. Below are some of the most common reasons surgeons perform knee arthroscopy.

A meniscus tear means a fibro-cartilaginous bumper structure that protects the knee joint articular cartilage and acts as a shock absorber called the meniscus has a tear in it. Meniscus tears can occur on the medial or lateral meniscus, on the front, middle, or back of the meniscus. Click to learn more about torn meniscus.

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Sometimes pieces of cartilage can detach from the surface of the knee joint and become loose and grow, moving when the knee bends. This loose body can cause sudden pain and reduce or hinder movement. This “loose body” can be removed from the knee joint arthroscopically.

When the lining of the knee joint (Synovium) is inflamed, arthroscopic tools can be used to cut out and cauterize the inflamed hypertrophied tissue that causes pain and swelling. This inflamed scar tissue synovium can sometimes occur after joint replacement surgery and become trapped between the implants causing pain, and can be removed arthroscopically.

Articular Cartilage Flap Tears that cause pain, catching, locking, or loss of motion can also be cut back to a smooth edge using the same tools used to trim the meniscus tear. These flaps can occur from acute injury or from degenerative arthritis.

In cases where there is loss of cartilage through an isolated area of ​​the surface of the joint from injuries or degenerative conditions, the technique to drill a small channel into the bone to reach the blood supply can cause a healing reaction and bring cells to the surface to. create a repair layer of cartilage on the bone. This is called micro-fracturing the bone with small tools called arthroscopic picks to induce this healing response.

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A variant of the lateral meniscus is called the discoid lateral meniscus. This is a larger than normal meniscus with more meniscus tissue in the middle of the structure. Sometimes there may be a tear of the enlarged meniscal tissue that is painful, requiring a partial lateral meniscectomy. This is the removal of the collapsed part of the lateral meniscus and the sculpting of the remaining part back to the smooth edge.

Some patients have a condition where the knee cap (patella) does not stay in the center of the knee when bending, and tends to drift to the side (laterally). In some cases, this causes pain and degeneration. In these cases, one option is to release (cut) the tissue on the lateral side of the knee cap arthroscopically from the inside with a cauterizing tool to allow the knee cap to re-track centrally. This is called arthroscopic lateral release.

In rare cases of total knee replacement, scar tissue develops that catches between the knee cap implant and the femur implant when bending the knee which creates a clunking sound and catching feeling. During arthroscopic surgery, you can use razors and cauterizing tools to remove scar tissue and stop the catching, clunking and crunching that may be present.

When the Anterior Cruciate ligament is torn, it can be reconstructed during an arthroscopic procedure where a new ligamentous structure is inserted in place of the old torn ligament.

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When performing an arthroscopy, the surgeon will insert an arthroscope into the knee joint through a small ¼ inch incision, and through the second incision a small device can be inserted to trim or repair the damage to the knee.

Fluid is injected into the knee joint and drained out of the knee joint during the procedure to enlarge the joint so that the structure and cartilage can be clearly seen. The surgeon will look all over the inside of the knee to find any damage and this can be photographed to show you later what went wrong.

During the procedure, torn cartilage can be repaired with stitches or cut, damaged or torn cartilage can be shaved with a special small razor, debris can be removed with a suction shaver and other tools can be used to close the tissue. The arthroscope and instruments are then removed, and the incision is closed with sutures.

When the surgery is over, you’ll wake up in the recovery room and you’ll have an Ace wrap on your knee and cold therapy on the incision site. The information below is a general overview of your recovery. I see patients with this condition every day. They are one of the most challenging groups.

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A common scenario is when a patient undergoes arthroscopic knee surgery for a torn meniscus. The patient was told that the surgery would be minor and recovery would be quick. Expectations were high. But the patient is now 3 months out from surgery and he is still in pain. The patient is now frustrated and concerned. Adding insult to injury is the fact that almost every patient has a neighbor or co worker who has “same” surgery and who returns to do everything in “2 weeks”. Or worse, professional athletes undergo the same surgery and return to the field with scores 4 weeks later.

I find this type of case very difficult. What makes these problems even more challenging is the fact that they often cannot be solved with a 15-minute consultation.

The good news is that the majority of patients just need more time to heal or more therapy and rehabilitation.

If a patient has had surgery less than 3 months ago, I usually find that they are not healing and need more time or maybe the therapist is targeting a specific deficiency. Sometimes rehabilitation requires releasing the scar tissue with an “active release” or “deep tissue work” type of rehabilitation. Sometimes the key is improving patellofemoral joint flexibility with a good physical therapist. The latter is one of the most common causes of persistent pain. It’s an easy case. The goals of the therapy are usually to loosen the patella femoral joint, increase quadriceps flexibility, increase extension, and break down scar tissue.

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The challenge is trying to figure out when things are good and a little slow or if there really is an undiagnosed problem or a new problem.

To understand what can cause pain after knee arthroscopy, I need to start with a good history and examination. These issues cannot be resolved by email or phone. I spent a lot of time trying to understand the current as well as the pre-op symptoms. I did a detailed examination looking at leg length, alignment, flexibility, strength and evaluation of the joints above and below the knee. Details matter. It is also helpful when patients bring old surgery reports, pre-operative MRI and knee joint surgery images. These images allow me to see the condition of the articular cartilage and the remnants of the meniscus after the surgical procedure. I also look for conditions that may be causing the referred pain such as spine or hip problems. My exam also focuses on the exact area of ​​pain and tenderness.

An up-to-date X-ray and MRI are essential for a complete evaluation. Appropriate X-rays include standing weight-bearing views of both knees (Rosenberg view), Lateral Sunrise and Patellofemoral views. These X-rays are very important because they provide information that an MRI does not. MRI may show “subchondral bone edema” (a.k.a. fracture insufficiency) in the rheumatic area. Bone marrow edema causes pain, so these findings cannot be ignored.

MRI reports are not always accurate in identifying the cause of pain. It is not unusual for a recent MRI to say “meniscus tear” in the area that has been treated with a meniscectomy. That

Post Knee Arthroscopy For Debridement Of Scar Tissue (8.5 Months Post Aclr)

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