Type of Surgery
Information
Last updated: 11/24/2009
Whether or not surgical treatment is the best choice depends on a number of factors and alternatives. Age and the degree of injury or damage are key to deciding whether to have surgery or rehabilitation. The physician calibrates the severity of acute injuries and either proceeds to a determined treatment plan immediately or recommends surgery. Alternatives for acute ligament injuries depend on the severity of injury and whether the patient can make lifestyle changes and is willing to move away from athletic activities. This decision becomes paramount for many people with collateral and cruciate injuries.
According to the American Association of Orthopedic Surgeons, conservative treatment for acute injuries involves RICE: Rest, Ice, Compression, Elevation, as well as a follow-up rehabilitation plan. The RICE protocol involves resting the knee to allow the ligament to heal, applying ice two or three times a day for 15–20 minutes, compression with a bandage or brace, and elevation of the knee whenever possible. Rehabilitation requires range-of-motion exercises to increase flexibility, braces to control joint immobility, exercise for quadriceps to support the front of the thigh, and upper thigh exercise with a bicycle.
For arthritis-related damage and pain management, anti-inflammatory medication, weight loss, and exercise can all be crucial to strengthening the knee to relieve pain. Evidence suggests that these alternatives work as well as surgery.
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Athletes commonly tear or rupture the anterior cruciate ligament in the knee and require surgery to repair it. The narrator is this 3D animation explains how the patellar tendon is used to reconstruct the ACL.
Surgeons watching a monitor showing the inside of a patient's knee during arthroscopic knee surgery. (Custom Medical Stock Photo. Reproduced by permission.)
Step A shows the anatomy of the knee from the front with the leg bent. To repair a torn meniscus, three small incisions are made into the knee to admit laparoscopic instruments (B). Fluid is injected into the joint to aid in the operation. The injury is visualized via the instruments, and the torn area is removed (C). (Illustration by GGS Inc.)
Other Information
Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure in which an examination and sometimes treatment of damage of the interior of a joint is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed either to evaluate or to treat many orthopaedic conditions including torn floating cartilage, torn surface cartilage, ACL reconstruction, and trimming damaged cartilage.
The advantage of arthroscopy over traditional open surgery is that the joint does not have to be opened up fully. Instead, only two small incisions are made - one for the arthroscope and one for the surgical instruments. This reduces recovery time and may increase the rate of surgical success due to less trauma to the connective tissue. It is especially useful for professional athletes, who frequently injure knee joints and require fast healing time. There is also less scarring, because of the smaller incisions. Irrigation fluid is used to distend the joint and make a surgical space. Sometimes this fluid leaks into the surrounding soft tissue causing extravasation and edema
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New procedures like minimally invasive procedures are often subject to scrutiny, but I think that one of the biggest problems facing these innovative procedures is for people to understand exactly what we do.
-Dr. Michael Perry, Laser Spine institute
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