Arthroscopic surgery
Meniscal repair surgery/excision.
Excision, for more information click here.
Surgery, for more information click here.
Meniscal lesions usually gets excised (partially).
Certain lesions (in the young patients, torn in the red zone or root) will be considered for the repair.
The practice do not repair with synthetic or allograft tissue.
Ligaments
Cruciate/Collateral/medialpatellofemoral ligament repair augmentation.
ACL
ACL
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PCL
MPFL
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Primary repair only done on certain collateral ligament lesions.
Cruciate ligament Augmented procedure preferably with own tissue (autograft) is done – patella tendon, hamstrings.
Sometimes when autograft is not possible allograft (deadman’s tissue) would be considered. Synthetic graft will not be considered for intraarticular ligament repair.
Osteochondral surgery
Mosaicplasty
Isolated osteochondral lesions, especially in the young might be considered for repair.
Own tissue is harvested in the same joint to repair the defect. No synthetic graft to be used.
Osteotomy
Tibia
Femur
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This is considered in the 30-45 years age group, for arthritic and or ligamentous lesions.
This is to restore the mechanical axis of the lower limb.
Procedure help buy time for the patient so that replacement surgery is done in later life.
Usually done on the tibial side.
Arthroplasty
biCondylar knee replacements
Replacement surgery is preferably offered when discomfort and function has deteriorated to an extent where daily activities are influenced. It is true that the older the patient before replacement surgery, the better.
Each case gets individualized.
Example
Before - Back
Before - Front
Unicondylar OXFORD
After- Back
After - Front
Patellofemoral
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Lastly, partial replacement has come into favour certain specific patients/lesions.
Especially the medial compartment pathology does well.
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The lateral joint and patellofemoral joint replacements might be considered in some cases-less successful/indicated.