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Friday, June 12, 2009

Surgical Treatment of Knee: Knee Arthroscopy

By Dr. Stefan Tarlow

The most common surgical procedure in Orthopedic Surgery is Knee Arthroscopy. The operation is performed at a hospital or outpatient surgical center. The patient is usually administered a general anesthetic. The procedure usually takes 30-45 minutes.

Patients are on crutches for a day or day, take oral pain medications for less than a week, return to desk work in 2-4 days, and are usually fully recovered in 2-4 weeks (for simple arthroscopic procedures such as menisectomy, chondroplasty, loose body removal and lateral release).

Knee arthroscopy outcomes vary, but can be predicted based on factors like age and diagnosis. As a rule, if the patient is younger than 55 years with only one problem (like a torn meniscus, a loose body, a small area of joint surface damage) tend to have a higher probability of successful surgical outcomes.

Patients older than 55 with more than one disease process (most common is torn meniscus with chondral damage " generally known as arthritis) have highly variable outcomes after knee arthroscopy [improved knee outcome in 60% range for these multiple disease process knees].

The least predictable surgical outcomes are with Arthroscopic Lateral Retinacular Release for patellar tracking problems and Arthroscopic Chondroplasty for arthritis. The best surgical outcomes are after Arthroscopic Medial Menisectomy, Arthroscopic Loose Body Removal, and Arthroscopic Lateral Meniscal repair.

Diagnostic Arthroscopy: Even in the age of high resolution 3T MRI scans there is still a role for the surgeon to only look inside the knee for diagnostic purposes.

This is done to assess healing of meniscal repair, looking for wearing of Total Knee Replacement, healing of microfracture, healing of Autologous Chondrocyte Implantation, assessment of ligament injury (or a new injury or after surgical reconstruction of knee ligament), or when knee symptoms are unexplained even after a physical, Xray, history, and MRI of the knee area.

A more detailed report is found the website of Phoenix knee doctor, Dr. Stefan Tarlow. - 17273

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