Surgery Treatments for Knee Pain and Injuries

Knee surgery is often used for the treatment of different conditions that can cause knee pain. While non-surgical treatments are often attempted for initial treatment, there are situations where knee surgery becomes the recommended or necessary treatment. Learn about different types of knee surgery and the conditions that are best treated with each.

1

Arthroscopy for Trimming a Torn Meniscus

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Meniscectomy is the official name of the surgery that involves the removal of a portion of the meniscus cartilage from the knee joint. The meniscus is a shock-absorbing wedge of cartilage that sits between the bone ends to provide cushioning and support. Smaller meniscus tears can usually be trimmed to relieve the symptoms of a torn meniscus.

2

Meniscus Repair

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A meniscus repair is a surgical procedure done to repair the damaged meniscus. The meniscus repair can restore the normal anatomy of the knee and has a better long-term prognosis when successful. However, the meniscus repair is a more significant surgery. The recovery is longer, and, because of limited blood supply to the meniscus, it is not always possible.

3

Lateral Release

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The kneecap moves up and down the end of the thigh bone in a groove of cartilage. The kneecap can be pulled to the outside of this groove, or may even dislocate from the groove, causing pain with bending of the knee joint. A lateral release is performed to loosen the ligaments that pull the kneecap toward the outside of the groove. Lateral release used to be commonly performed for people with vague symptoms of knee pain. In recent years, surgeons have been much more careful in determining which patients might be appropriate candidates for this surgical procedure.

4

Plica Excision

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A plica is a remnant of tissue left over from fetal development. In early development, your knee was divided into separate compartments. The dividers of the compartments are gradually lost over time, but some remnant remains. When this remnant tissue is more prominent, it is called a plica. When the plica is irritated, it is called plica syndrome. A plica resection is performed to remove this irritated tissue.

5

Meniscus Transplant

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Meniscus transplantation consists of placing the meniscus from a donor patient into an individual who has had their meniscus removed. The ideal patient for a meniscus transplant is someone who had their meniscus removed, and subsequently begins to develop knee pain. Meniscus transplant is not performed for an acute meniscus tear, rather it is performed when removal of the entire meniscus has caused persistent pain in the knee.

6

ACL Reconstruction

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The anterior cruciate ligament, or ACL, is one of four major knee ligaments. The ACL is critical to knee stability, and people who injure their ACL often complain of symptoms of their knee giving out from under them. Therefore, many patients who sustain an ACL tear opt to have surgical treatment for this injury. ACL injuries are often associated with sports activities, where they most often occur. However, ACL injuries can also affect people with her normal daily activities.

7

Microfracture

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Microfracture is a surgical procure performed to address areas of cartilage damage inside the knee joint. Microfracture causes a healing response so that new cartilage is formed where there was a gap in cartilage. The problems with microfracture include that this only works for small areas of damage (not widespread loss of cartilage) and the healing cartilage is not the same as normal joint cartilage.

8

Patellar/Quadriceps Tendon Repair

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The patellar tendon and quadriceps tendon on the front of the knee joint can be injured, causing a loss of strength of leg extension. When the tendon is torn, patients have a difficult time straightening the knee joint. Treatment of a patellar tendon or quadriceps tendon rupture is nearly always a surgical repair. Without surgical repair, not only can straightening the knee be difficult, but even normal walking is sometimes challenging.

9

Partial Knee Replacement

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A partial knee replacement is an option for certain types of knee arthritis. When the cartilage loss is limited to a small portion of the knee joint, it may be possible to replace just the worn-out portion of the joint. However, in cases where the arthritis is more widespread, a total knee replacement will need to be performed. Partial knee replacements are becoming more common as robotic-assisted surgery is becoming more prevalent.  The knee joint is generally divided into 3 compartments, and each of these 3 compartments (medial, lateral, and patellofemoral) can be replaced with a partial knee replacement.

10

Knee Replacement Surgery

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When a knee replacement is performed, the bone and cartilage on the end of the thigh bone (femur) and top of the shin bone (tibia) are removed. This is performed using precise instruments to create surfaces that can accommodate the implant perfectly. A metal and plastic knee replacement implant is then placed in to function as a new knee joint. Depending on the condition of the cartilage underneath the kneecap, the kneecap surface may also be replaced. Knee replacement surgery is very successful, with about 90% of patients reporting good long-term results.

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A Word From Verywell

 Determining the best surgical procedure to manage each individual patient can be a complex decision. Not every type of knee pain is managed with surgery, and determining the most appropriate surgery can be complex.

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