and Joint Replacement Dr. James W. Cahill • Dr. Paul E. Kovatis • Dr. Michael C. Distefano
About Knee Arthroscopy
Arthroscopy may be used to treat a variety of conditions in the knee. Arthroscopy is a surgical procedure that is less invasive than open procedures like knee replacements.
Arthroscopy is performed using a small camera called an arthroscope. By inserting the arthroscope into a small incision in the knee, Dr. Cahill is able to view the structures of the knee on a monitor, rather than looking at it directly. This allows him to perform the procedure through much smaller incisions than what would be required for an open procedure. Small operating instruments are then inserted through other small incisions to complete the procedure.
Arthroscopy can be used to view, repair, or remove damaged tissue. Dr. Cahill uses arthroscopy for a variety of procedures. In the knee, Dr. Cahill often uses arthroscopy for ACL repair and reconstruction and cartilage repair.
Arthroscopic ACL Repair / Reconstruction
ACL tears are among the most common knee injuries. Some ACL tears may be treated with nonsurgical methods, but if the knee is unstable due to the tear, surgical repair may be necessary.
ACL tears are generally not sutured back together. Rather, they are replaced with a tendon graft from either the hamstring, patellar, or quadriceps tendon. Grafts may also be taken from a cadaver. Tendon grafts provide more stability and strength to the torn ACL than it would have by simply suturing the torn pieces back together.
During the procedure, the tendon graft is harvested and prepared to fit the correct size to repair the ACL. Dr. Cahill then inserts the arthroscope through a small incision in the knee. Other small incisions are then made to insert the operating instruments. Any loose cartilage is trimmed, along with the torn portion of the ACL. Tunnels are drilled into the bone at the ends of the femur and tibia in approximately the same position as the ACL. A long needle is then passed through the tunnels to pull the tendon graft into the correct positioning. The graft may be held in place with interference screws, spiked washers, posts, or staples. After verifying correct tension of the graft, the incisions are closed.
The majority of patients are able to return home the day of the surgery.
Over time, the cartilage that covers and protects the ends of our bones can begin to wear away and become damaged. Because the cartilage plays a critical role in joint function, cartilage damage can cause pain and impaired knee movement.
Cartilage repair and restoration are relatively new procedures. Cartilage does not naturally heal itself very well, so the goal of cartilage restoration is to help to stimulate the growth of new cartilage. Cartilage repair procedures tend to be the most successful in patients with a single or contained instance of cartilage damage; it does not work as well if the cartilage is damaged in multiple parts of the knee.
Cartilage repair is typically done arthroscopically. There are a few different approaches to cartilage repair and restoration. In some approaches, the surgeon makes tiny holes in the joint surface, creating a new blood supply to the joint. With that new blood supply comes new cells that can help to induce a healing response in the cartilage. Other methods involve growing and implanting new cartilage cells or transplanting a cartilage graft taken from another part of the joint or an allograft.
Benefits of Knee Arthroscopy
Arthroscopy is not available for all procedures in the knee. However, where appropriate, arthroscopy can provide several benefits. The arthroscope allows Dr. Cahill to view the inside of the joint without having to make a large incision. Instead, the procedure is performed through much smaller incisions. Dr. Cahill may have to make a few small incisions to access the correct areas in the knee, but the recovery process from this method is often less painful when compared with recovery from open surgery with a large incision.
Smaller incisions often result in quicker recovery times because they take less time to heal. In many cases, patients who undergo arthroscopic surgery are able to go home the day of surgery. Quicker recovery times and reduced pain also make it easier to participate in physical therapy after surgery.
Knee Arthroscopy in Hackensack, NJ
Dr. James Cahill has extensive experience with orthopedic surgery and keeps current on all of the latest advances in the field, including arthroscopic surgery. If you would like to learn more about knee arthroscopy options or schedule an appointment with Dr. Cahill, please contact our office at (201) 489-0022.