Often times once patients have failed conservative measures then we discuss surgical options. Typically we hold off on proceeding with surgery until patients have failed ‘anti-inflammatories’ Tylenol, icing as well as physical therapy.
The operative indications for knee pain is highly variable. Patients with something isolated to a medial meniscus tear where there pathology seems to be mostly meniscus related and not arthritic related will respond well to an arthroscopy. An arthroscopy is a procedure where we make a couple of small holes in the front of your knee and we go in with a camera; find the meniscus tear and clean up the meniscus tear. That is very good in alleviating patients’ symptoms that have isolated meniscus tear symptoms. Patients with more advanced disease such as arthritis however require usually a surgery much larger than an arthroscopy such as a knee arthroplasty or knee replacement.
Knee replacements can either be partial where part of the knee is replaced or a total, when the entire knee is replaced. A total knee can be a misnomer as most of our work is done on just on the very distal and proximal ends of the bone where about a centimeter of the tips of each bone is removed and a metal cap is placed. In-between the metal caps is a piece of plastic.