The knee, a vital and fragile joint !
The knee is the joint between the lower part of the femur and the higher part of the tibia. The surfaces of these bones are covered with cartilage where they come into contact. The menisci, small C-shaped cushions, fulfil the role of shock absorbers between femur cartilage and tibia cartilage and the ligaments provide stability.
The knee joint is vital because it supports the weight of the body and it is also for this reason that it is particularly vulnerable. An accident, most likely to occur during physical activity, can cause damage to the ligaments or the meniscus which sometimes requires knee surgery. Wear and tear on a joint due to overuse can also cause damage that can only be remedied by surgery.
Knee ligament reconstruction
A very common knee operation involves the Anterior Cruciate Ligament, a sort of elastic ribbon linking the anterior part of the tibia to the posterior part of the femur. This ligament, which is vital to the stability of the knee during rotational movement, can be ruptured following trauma. As a general rule, the anterior cruciate ligament does not heal on its own: to repair it, a knee operation known as knee ligament reconstruction is required.
This procedure consists in replacing the ruptured ligament. The operation is performed by arthroscopy or “keyhole surgery”, i.e. without opening the joint.
Another alternative in the case of partial damage is to inject a platelet concentrate (PRP) to optimize the quality of healing.
The menisci are made of cartilage which tends to thin over time. A significant trauma to the knee (or repeated minor trauma caused by some movements) can cause meniscal damage.
Certain types of damage cannot heal on their own and require an operation known as meniscal surgery which is also performed by arthroscopy. Depending on the severity of the damage, this knee surgery can involve either a meniscal suture or a meniscectomy (removal of the damaged part of the meniscus).
This relieves pain, locking and swelling. After the operation, the patient can walk normally and resume his/her usual activities.
Patella (kneecap) realignment
When patella dysfunction – in conjunction with poor connection to the femoral trochlea – is observed, it may be necessary to consider knee surgery. Kneecap misalignment is not remedied naturally and cartilage damage will gradually occur as a consequence.
The knee operation for this case is called patella realignment and consists in realigning the patella in the groove of the trochlea. The patella is then able to function smoothly again, as the problems causing its misalignment have been resolved, and more serious damage is therefore avoided.
Knee surgery for cartilage wear and tear
Damage to knee cartilage can be caused by trauma, repeated physical effort or incomplete development. When cartilage has been damaged in this way, it is possible to perform a knee operation known as knee cartilage surgery, which can diminish the pain and discomfort caused by the damage.
The joint can also be affected by osteoarthritis, a degeneration of the cartilage causing pain and discomfort that intensifies to such an extent that everyday actions or certain specific movements become impossible. According to whether the wear and tear on the cartilage is limited to a specific area or not, the knee operation consists in performing either unicompartmental or total replacement. These knee operations reduce pain and joint mobility is recovered.
In certain cases, one may opt for another knee operation, tibial valgus osteotomy, which consists in realigning the tibia relative to the knee joint, where misalignment was causing friction and therefore wear and tear on the cartilage.