What is the meniscus?
The meniscus is a hard but at the same time elastic structure composed mainly of water and collagen fibers. Each knee has two menisci, the medial and the external. The menisci have an extremely important role in the function of the knee by increasing the contact surface between the two bones, while at the same time stabilizing the knee and at the same time absorbing shocks during loading, making the movement of the joint smoother. A meniscus tear is one of the most common knee conditions.
How does a meniscus tear happen?
Meniscal tears are classified into acute and degenerative. Acute lesions usually occur in young patients, mainly athletes. Usually these patients experience acute pain with swelling of the knee and possibly “locking” of the joint. Degenerative tears concern older patients, due to the “aging” of the tissue with loss of elasticity. Usually patients report a mild mechanism of injury (simply standing or deep sitting). While it is not uncommon for patients to have recurrent episodes of knee edema (swelling). With relatively mild pain without any significant prior injury.
Treatment of meniscal tears
A meniscal tear can be treated conservatively or surgically, depending on whether it is of acute or degenerative etiology. As a rule, small tears of degenerative etiology can be treated conservatively for a period of about 2-3 months. Conservative treatment includes rest, short-term use of nonsteroidal anti-inflammatory drugs. Modification of patient activities, cryotherapy, and rehabilitation with physical therapy and muscle strengthening. After this period and appropriate recovery, a large number of patients become asymptomatic. However, a percentage of patients continue to have symptoms despite conservative treatment. If the pain or swelling persists and makes the patient’s daily life difficult, then surgical treatment of the problem is indicated.
Acute tears in young patients require, with very few exceptions, surgical treatment with the arthroscopy method. Arthroscopy is a modern surgery, with which the orthopedist, through a small incision of about 5 millimeters, inserts a camera connected to a fiber optic lens (arthroscope). And sees in magnification each intra-articular damage with excellent accuracy. Then, from one or more additional incisions of the same length, with the help of special surgical instruments depending on the occasion. And with extreme precision of movements, he intervenes to correct it. During surgery, either an attempt is made to save the meniscus (Save the meniscus!) by suturing the damage, or the injured part of the meniscus is removed (partial meniscectomy). The choice of treatment depends on the location and consequently the blood supply of the torn part of the meniscus, as well as the morphology and age of the lesion.
What is arthritis?
Knee arthritis is an inflammatory disease characterized by the destruction of the structural elements of the joint. It usually affects middle-aged and older people. Its main symptoms are pain, swelling, and stiffness of the joint, while it can significantly affect the patient’s quality of life by making his daily life difficult. The most common form of knee arthritis is osteoarthritis. Osteoarthritis is due to the progressive degeneration of the elements of the knee, mainly the articular cartilage. Other common forms of arthritis are rheumatoid and post-traumatic.
Arthroscopy and Arthritis
Proximal fibular ostectomy is a useful surgical variant for patients with this entity, due to its easy performance. No age limit and the possibility of being combined with other advantageous procedures, such as knee arthroscopy. This procedure is effective in relieving pain and improving joint function.
For its part, knee arthroscopy allows the diagnosis of degenerative joint disease that confirms and is the way to carry out techniques. Some of them are lavage, debridement, meniscectomy and fractures, among others.
Due to the novelty of this technique, the authors aim to present the clinical case of a patient with knee osteoarthritis and angular deformity. That operates on through combinations and simultaneous arthroscopy and OPP.
Arthroscopy has a huge recognition and uses route in patients with gonarthrosis. When we use it in patients with angular deformity, such as varus. It detects 90% of patients with medial compartment involvement, both meniscus and cartilage.
Procedures in this way that lengthen the useful life of the joint. and allows to evaluate the entire extension of the EDA. In case of severe injury to the lateral compartment. Doctors do not recommend realignment procedures.
The OPP allows to reduce the weight loads on the medial compartment and then correct the angular deformity in various degrees. The results of this technique alone are satisfactory.
A study in cadavers demonstrates the reduction of weight loads in the medial compartment. In the entire joint. To date, no articles have been published that address the combined and simultaneous performance of knee arthroscopy and PPO. Hence the importance of the work, which allows combining the advantages of these two procedures, anesthetic and surgical time.
What are the symptoms of the disease?
In the initial stages of the disease, the pain is usually more intense in the morning and subsides during the day. Progressively the pain becomes more and more intense and worsens with activities. Such as walking while in the later stages it becomes constant. Many patients complain of severe worsening of pain with the change of weather and especially with humidity.
The diagnosis of osteoarthritis is made by taking a detailed history and clinical examination while it is confirmed by radiological control. Rarely, an MRI is necessary to accurately visualize the joint.
Conservative treatment or surgery?
Unfortunately, there is no treatment that can restore the knee to its previous state. In the early stages of the disease, symptoms can subside with conservative measures. These include avoiding activities that exacerbate pain (such as long hours of walking or using stairs) while encouraging activities that strengthen the muscles that stabilize the knee.
Pharmaceutically, the intra-articular injection of hyaluronic acid, either alone or in combination with cortisone or platelet-rich plasma (PRP). Can limit symptoms and perhaps slow the progression of disease.
In cases of more advanced disease or when conservative treatment fails, surgical treatment is recommended, with the aim of improving the patient’s quality of life. Arthroplasty is the operation in which an orthopedist replaces the worn surface of the knee with a special prosthesis. With the new minimally invasive techniques as well as the fast track surgery protocols. The patient’s hospitalization is minimized, blood loss and post-operative pain are reduced while ensuring a faster return to daily activities.
In recent years there has been a revolution in the field of knee arthroplasty with the introduction of robotics. During robotically assisted knee arthroplasty a three-dimensional model of the patient’s knee is created with the help of a CT scan. The surgeon using this model preoperatively personalizes the operation to the anatomy and needs of the specific patient. Then the orthopedist, with the help of the robotic arm, proceeds with extreme precision in the preparation of the bone and the placement of the materials.
What is the meniscus?
The meniscus is a hard but at the same time elastic structure composed mainly of water and collagen fibers. Each knee has two menisci, the medial and the external. The menisci have an extremely important role in the function of the knee by increasing the contact surface between the two bones, while at the same time stabilizing the knee and at the same time absorbing shocks during loading, making the movement of the joint smoother.
How does a meniscus tear happen?
Meniscal tears are classified into acute and degenerative. Acute lesions usually occur in young patients, mainly athletes. Usually these patients experience acute pain with swelling of the knee and possibly “locking” of the joint. Degenerative tears concern older patients, due to the “aging” of the tissue with loss of elasticity. Usually patients report a mild mechanism of injury (simply standing or deep sitting). While it is not uncommon for patients to have recurrent episodes of knee edema (swelling).
Treatment of meniscal tears
A meniscal tear can be treated conservatively or surgically, depending on whether it is of acute or degenerative etiology. As a rule, small tears of degenerative etiology can be treated conservatively for a period of about 2-3 months. Conservative treatment includes rest, short-term use of nonsteroidal anti-inflammatory drugs. Modification of patient activities, cryotherapy, and rehabilitation with physical therapy and muscle strengthening. After this period and appropriate recovery, a large number of patients become asymptomatic. However, a percentage of patients continue to have symptoms despite conservative treatment. If the pain or swelling persists and makes the patient’s daily life difficult, then surgical treatment of the problem is indicated.
Acute tears in young patients require, with very few exceptions, surgical treatment with the arthroscopy method. Arthroscopy is a modern surgery, with which the orthopedist, through a small incision of about 5 millimeters, inserts a camera connected to a fiber optic lens (arthroscope). And sees in magnification each intra-articular damage with excellent accuracy. Then, from one or more additional incisions of the same length, with the help of special surgical instruments depending on the occasion. And with extreme precision of movements, he intervenes to correct it. During surgery, either an attempt is made to save the meniscus (Save the meniscus!) by suturing the damage, or the injured part of the meniscus is removed (partial meniscectomy). The choice of treatment depends on the location and consequently the blood supply of the torn part of the meniscus, as well as the morphology and age of the lesion.
What is arthritis?
Knee arthritis is an inflammatory disease characterized by the destruction of the structural elements of the joint. It usually affects middle-aged and older people. Its main symptoms are pain, swelling, and stiffness of the joint, while it can significantly affect the patient’s quality of life by making his daily life difficult. The most common form of knee arthritis is osteoarthritis. Osteoarthritis is due to the progressive degeneration of the elements of the knee, mainly the articular cartilage. Other common forms of arthritis are rheumatoid and post-traumatic.
Arthroscopy and Arthritis
Proximal fibular ostectomy is a useful surgical variant for patients with this entity, due to its easy performance. No age limit and the possibility of being combined with other advantageous procedures, such as knee arthroscopy. This procedure is effective in relieving pain and improving joint function.
For its part, knee arthroscopy allows the diagnosis of degenerative joint disease that confirms and is the way to carry out techniques. Some of them are lavage, debridement, meniscectomy and fractures, among others.
Due to the novelty of this technique, the authors aim to present the clinical case of a patient with knee osteoarthritis and angular deformity. That operates on through combinations and simultaneous arthroscopy and OPP.
Arthroscopy has a huge recognition and uses route in patients with gonarthrosis. When we use it in patients with angular deformity, such as varus. It detects 90% of patients with medial compartment involvement, both meniscus and cartilage.
Procedures in this way that lengthen the useful life of the joint. and allows to evaluate the entire extension of the EDA. In case of severe injury to the lateral compartment. Doctors do not recommend realignment procedures.
The OPP allows to reduce the weight loads on the medial compartment and then correct the angular deformity in various degrees. The results of this technique alone are satisfactory.
A study in cadavers demonstrates the reduction of weight loads in the medial compartment. In the entire joint. To date, no articles have been published that address the combined and simultaneous performance of knee arthroscopy and PPO. Hence the importance of the work, which allows combining the advantages of these two procedures, anesthetic and surgical time.
What are the symptoms of the disease?
In the initial stages of the disease, the pain is usually more intense in the morning and subsides during the day. Progressively the pain becomes more and more intense and worsens with activities. Such as walking while in the later stages it becomes constant. Many patients complain of severe worsening of pain with the change of weather and especially with humidity.
The diagnosis of osteoarthritis is made by taking a detailed history and clinical examination while it is confirmed by radiological control. Rarely, an MRI is necessary to accurately visualize the joint.
