How well can cartilage damage be treated during arthroscopy? | Arthroscopy of the knee joint

How well can cartilage damage be treated during arthroscopy?

Cartilage damage in the knee is the most common indication for therapeutic arthroscopy of the knee. It occurs either as a result of long-term stress in the knee caused by work or sports, especially in older patients, or after sports accidents. Cartilage damage in the knee is often initially treated conservatively.

If this is not sufficient, arthroscopy is used. Depending on the type of injury, there are different ways of treating cartilage damage. In principle, the chances of successful and sustainable treatment of cartilage damage in young people are higher due to better blood circulation.

If a cartilage is frayed and broken up, so that recurring pain and swelling of the knee occur, a so-called “cartilage smoothing” can be performed in arthroscopy. This involves removing the frayed pieces of cartilage and adjusting and smoothing the surfaces. In young patients there is the possibility of microfracturing in the case of advanced cartilage damage.

The bone is punctured at several points, so that a blood clot is formed on the joint surface, which is then transformed into cartilage-like connective tissue. Young people with particularly severe cartilage defects can even benefit from a cartilage cell transplant. If the individual prerequisites for cartilage transplantation are met, the procedure can in many cases provide good results. In particular, patient age, blood circulation and the location of the cartilage defect are important factors for the success of the transplantation.

Aftercare of a knee arthroscopy

As a rule, control examinations are carried out the day after the operation and one week after the operation. After the operation, the knee should always be protected and cooled. It may be necessary to relieve the knee joint for some time by using forearm supports when walking.

The operated leg should only “walk along” when in contact with the ground. Various treatment methods, such as physiotherapy and electrotherapy, supplement the joint relief. In the case of existing arthrosis, which cannot be improved by arthroscopy, follow-up treatment with hyaluronic acid is recommended.

Hyaluronic acid treatment can significantly reduce the symptoms of arthrosis such as pain and restricted mobility. The individual follow-up care after a knee arthroscopy should always be discussed with the treating physician. In some cases, it varies greatly depending on the reason for the operation.

The insertion of a drainage is usually decided by the surgeon during the operation. In many cases, drains are not necessary, since no bleeding has occurred during the arthroscopy. However, if there are signs of bleeding in the knee, a drainage may be useful for the first few days after the operation.

Even if the arthroscopy is performed from the knee in the so-called “bloodlessness”, a drainage may be necessary due to the increased blood circulation in the knee after the bloodlessness has been switched off. Slight bruising of the knee can resorb itself, whereas large bruises must be punctured and suctioned with a needle. In order to prevent this, the decision to drain must be made differently for each individual, as drainage can in turn be associated with further risks and subsequent complications.

The duration of relief depends on the procedure performed and the symptoms after knee arthroscopy. Cruciate ligament operations, cartilage transplants or other interventions that are accompanied by a subsequent healing phase often require a longer period of relief. In contrast, pure arthroscopy does not require any relief.

The leg should be fully loaded as early as possible after the operation to prevent thrombosis and to avoid muscle atrophy and restricted mobility. For about 4-5 days after the arthroscopy, there may be pain in the knee, which makes it impossible to load it for the time being. If possible within these 4 days, the leg should be fully loaded despite the pain. Only after about three to six weeks after the operation can sport be resumed, provided that the joint heals smoothly. In any case, the exact time of resuming training must be discussed with the attending physician.