Knee Procedures
Total Knee Replacement
Total knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn out or damaged surfaces of the knee joint are removed and replaced with an artificial prosthesis.
Minimally Invasive Knee Joint Replacement
Total knee replacement is a very successful surgical treatment for knee arthritis. Over the years, minimally invasive knee replacement surgical techniques have been developed to lessen tissue trauma and improve patient outcomes. This minimally invasive approach involves much smaller incisions than the usual 10-12 inch incisions used in the traditional knee replacement and spares the quadriceps muscle and tendon, which control bending of the knee, from being cut to access the knee joint.
Robotic Assisted Knee Replacement
Robotic-assisted knee replacement surgery is an alternative to the conventional knee replacement procedure. It is performed using robotic-arm technology that allows your surgeon to precisely perform the surgery through a smaller incision as compared to traditional surgery.
Patient Specific Knee Replacement
Robotic-assisted knee replacement surgery is an alternative to the conventional knee replacement procedure. It is performed using robotic-arm technology that allows your surgeon to precisely perform the surgery through a smaller incision as compared to traditional surgery.
Revision Knee Replacement
Patient Specific Knee Replacement is a newer technology in total knee replacement surgery. It is an advanced procedure using an individualized patient-specific knee implant for replacement of all three components of the knee. The difference with patient specific knee replacement from other knee replacement surgeries is the use of an MRI scan prior to the surgery that provides a clear view of the shape and structure of the different components of the joint.
Knee Arthroscopy
Knee arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to diagnose or treat a knee problem. It is a relatively safe procedure and you will usually be discharged from the hospital on the same day of surgery.
Unicompartmental/Partial Knee Replacement
Unicompartmental knee replacement is a minimally invasive surgery in which only the damaged compartment of the knee is replaced with an implant. It is also called a partial knee replacement.
Computer Navigation for Total Knee Replacement
Computer navigation provides your surgeon with real-time 3-D images of your mapped knee and the surgical instruments during surgery. The data for the images is provided by infrared sensors fixed to the bones of the knee and surgical instruments. Their position is tracked by an infrared camera placed above the surgical table, which is connected to a computer.
Muscle-sparing Knee Replacement
Muscle-sparing knee replacement, also known as quadriceps-sparing knee replacement, is a minimally invasive surgical procedure that introduces knee implants through a smaller incision than thattypically seen in traditional knee replacement, thus preventinginjury to the quadriceps muscle and tendon.
Rapid Recovery Knee Replacement
Rapid recovery knee replacement, also known as an outpatient knee replacement, is an innovative procedure that is performed to replace a damaged knee joint with a prosthesis using minimally invasive techniques and surgical instruments that minimize post-operative pain and discomfort and promote faster recovery for patients.
Tricompartmental Knee Replacement
Tricompartmental knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn-out or damaged surfaces of the knee joint are removed and replaced with artificial parts.
Cartilage Replacement
Articular or hyaline cartilage is the tissue that covers bone surface of the knee which helps in smooth interaction between the two bones in the knee joint. It has less capacity to repair by itself because there is no direct blood supply to cartilage.
ACL Reconstruction
ACL (anterior cruciate ligament) reconstruction is a commonly performed surgical procedure. With recent advances in arthroscopic surgery, it can now be performed with minimal incision and low complication rates.
Arthroscopic Debridement
Arthroscopic debridement or a clean-up is a surgical procedure performed using an arthroscope. In this procedure, the cartilage or the bone that is damaged is removed using surgical instruments and the edges of the articular cartilage that are rough will be smoothened.
Knee Osteotomy
Knee osteotomy is a surgical procedure in which the upper part of shinbone (tibia) or lower part of thighbone (femur) is cut and realigned. It is usually performed in arthritic conditions affecting only one side of your knee. The aim is to take the pressure off the damaged area and shift it to the other side of your knee with healthy cartilage.
Knee Fracture Surgery
Knee fracture surgery is a surgical procedure performed to correct the cracked or broken bones in or around the knee to restore normal anatomical function, stability, and motion.
Patellar Tendon Repair
Patellar tendon repair is the surgery performed to reattach the torn tendon to the kneecap and to restore normal function in the affected leg.
Quadriceps Tendon Repair
Quadriceps tendon is a thick tissue located at the top of the kneecap. The quadriceps tendon works together with the quadriceps muscles to allow us to straighten our leg. The quadriceps muscles are the muscles located in front of the thigh.
Knee Trauma Reconstruction
Knee trauma reconstruction is a surgical procedure to repair a soft-tissue injury of the knee such as a torn ligament using a tissue graft or replacing the damaged bony surfaces of the knee joint with an artificial knee joint called a prosthesis. Artificial knee joints are usually made of metal, ceramic or plastic, and consist of the femoral and the tibial components.
Meniscal Surgery
Meniscal surgery is a surgical procedure employed for the treatment of torn or damaged meniscal tissues in the knee. It is mostly performed as a minimally invasive keyhole procedure.
Periprosthetic Knee Fracture Fixation
Periprosthetic knee fracture fixation is a procedure performed to stabilize a fracture that occurs in the bone present around a knee prosthesis. The fracture may involve the lower part of the thighbone (femur), the kneecap (patella) or the upper part of the shinbone (tibia).
Nonoperative Treatments for ACL Injuries
The ACL (anterior cruciate ligament) is one of the four major ligaments located within the knee joint. It connects the femur (thighbone) to the tibia (shinbone). It plays a key role in holding the two bones within the knee and keeping the joint stable while your knee moves back and forth.
Intraarticluar Knee Injection
An intra-articular knee injection is a very effective form of treatment where medicine is delivered directly into the knee joint with the primary objective of relieving pain from conditions such as arthritis.
Knee Conditions
Articular Cartilage Injury
Articular or hyaline cartilage is the tissue lining the surface of the two bones in the knee joint. Cartilage helps the bones move smoothly against each other and can withstand the weight of the body during activities such as running and jumping. Articular cartilage does not have a direct blood supply to it so has little capacity to repair itself.
Chondral or Articular Cartilage Defects
The articular or hyaline cartilage is the tissue lining the surface of the two bones in the knee joint. Cartilage helps the bones move smoothly against each other and can withstand the weight of your body during activities such as running and jumping. Articular cartilage does not have a direct blood supply to it, so has less capacity to repair itself.
Knee Osteoarthritis
Osteoarthritis also called degenerative joint disease, is the most common form of arthritis. It occurs most often in older people. This disease affects the tissue covering the ends of bones in a joint (cartilage).In a person with osteoarthritis, the cartilage becomes damaged and worn out causing pain, swelling, stiffness and restricted movement in the affected joint.
Knee Infection
Knee infection is a serious medical condition that needs immediate treatment. Infection may occur followed by a knee replacement surgery or trauma and is usually caused by bacteria. Infection may spread to the space of the knee joint or deep layers of your knee causing serious complications.
Knee Pain
Knee pain is a common condition affecting individuals of various age groups. It not only affects movement but also impacts your quality of life. An injury or disease of the knee joint or any structure surrounding the knee can result in knee pain. A precise diagnosis of the underlying cause is important to develop an appropriate treatment plan.
Knee Sprain
Knee sprain is a common injury that occurs from overstretching of the ligaments that support the knee joint. A knee sprain occurs when the knee ligaments are twisted or turned beyond its normal range, causing the ligaments to tear.
Jumper's Knee
Jumper’s knee, also known as patellar tendinitis, is inflammation of the patellar tendon that connects your kneecap (patella) to your shinbone. This tendon helps in the extension of the lower leg.
Runner's Knee
Patellofemoral pain syndrome also called runner’s knee refers to pain under and around your kneecap. Patellofemoral pain is associated with a number of medical conditions such as anterior knee pain syndrome, patellofemoral malalignment, and chondromalacia patella.
Kneecap Bursitis
Bursitis refers to the inflammation and swelling of the bursa. Inflammation of the bursa in front of the kneecap (patella) is known as kneecap bursitis or prepatellar bursitis.
Hoffa's Fat Pad Syndrome
Hoffa’s fat pad syndrome also called fat pad impingement, infrapatellar fat pad syndrome, and Hoffa's disease, is a condition characterized by anterior knee pain, pain in the center, and front of your knees, due to inflammation of the Hoffa’s fat pad.
Iliotibial Band Syndrome
Iliotibial band syndrome is an overuse injury resulting from the inflammation of the iliotibial band. It occurs when the iliotibial band and the lower outside portion of the thighbone at the knee joint rub against each other.
Knee Injury
Pain, swelling, and stiffness are the common symptoms of any damage or injury to the knee. If care is not taken during the initial phases of injury, it may lead to joint damage, which may end up destroying your knee.
Knee Ligament Injuries
An ACL injury is a sports-related injury that occurs when the knee is forcefully twisted or hyperextended. An ACL tear usually occurs with an abrupt directional change with the foot fixed on the ground or when the deceleration force crosses the knee. Changing direction rapidly, stopping suddenly, slowing down while running, landing from a jump incorrectly, and direct contact or collision, such as a football tackle, can also cause injury to the ACL.
ACL Tears
The anterior cruciate ligament (ACL) is one of the major ligaments of the knee. It is located in the middle of the knee and runs from the femur (thighbone) to the tibia (shinbone). The ACL prevents the tibia from sliding out in front of the femur. Together with the posterior cruciate ligament (PCL), it provides rotational stability to the knee.
Meniscal Tears
A meniscal tear is a common knee injury in athletes, especially those involved in contact sports. A sudden bend or twist in your knee causes the meniscus to tear. Elderly people are more prone to degenerative meniscal tears as the cartilage wears out and weakens with age.
Osgood Schlatter Disease
Osgood-Schlatter disease refers to a condition in older children and teenagers caused by excessive stress to the patellar tendon (located below the kneecap). Participants in sports such as soccer, gymnastics, basketball, and distance running are at higher risk for this disease.
Patellar Tendon Rupture
The patellar tendon works together with the quadriceps muscle and the quadriceps tendon to allow your knee to straighten out. Patella tendon rupture is the rupture of the tendon that connects the patella (kneecap) to the top portion of the tibia (shinbone).
Quadriceps Tendon Rupture
The quadriceps can rupture after a fall, direct blow to the leg and when you land on your leg awkwardly from a jump. Quadriceps tendon rupture most commonly occurs in middle-aged people who participate in sports that involve jumping and running. Other causes include tendonitis (inflammation of quadriceps tendon), diseases such as rheumatoid arthritis, diabetes mellitus, infection and chronic renal failure, which weaken the quadriceps tendon.
Knee Fracture
A fracture is a condition in which there is a break in the continuity of the bone. In younger individuals, these fractures are caused by high energy injuries, as from a motor vehicle accident. In older people, the most common cause is a weak and fragile bone.
Shin Splints
Shin splints are pain and inflammation of the tendons, muscles and bone tissue along the tibia or shinbone (lower leg). It occurs because of vigorous physical activities such as exercise or sports. The condition is also referred to as medial tibial stress syndrome (MTSS).
Knee Anatomy
The knee is a complex joint made up of different structures - bones, tendons, ligaments, and muscles. They all work together to maintain the knee’s normal function and provide stability to the knee during movement.
Having a well-functioning healthy knee is essential for our mobility and ability to participate in various activities. Understanding the anatomy of the knee enhances your ability to discuss and choose the right treatment procedure for knee problems with your doctor.
Bones of the Knee
The knee is a hinge joint made up of two bones, the thighbone (femur) and shinbone (tibia). There are two round knobs at the end of the femur called femoral condyles that articulate with the flat surface of the tibia called the tibial plateau. The tibial plateau on the inside of the leg is called the medial tibial plateau and on the outside of the leg, the lateral tibial plateau.
The two femoral condyles form a groove on the front (anterior) side of the knee called the patellofemoral groove. A small bone called the patella sits in this groove and forms the kneecap. It acts as a shield and protects the knee joint from direct trauma.
A fourth bone called the fibula is the other bone of the lower leg. This forms a small joint with the tibia. This joint has very little movement and is not considered a part of the main joint of the knee.
Articular Cartilage and Menisci of the Knee
Movement of the bones causes friction between the articulating surfaces. To reduce this friction, all articulating surfaces involved in the movement are covered with a white, shiny, slippery layer called articular cartilage. The articulating surface of the femoral condyles, tibial plateaus and the back of the patella are covered with this cartilage. The cartilage provides a smooth surface that facilitates easy movement.
To further reduce friction between the articulating surfaces of the bones, the knee joint is lined by a synovial membrane that produces a thick clear fluid called synovial fluid. This fluid lubricates and nourishes the cartilage and bones inside the joint capsule.
Within the knee joint, between the femur and tibia, are two C-shaped cartilaginous structures called menisci. Menisci function to provide stability to the knee by spreading the weight of the upper body across the whole surface of the tibial plateau. The menisci help in load-bearing i.e. it prevents the weight from concentrating onto a small area, which could damage the articular cartilage. The menisci also act as a cushion between the femur and tibia by absorbing the shock produced by activities such as walking, running and jumping.
Ligaments of the Knee
Ligaments are tough bands of tissue that connect one bone to another bone. The ligaments of the knee stabilize the knee joint. There are two important groups of ligaments that hold the bones of the knee joint together, collateral and cruciate ligaments.
Collateral ligaments are present on either side of the knee. They prevent the knee from moving too far during side to side motion. The collateral ligament on the inside is called the medial collateral ligament (MCL) and the collateral ligament on the outside is called the lateral collateral ligament (LCL).
Cruciate ligaments, present inside the knee joint, control the back-and-forth motion of the knee. The cruciate ligament in the front of the knee is called anterior cruciate ligament (ACL) and the cruciate ligament in the back of the knee is called posterior cruciate ligament (PCL).
Muscles of the Knee
There are two major muscles in the knee - the quadriceps and the hamstrings, which enable movement of the knee joint. The quadriceps muscles are located in front of the thigh. When the quadriceps muscles contract, the knee straightens. The hamstrings are located at the back of the thigh. When the hamstring muscles contract, the knee bends.
Tendons of the Knee
A tendon is a tissue that attaches a muscle to a bone. The quadriceps muscles of the knee meet just above the patella and attach to it through a tendon called the quadriceps tendon. The patella further attaches to the tibia through a tendon called the patella tendon. The quadriceps muscle, quadriceps tendon, and patellar tendon all work together to straighten the knee. Similarly, the hamstring muscles at the back of the leg are attached to the knee joint with the hamstring tendon.
