Surgery for Knee Tears
Reconstructive surgery is often required to restore full function to the knee after an injury to a ligament or meniscus. Surgeons at NYU Langone Orthopedic Center perform minimally invasive arthroscopic procedures to repair or reconstruct several types of knee tears, including a torn anterior cruciate ligament, posterior cruciate ligament, or meniscus.
For an injury to the lateral collateral ligament, our doctors use advanced techniques to ensure that you regain full strength and range of motion in the knee.
NYU Langone surgeons perform knee surgery using general or regional anesthesia and recommend the best option for you before surgery. They may also inject an anesthetic into the knee during the procedure to provide continued pain relief in the hours after surgery.
Surgeons at NYU Langone perform arthroscopic surgery to reconstruct a torn anterior cruciate ligament, posterior cruciate ligament, or meniscus. If more than one of these structures is damaged, or if there is also a fracture in a bone within the knee joint, our surgeons can address multiple injuries during one procedure.
Knee arthroscopy is almost always an outpatient procedure, meaning you can return home the day of surgery.
In knee arthroscopy, surgeons reach the knee through very small incisions, minimizing damage to nearby muscle and other soft tissue. Doctors create a tissue graft, in which they use a small piece of tissue from another part of the body to reconstruct the injured ligament. This tissue is usually obtained from another part of your knee or leg and is called an autograft. In older people or in those who have had reconstructive knee surgery, doctors may obtain this tissue from a donor bank.
During the procedure, the surgeon inserts a pencil-size instrument called an arthroscope, which has a light and camera at its tip, into one of the incisions. Images of the knee appear on a computer monitor, helping the doctor to navigate the joint.
Next, the surgeon uses instruments inserted through another of the small incisions to reconstruct the torn ligament or meniscus and, if necessary, reattach it to the bone. He or she does this by implanting small plastic or metal anchors into the thigh bone and lower leg bone. Sterile thread is looped through these anchors and around the ligament or meniscus, securing the tissue in the correct position.
The transplanted tissue grows into the surrounding tissue over time, completely repairing the torn ligament or meniscus and restoring joint function. After the procedure is complete, the incisions are closed with stitches.
Surgeons use an open technique to repair or reconstruct a lateral or medial collateral ligament in the knee. Usually, our doctors repair a torn medial or lateral ligament if it has separated from the thigh bone or the shin bone.
A surgeon may also use an open procedure to reconstruct a torn lateral collateral ligament using an allograft, a piece of tissue obtained at a donor bank.
To perform open surgery, a surgeon makes an incision along the inner or outer side of the knee, depending on the location of the injured ligament. He or she accesses the injured ligament through the incision and repairs it by sewing the tissue back together. He or she may opt to use allograft tissue to replace the torn ligament.
To attach an allograft, a surgeon creates several tiny tunnels in the thigh and lower leg bones and uses small metal screws and buttons to hold the new ligament material in place. Over time, the allograft grows into the surrounding tissue and bone and becomes as strong and flexible as the natural ligament.
After the ligament has been repaired or reconstructed, a surgeon closes the incision with stitches.
What to Expect After Knee Surgery
Unlike arthroscopic surgery, open surgery may require a hospital stay of one or two days for observation. NYU Langone pain management specialists can provide medication to ensure that you are comfortable while your knee begins to heal.
When you are discharged, doctors provide a brace and crutches to help you move around at home without putting stress on the knee. Doctors recommend rest, ice, heat, compression, and elevation during the first week after surgery. Your doctor may instruct you to use crutches for one to two weeks after surgery and wear a knee brace for another two weeks after that.
Two weeks after the surgery, the doctor checks the incisions to ensure they are healing properly and then removes the stitches. Your surgeon also examines your knee and asks you to bend your leg gently in different directions to assess its range of motion.
Our doctors recommend starting physical therapy after swelling and pain have subsided, which is usually two to three weeks after surgery. Physical therapy helps you rebuild strength, flexibility, and range of motion in the knee.