Arthroscopic Surgery vs. Knee Replacement

Once conservative knee pain treatment options no longer provide benefit, people with chronic, severe knee pain must often make a decision between two procedures: arthroscopic surgery or knee replacement. The choice is an important one, and patients should be aware of the differences between arthroscopic surgery and knee replacement before making a decision.

The Difference Between Arthroscopic Surgery and Knee Replacement

The major difference between arthroscopic surgery and knee replacement surgery is that one surgery preserves your natural knee joint, while the other surgery replaces the knee joint with an artificial joint. Another important difference between arthroscopic surgery and knee replacement is the size of the incisions. In arthroscopic knee surgery, three tiny incisions are made in the knee joint, each about a centimeter long (less than an inch). Knee replacement surgery, on the other hand, is an open procedure. For knee replacement surgery, the surgeon must make a relatively long incision over the center of the knee, exposing the entire joint.

Importantly, knee replacement surgery can be performed in the typical fashion or using a minimally invasive technique. Minimally invasive knee replacement surgery is still an open surgical procedure. It is not arthroscopic knee surgery. Thus, the differences between arthroscopic surgery and knee replacement surgery also apply to the minimally invasive approach. However, the incision and resulting scar is a bit smaller with the minimally invasive approach than it is with traditional knee replacement surgery.

Arthroscopic Surgery or Knee Replacement

When people with chronic knee pain and osteoarthritis consider surgery, they must decide whether they will have arthroscopic surgery or knee replacement surgery. The goal of arthroscopic knee surgery is to resurface the areas of joint that touch one another. For example, one of the problems that occurs in osteoarthritis is bone spurs. Bone spurs jut out from joint surfaces and rub against opposing joint surfaces. This causes pain, inflammation, and decreased range of motion. An orthopedic surgeon could use arthroscopic surgery to shave down the bone spurs and smooth the surfaces of the knee joint.

Arthroscopic knee surgery can also be used to repair torn ligaments and torn cartilage within the knee. As with resurfacing, repaired cartilage and ligaments can restore function and reduce pain.

As the name implies, the goal of knee replacement surgery is to replace the joint. Since the replacement joint is artificial, it moves smoothly and is less likely to develop bone spurs or other malformations. Another benefit of knee replacement surgery is that the artificial device does not have nerve endings, so it cannot send pain signals to the brain. Most people who undergo knee replacement surgery are very pleased with the results. Most patients report substantially less pain and improved knee function after surgery.

Should I Get Arthroscopic Surgery?

The basic question facing most people with chronic knee problems is, “Should I get arthroscopic surgery?” The answer to this question is yes under certain circumstances. Orthopedic surgeons generally only offer arthroscopic surgery to patients who have already tried other knee pain treatment options and did not find adequate relief of their symptoms. Knee pain treatment options include over-the-counter and prescription pain relieving medications, physical therapy, and steroid injections into the knee joint.

Once conservative knee pain treatment options have failed, arthroscopic surgery is usually considered before knee replacement surgery. There are many reasons for considering arthroscopic surgery before knee replacement. Arthroscopic surgery is less invasive, and recovery time is much shorter than it is with knee replacement surgery. The natural knee joint tends to have better range of motion that an artificial knee joint as well.

Therefore, people who wish to preserve the full ability to flex their leg at the knee often choose arthroscopic surgery over knee replacement surgery. Lastly, knee replacement surgery is always an option after one or even several arthroscopic surgeries. Thus, if people do not want to commit to a full knee replacement surgery, they can attempt to fix the problem with arthroscopic surgery.

In some cases, arthroscopic surgery may not be a surgical option. It is possible that disease in the knee joint has progressed to a point that arthroscopic surgery simply cannot fix it. In those cases, patients usually opt for knee replacement surgery or continue with other conservative knee pain treatment options, even if they do not fully relieve symptoms.

The board-certified surgeons at Regional Orthopedics are the area’s leading experts in arthroscopic surgery and knee replacement. If you want to learn more about knee pain treatment options including arthroscopic surgery or knee replacement, schedule an appointment to talk to the orthopedic surgeons at Regional Orthopedics.

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