A minimally invasive procedure, surgeons perform loose body removal to remove fragments of bone, cartilage, or other loose tissue from the knee joint. Loose bodies can cause a patient a great deal of pain and discomfort with movement and even at rest. Often, loose bodies form from previous injuries to the knee joint or degenerative arthritis of the knee over time. Loose bodies may also derive from scar tissue following previous surgeries of the knee. Surgeons may also perform loose body removal during joint arthroscopy to treat many knee conditions including torn meniscus, osteochrondritis dissecans, or recurrent patella dislocation.
Symptoms of Loose bodies in the knee
Individuals who participate in recreational activities or work in physically rigorous jobs put themselves at risk for developing loose bodies in the knee. Patients suffering from loose bodies may not have the ability to fully flex or extend the leg without pain. All patients process pain differently so symptoms may vary. Many patients suffering from loose bodies within the knee joint often report symptoms of:
- Knee pain
- Knee swelling
- Pain with movement
- Catching or locking of the knee
Diagnosing loose bodies within the knee
Patients experiencing any symptoms related to loose bodies within the knee should seek medical attention from an orthopedist. If left untreated, loose bodies within the knee may cause further damage to the surrounding tissues. If a patient has knee pain, the patient should see an orthopedic knee surgeon. Even if the patient does not think that they have a serious issue, they should seek medical attention in order to rule anything out. When seeing an orthopedic knee specialist, the physician starts with a physical examination. The physician asks the patient about their medical history and then asks about their day to day activities. To diagnose loose bodies within the knee, surgeons use diagnostic testing. Physicians typically start with an Xray of the knee because loose bodies often contain bone and cartilage which XRays detect. Other forms of diagnostic testing that a physician may use include CT scans, MRI, and arthrography.
How to perform loose body removal
Surgeons typically perform loose body removal in the knee with the patient under either local or general anesthesia depending on the severity. With a patient under local anesthesia, the patient remains in a twilight stage. In a twilight stage, the patient remains awake but cannot feel the pain. With the patient under general anesthesia, the anesthesiologist puts the patient to sleep for the duration of the procedure. The anesthesiologist then wakes the patient up once the surgeon completes the surgery. Two main types of surgery exist for removing loose bodies. The most common way, arthroscopically, surgeons use an arthroscopic approach to perform loose body removal surgery. Using an arthroscopic approach means that the surgeon performs the procedure minimally invasively. The surgeon starts with making two to three small keyhole incisions in the knee of the patient. The surgeon uses these keyhole incisions to view the surgical area and remove the loose bodies. Through one of the portals, the doctor fills the knee with a saline solution. A sterile solution, saline helps the knee expand and gives the surgeon better vision of the knee and loose bodies. Once the surgeon locates the loose bodies within the knee, the knee surgeon uses a tool called a grabber to remove the loose bodies from the knee joint. Once the surgeon removes all loose bodies, the surgeon closes the portals and that completes the procedure.
The second surgical option, called an arthrotomy, does not get performed often. A surgeon may perform an arthrotomy when the patient has large loose bodies. Large loose bodies may not fit through the small portals associated with arthroscopy. During an arthrotomy, the surgeon must make larger incisions.
What is recovery like from a loose body removal surgery?
Following either procedure, the physician may recommend that the patient participates in a physical therapy regimen. Physical therapy can help the patient regain some of the previously lost range of motion and help ensure that scar tissue does not form within the joint following surgery.
EXPERIENCING KNEE PAIN? CALL 817-375-5200 TO SCHEDULE AN APPOINTMENT WITH AN AOA ORTHOPEDIC KNEE SPECIALIST TODAY