Understanding Knee Surgery: 8 Knee Surgery Types & Their Benefits

The knee is essential for posture and movement, but its complex structure and the immense forces it endures make it vulnerable to injury. Overuse, trauma, or arthritis can lead to knee pain and instability, affecting your ability to move freely and enjoy daily life.

If you’ve been dealing with persistent knee discomfort or instability, you might be a candidate for knee surgery. Different knee surgery types are available depending on the extent and location of the damage. Explore the common knee surgeries below and see whether they’re right for you.

Anatomy of the Knee

Understanding the knee’s anatomy can help you understand the different knee surgery types available.

Three bones meet to form the knee joint: the thigh, the shin, and the kneecap. These bones form three compartments:

• The inner joint between the thigh and shin bones
• The outer joint between the thigh and shin bones
• The joint between the kneecap and thigh bone

Articular cartilage covers these bones for smooth movement. Two menisci cushion the joint and act as shock absorbers. There are also four main ligaments that keep the knee joint stable.

Knee Replacement

Knee replacement, also called knee arthroplasty, is the surgical repair of the knee joint. This procedure is one of the most effective procedures in orthopedics, with consistently successful results.

It involves removing worn cartilage from the surfaces of joints and resurfacing them with implants made of plastic or metal. It can be total or partial.

You may benefit from knee replacement if you experience:

• Severe knee pain or stiffness that affects daily functioning
• Knee pain even while resting
• Pain, inflammation, or swelling that doesn’t improve with rest or medication
• Bowing in or out of the knee
• No improvement from treatments like injections, physical therapy, or previous surgeries

One of Alexander Orthopaedics’ specialties is robotics-assisted knee surgery. 3D digital modeling eliminates the need for a CT scan and ensures a highly efficient, accurate procedure, plus a precision-matched implant tailored to your unique anatomy. This provides a superior knee replacement experience, leading to quicker recovery and improved long-term outcomes.

1. Total Knee Replacement

In total knee replacement (TKR), the surgeon removes and replaces at least two parts of your knee joint. Individuals who underwent TKR report significant improvements in pain relief, restored function, and quality of life. Other benefits include:

• Improved mobility
• Long-term pain relief
• Enhanced quality of life
• Correction of leg deformity

2. Partial Knee Replacement

In contrast to total knee replacement, partial knee replacement (also called unicompartmental knee replacement) involves resurfacing only one knee joint compartment. Surgeons often opt for this procedure in younger patients (under 50) rather than a TKR.

Because this procedure preserves more of the healthy joint, it can feel more natural than a TKR. It is also less invasive and performed through a smaller incision, offering several benefits over TKR:

• Shorter recovery time
• Less pain after surgery
• Lower risk of infections and blood clots
• Less blood loss

You may not be eligible for the procedure if you have:

• Significant knock-knee or bowleg
• Significant contracture and stiffness
• ACL deficiency
• Obesity
• Inflammatory arthritis

The indications and contraindications for the procedure vary widely. Experts here at Alexander Orthopaedics can help you determine the best method for you.

3. ACL Reconstruction

The anterior cruciate ligament (ACL) is the most frequently injured knee ligament, and are among the most common knee injuries in the U.S., with an estimated 400,000 ACL reconstruction surgeries performed every year.

Tearing your ACL can make your knee “give way” and make you stumble or fall, typically with sidestep or pivoting movements.

ACL reconstruction surgery replaces the torn ACL ligament with graft tissue, either from your own body (typically the kneecap or hamstring tendon) or a donor. The surgeon drills bone tunnels in the tibia and femur, removes the damaged ligament, and positions the ACL graft in its place.

Why is ACL reconstruction necessary?

The main reason why people undergo ACL reconstruction is to restore the knee’s function so they can return to their prior level of activity. The other reason is to reduce the risk of future injuries.

What are the indications of ACL reconstruction?

A surgeon usually recommends ACL reconstruction in the following cases:

• ACL tear combined with other injuries, like other ligament and meniscal tears
• Active adult patients with high activity levels, like those involved in sports
• ACL tear with significant instability, which may lead to damage in other areas of the knee

In children and adolescents, an ACL tear can increase the risk of future cartilage and meniscus injuries. However, surgery may affect the growth plates, potentially leading to bone growth issues. Specific techniques can help avoid the growth plates, reducing these risks. It’s best to consult a surgeon to understand the procedure’s benefits and risks.

4. Meniscus Surgery

The menisci are two c-shaped tough cartilages between the thigh and shin bone. They help stabilize, load-share, absorb shock, and lubricate the knee joint.

Meniscus tears are among the most common sports-related knee injuries. They often occur due to impact from contact sports like football and volleyball but can also result from non-contact injuries. Middle-aged or older adults are also susceptible to meniscus injuries due to degenerative changes in the knee and knee osteoarthritis.

Tears typically occur from twisting or shearing forces, with pressure applied on a bent knee with feet planted, such as during squatting, kneeling, heavy lifting, or sudden stops and changes in direction.

How do I know if I tore my meniscus?

A tear can present in various ways, depending on the mechanism of injury, but common signs include:

• Knee pain, swelling, weakness, or stiffness
• A feeling of the knee giving way
• Feeling a block when trying to move the knee
• Difficulty fully bending or straightening the knee

Types of meniscus surgeries

There are three types of meniscus surgeries. These are typically done using knee arthroscopy:

• Partial meniscectomy: Also called meniscus trimming, this most common meniscus surgery involves removing only the torn part and leaving behind as much healthy tissue as possible. You may be able to immediately bear weight on the knee and move it entirely soon after the injury.
• Meniscus repair: A surgeon may suture (stitch) the damaged portion of the meniscus depending on the condition of the injured meniscus, its location, and the type of tear. Because the torn tissues must heal back together, recovery is longer than for a meniscectomy.
• Meniscus transplant/replacement: This procedure involves replacing torn meniscus with donor cartilage. This surgery is uncommon and follows strict eligibility criteria, including being under 40-45 years old, having little to no arthritis, and having a prior meniscus injury or surgery.

5. Microfracture Surgery

Normal wear and tear or injury can damage the articular cartilage, the smooth tissue covering the ends of bones. Microfracture surgery aims to promote cartilage growth by stimulating a new blood supply.

This procedure is used for small areas of damage and is done arthroscopically. The surgeon removes the damaged cartilage and makes tiny holes in the bone to trigger a healing response. This encourages new blood flow and helps bring in healthy cartilage cells for repair.

6. Lateral Release Knee Surgery

Patellofemoral pain syndrome (PFPS) is a catch-all term for pain around the kneecap. It’s also called runner’s or jumper’s knee because this condition is common among individuals participating in sports.

Pain from PFPS can occur when the kneecap is out of place, so it doesn’t sit properly in its groove. Because of this, the kneecap doesn’t glide efficiently over the groove, leading to irritation caused by pressure between its back and the bone behind it (trochlea).

If the fibrous tissue on the outer side of the kneecap (lateral retinaculum) is tight and pulling the kneecap out of alignment, a lateral release surgery can be performed. This arthroscopic procedure involves cutting the tissue to reduce tension and realigning the kneecap for smoother movement.

7. Plica Removal

A plica is a thick tissue band extending from the protective membrane surrounding the joint (synovial capsule). It can become inflamed or irritated from injury or overuse, leading to plica syndrome.

You may have plica syndrome if you experience knee pain with clicking or popping sounds. Other common symptoms include:

• Painful catching sensations inside the kneecap
• Tenderness on the inner side of the knee
• Instability when walking
• Swelling in the knee

Cases that don’t respond to conservative treatments may benefit from surgical resection of the plica via arthroscopy.

Arthroscopic vs. Open Knee Surgery

Knee surgery can be performed either as traditional open surgery or minimally invasive arthroscopic surgery. The key difference is the incision size: arthroscopic surgery uses small incisions, about the size of a quarter, while open surgery requires larger incisions to access the knee.

The small incisions in an arthroscopic surgery offer several advantages, including:

• Faster recovery time
• Minimized damage to normal structures around the joint
• Less post-surgical pain
• Reduced risk of complications, like infections and blood loss
• Fewer scarring

Your surgeon may choose open surgery if arthroscopy doesn’t provide enough access to the joint or if the case is complex, such as severe joint damage or multiple injuries. Open surgery offers a clear view and more space to repair extensive damage or fit larger pieces.

How to Know Which Type of Knee Surgery Is Right for You

Choosing the right knee surgery depends on several factors, including your condition and overall health. Some procedures also have specific eligibility criteria.

Knee surgery is highly personalized, so it’s essential to consult with an orthopedic specialist to explore the best non-surgical and surgical options for pain relief and function restoration. They’ll create a tailored treatment plan based on your goals, needs, and lifestyle for a smoother recovery and return to daily activities.

There are also things you must consider before undergoing knee surgery, including the importance of physical therapy, home preparation for recovery, and having a strong support network.

Recovery and Rehabilitation Post Knee Surgery

The recovery and rehabilitation after a knee surgery varies widely from person to person based on the type of surgery and individual factors like age and overall health.

Typical Recovery Time

After a total knee replacement, you may stay in the hospital for 1 to 4 days, though some outpatient procedures allow you to go home the same day. Complete recovery may take up to a year, but most people return to daily activities within six weeks.

Meanwhile, knee arthroscopy recovery time can take 2 to 3 months for most patients. However, this timeframe still varies from person to person and on the type of procedure done.

Tips for Faster Recovery

Your knee needs to take time to heal after surgery. However, you can take some steps to shorten it:

• Take pain medications: After surgery, your surgeon will provide you with a pain relief regimen to help manage post-op pain as the anesthesia wears off. Some medications can be addictive and should only be taken as directed by your doctor. Tell your doctor if pain persists—they may prescribe more potent pain relievers.
• Rest, Ice, Compress, Elevate (RICE): Rest and give your knee the time to heal. While swelling is a natural response to injury, it can also delay healing. Cold therapy and compression garments can help resolve swelling and inflammation in the surrounding tissues. Icing also numbs the nerve endings in the affected area, helping relieve pain. Elevating your legs lets gravity assist in returning the excess fluids drain toward the heart.
• Exercise and physical therapy: Moving as early as possible can help speed recovery, reduce blood clots, and lessen post-operative pain. Physical therapy also helps improve blood circulation, reduce tissue swelling, slowly improve the range of motion and flexibility of your joint, prevent scar tissue formation, regain muscle strength, and improve balance and gait.
• Use your medical device: Your surgeon may give you a knee brace after surgery to help protect and stabilize your knee. In addition to the knee brace, your surgeon may recommend using crutches or canes to aid your recovery. Follow your doctor’s guidelines on their use and use them even if you already feel strong—these devices will give your new joint the support as it heals
• Maintain a healthy lifestyle: Eating a balanced, nutritious diet, staying active, and getting quality sleep are crucial for healing. Foods like fatty dishes and other omega-3 rich foods are also good for joint health.
• Keep a healthy weight: Maintaining a healthy weight is also important, as excess weight can strain the knee joint. Managing weight post-surgery can improve joint function, extend implant life, and reduce the need for revision surgery while lowering the risk of complications and enabling more physical activities.

As your recovery progresses, your needs may change, so consult a specialist for personalized advice on activities

Frequently Asked Questions about Knee Surgery

What is the least invasive type of knee surgery?

Arthroscopy is the least invasive type of knee surgery. It involves using a small incision to insert an arthroscope, a tube with a light and camera that allows the surgeon to view the joint through a monitor. Additional tools are inserted into the knee through another incision to perform a procedure.

What are the newest alternatives to knee replacement?

New alternatives to knee replacement surgery focus on regenerative treatments that relieve arthritis pain and support the body’s natural healing. These include options like platelet-rich plasma (PRP) injections, stem cell therapy, and autologous chondrocyte implantation (ACI).

As with any treatment, it’s essential to consult an orthopedic specialist to determine whether these options suit your condition.

What is the most painful knee surgery?

Total knee replacement is often considered the most painful knee surgery due to large incisions, cutting of tissues, joint surface removal, and extensive bone reshaping. However, post-operative pain can usually be managed with a personalized pain control plan, and most people can go back to doing normal activities within three to six weeks.

What knee surgery has the shortest recovery time?

Compared to traditional open surgery, arthroscopic procedures have a shorter recovery time, with most patients discharged on the same day of their surgery.

At what age do people typically get a knee replacement?

There is no set age limit for TKR surgery. However, the average age of patients getting TKR is 67 years old. Surgeons often don’t recommend them to people under 60 because younger individuals may wear out the implant due to their activity level, and the limited lifespan of implants (15 to 20 years) may mean they’ll need to have it replaced again.

Can knee surgery be done on an outpatient basis?

Most knee surgeries can be done on an outpatient basis thanks to minimally invasive procedures that allow patients to go home after their surgeries. Even total knee replacements can be done as an outpatient surgery, like what we do at Alexander Orthopaedics.

Explore your knee surgery options with our specialists. Contact us today to start your journey to pain-free movement.

Our experienced orthopedic specialists at Alexander Orthopaedics can offer guidance so you can make informed decisions about your care, whether you’re considering knee surgery or exploring alternative treatments to keep your knees healthy and pain-free.

If you’re ready for knee surgery, you can trust that Alexander Orthopaedics is fully committed to restoring your health and lifestyle. The Alexander Outpatient Advantage is our signature feature that sets us apart—combining a cutting-edge orthopedic surgery center with the comfort of home recovery, helping you get back to your normal life faster. Schedule a consultation with us today.