Minimally invasive solutions for meniscus and cartilage damage.
The knee is amenable to many keyhole operations, with the most common injuries being to the floppy cartilage in the middle of the knee, the meniscus, or the cartilage that lines the ends of the bones at the joint.
When we are younger these structures can be repaired, but if its part of more advancing arthritis then treatment is aimed at keeping your joint going for as long as possible prior to needing a replacement.
Keyhole surgery for meniscal tears
Historically the meniscus was removed if it was causing problems, but that led to early arthritis so we now try to preserve as much of the meniscus as possible with varying repair techniques.
Meniscal injuries in younger patients are different to meniscal injuries as we get older.  Younger sporting displaced meniscal tears often need repair, whilst tears as we get older are often part of arthritis.  Mechanical symptoms such as significant clicking or locking of the knee may warrant keyhole surgery to help with the symptoms, but meniscal tears with early underlying arthritis and without locking symptoms can be eased with injections.
Keyhole surgery for cartilage injuries.
Cartilage injuries are like meniscal injuries, with a difference between younger and older patients. Younger patients often have smaller cartilage lesions from a sudden injury, whereas as we get older we often have more generalised cartilage loss from arthritis. Â
The smaller localised lesions can be managed with cartilage augmentation procedures.  Many years ago, we used to drill holes in the bone to stimulate a form of scar tissue over the lost cartilage, but the type of cartilage that covered the bone wasn’t of great quality.  More modern techniques such as harvesting your own cartilage, which is then mixed with platelet plasma or moving a cartilage core from one site to another, aims to grow new cartilage in these defined areas.  
For more widespread cartilage loss, we can smooth the remaining cartilage, but keeping within a healthy weight, keeping the joint strong and the occasional use of injections or radiofrequency ablation may be the best option until you need a joint replacement.
