How is knee arthroscopy LOA performed?
Sedation with regional anesthesia is most often used for this procedure. Knee arthroscopy lysis of adhesions uses surgical tools and a small camera called an arthroscope. The knee is inflated with fluid to provide greater space and access within the joint for the procedure. Small incisions are made in the knee which allows for the arthroscope to project images of the injury onto a monitor. Adhesions are identified and then debrided with a surgical device called an arthroscopic shaver. Any areas of abnormal constraint or connection are released. Often an arthroscopic radiofrequency device is used for soft tissue release and vessel cautery during LOA. A lateral retinaculum release may be done as part of an LOA. This means the ligaments on the outer side of the knee are loosened for patients who experience limited patellar (kneecap) mobility. Improved patella mobility and excursion is a major goal of lysis of adhesions. Upon completion of the needed soft tissue releases, the knee is manipulated to confirm increased range of motion and normal stability.
As a note, more severe cases of arthrofibrosis may require a small incision to fully excise all of the scar tissue present. This is a judgment call that is determined by findings at the time of surgery. Fortunately, the need for open surgery does not change the postoperative management of affected patients.