Knee Procedures

Total Knee Arthroplasty or “knee replacement” is a very successful surgery for patients with severe osteoarthritis of the knee.   Osteoarthritis is the wearing away of the articular cartilage.  This condition causes increased pain with weight-bearing and activity.  For patients who have failed conservative treatments including prescription medications, injections, and activity modification, knee replacement can restore pain-free function.  Dr. Bushnell can evaluate you to determine if you need a knee replacement or if non-operative treatment may be better for you.

For more information on Total Knee Arthroplasty/Knee replacement, please visit:

Total Knee Replacement (AAOS Orthoinfo)
Total Knee Replacement (AAOS Orthoinfo) Spanish
Artificial Joint Replacement of the Knee (AAOS Orthoinfo)

Knee Replacement Surgery Video (YouTube)

Knee Replacement Surgery Video (AAOS OrthoInfo)

Knee meniscectomy is the most common surgical procedure performed on the knee.  A meniscus tear can occur as an acute injury or through degeneration.  Patients usually experience pain with weight-bearing, squatting, and twisting.   Meniscectomy is performed as a minimally invasive surgery using knee arthroscopy.  The meniscus is trimmed and smoothed with small instruments through 2 small stab incisions in the knee.  Patients usually recover quickly and completely.

Dr. Bushnell has advanced training in arthroscopic treatment of knee injuries.

For more information about Knee Meniscectomy, please visit:

Meniscal Tears (AAOS OrthoInfo)
Meniscal Surgery (E-Orthopod)

Articular cartilage injuries of the knee are characterized by pain and sometimes mechanical symptoms such and catching or locking.  After MRI evaluation, a more detailed exploration by knee arthroscopy is often performed.  The area of missing articular cartilage is examined and unstable pieces are trimmed.   Then, multiple small channels are placed into the bone to allow bone marrow and its accompanying stem cells to flow into the knee.  This matrix of cells ultimately heals as fibrocartilage and covers the exposed bone.  Range of motion exercises are begun immediately, but weight-bearing is restricted up to 8 weeks.  Full recovery may take several months to one year.  Microfracture was invented by Dr. Richard Steadman – the patriarch of the Steadman-Hawkins Clinic in Denver, Colorado, where Dr. Bushnell received his fellowship training.

For more information about Knee Microfracture, please visit:

Microfracture (Steadman Clinic)
What’s New in Cartilage Repair (AAOS Orthoinfo)
What’s New in Cartilage Repair (HSS)

Articular cartilage injuries of the knee are characterized by pain and sometimes mechanical symptoms such and catching or locking.  After MRI evaluation, different methods of cartilage repair are discussed.  Depending on the size of the cartilage lesion, age of the patient, and activity level, a surgical plan is developed.  Dr. Bushnell has advanced training in cartilage repair and can help determine the best treatment option for your specific injury.

For more information about cartilage repair of the knee, please visit:

Articular Cartilage Restoration (AAOS OrthoInfo)
What’s New in Cartilage Repair (Hospital for Special Surgery)
Advances in Articular Cartilage Defect Manegement (Mayo Clinic)

The medial patellofemoral ligament (MPFL) can be torn with a dislocation of the kneecap.  In some cases, patients may have suffered multiple dislocations over time.  Although tears of this ligament can sometimes heal in a brace, many cases will require ligament reconstruction – especially if the patient has suffered recurrent dislocations.  Dr. Bushnell offers a minimally-invasive technique for MPFL reconstruction, based on a method developed by his senior partner, Dr. Christopher Piller.  This surgical technique uses a cadaver ligament to rebuild the ligament on the inner side of the knee, stabilizing the patella and allowing the patient to return to full function and athletic participation.

For more information about MPFL reconstruction, please visit:

• MPFL Reconstruction (YouTube Video)

A torn or ruptured tendon at the knee can prevent a person from working or playing sports and even make normal walking impossible.  Knee tendon repair can be performed through a minimally-invasive incision using suture anchors to repair the torn tendon back down to the bone.  Dr. Bushnell is an internationally-published authority on the repair of tendons in the knee.

For more information about Knee Tendon Repair, please visit:

Patella Tendon Tear

Quadriceps Tendon Tear

Suture Anchor Repair of the Patellar Tendon (A Paper by Dr. Bushnell)

The ACL is the most commonly torn ligament in the knee.  When the ACL is torn in a young, active person, surgery for reconstruction of the ligament is usually required.  Dr. Bushnell has extensive training and experience in treatment of ACL injuries, including several techniques of ACL reconstruction.  Dr. Bushnell most commonly performs ACL reconstruction using the hamstring tendon technique, but he also performs patellar tendon and cadaver tendon reconstructions.

For more information about ACL Reconstruction, please visit:

ACL Injury: Does it Require Surgery?

ACL Reconstruction with Hamstrings (Video)

Animated Surgical Procedures

A meniscus tear can occur as an acute injury or through degeneration.  Patients usually experience pain with weight-bearing, squatting, and twisting.   The decision to repair a torn meniscus is based on several factors including patient age and location of the tear.   Meniscus repair is performed as a minimally invasive surgery using knee arthroscopy.  The meniscus is sutured with specialized, small instruments through 2 small stab incisions in the knee.  Recovery is longer as weight-bearing and activity restrictions are placed on the patient to allow the meniscus to heal.  Dr. Bushnell has advanced training in arthroscopic treatment of knee injuries.

For more information about meniscus repair, please visit:

Meniscus Repair (WebMD)
Meniscus Repair (AAOS OrthoInfo)

In knee arthroscopy, the surgeon inserts a small video camera (a “scope”) into the knee through a poke-hole incision.  A second poke-hole incision is made to insert various tools.  The surgeon can “tour” the knee and make definitive diagnosis of various different injuries and conditions.  Using arthroscopy, the surgeon can repair ligaments, clean out or repair cartilage, remove debris, or perform other procedures.

For more information about Knee Arthroscopy, please visit:

Knee Arthroscopy

Knee Arthroscopy (Spanish)