The arthroscope is a fibre-optic telescope that can be inserted into a joint (commonly the knee, shoulder and ankle) to evaluate and treat a number of conditions. A camera is attached to the arthroscope and the picture is visualized on a TV monitor. Most arthroscopic surgery is performed as day surgery and is usually done under general anesthesia. Knee arthroscopy is common, and millions of procedures are performed each year around the world.
Indications for Arthroscopy
- Torn floating cartilage (meniscus): The cartilage is trimmed to a stable rim or occasionally repaired
- Torn surface (articular) cartilage
- Removal of loose bodies (cartilage or bone that has broken off) and cysts
- Reconstruction of the Anterior Cruciate ligament
- Patello-femoral (knee-cap) disorders
- Washout of infected knees
- General diagnostic purposes
Arthroscopy in Arthritic knees
Not all patients with scans of their knees that show meniscal (cartilage) tears require arthroscopy. If the arthritis is severe you are likely to be recommended to wait and see how the pain settles down over a number of weeks. If there is a sharper mechanical type pain then your surgeon may still recommend arthroscopy. If there is a generalised aching pain then it is most likely an exacerbation of the arthritic pain and arthroscopy is unlikely to assist in your recovery.
Knee Arthroscopy: Patient Information
Please stop taking Aspirin and Anti-inflammatory medications 5 days prior to your surgery. You can continue taking all your other routine medication. If you smoke you are advised to stop a few days prior to your surgery.
You will be admitted on the day of surgery and need to remain fasted for 6 hours prior to the procedure.
The limb undergoing the procedure will be marked and identified prior to the anesthetic being administered.
Once you are under anesthetic, the knee is prepared in a sterile fashion. A tourniquet is placed around the thigh to allow a ‘blood – free’ procedure.
The arthroscope is introduced through a small (1.5cm) incision on the outer side of the knee. A second incision on the inner side of the knee is made to introduce the instruments that allow examination of the joint and treatment of the problem. Your surgeon will then perform the required surgery. This will take between 10 and 30 minutes.
Post-operative Recovery
- Pain medication will be provided and should be taken as directed
- You can remove the bandage in 24 hours and place waterproof dressings (provided) over the wounds.
- It is normal for the knee to swell after the surgery. Elevating the leg when you are seated and placing ice packs on the knee will help to reduce swelling.
- You are able to drive and return to work when comfortable unless otherwise instructed.
- Please make an appointment 7-10 days after surgery to monitor your progress and check your portal wounds
Risks related to arthroscopic knee surgery include
- Postoperative bleeding – usually will require a pressure dressing and change of dressings. Can lead to painful bleeding into the knee which will slow recovery
- Deep Vein Thrombosis – is rare and as you will mobilise immediately after the surgery no prophylaxis is required. Please notify your surgeon if you are at high risk of clots for any reason
- Infection
- Stiffness
- Numbness to part of the skin near the incisions
- Injury to vessels, nerves and a chronic pain syndrome
- Progression of the disease process
Post-Operative Exercises and Physical Therapy
Following your surgery you will be given an instruction sheet showing exercises that are helpful in speeding up your recovery. Strengthening your thigh muscles (Quadriceps and Hamstrings) is most important. Swimming and cycling (stationary or road) are excellent ways to build these muscles up and improve movement.
