Knee arthroscopy is a surgical procedure used to diagnose and treat problems in the knee joint. A fibre optic telescope is inserted through two or three small incisions around the knee joint. The telescope is connected to a video monitor via a fibre-optic cable. The procedure allows a clear view of the whole of the knee joint. Photos or videos of the procedure are recorded and may be printed out or viewed on a computer.
Indications of knee arthroscopy
The procedure is performed for the following reasons:
- Repair or removal of a meniscal tear (“torn cartilage”)
- Repair or removal of damaged or unstable articular hyaline cartilage
- Removal of loose bodies (cartilage or bone)
- Reconstruction of an anterior cruciate ligament
- Multi ligament reconstruction
Knee arthroscopy is performed at our operating theatre in Melbourne as a day procedure. Patients are required to fast for at least six hours before the surgery and to arrive at the hospital a few hours prior to the procedure being done.
The operation generally takes around thirty minutes. At the end of the procedure the orthopaedic surgeon will close the two or three small incisions in the skin using a suture or steri-strips. Local anaesthetic is placed into the knee and into the small wounds to make them numb. Dressings are then applied and a large bandage is then placed on the knee.
For this procedure a general anaesthesia is administered by a specialist anaesthetist. Sometimes regional anaesthesia is used (spinal anaesthetic).
After the procedure the patient will be taken to the recovery room for a brief period. Most patients are able to go home within one or two hours of their knee arthroscopy. Patients need to be taken home by a family member or a friend when they are discharged from hospital.
Recovery from surgery is usually rapid. Rest and elevation are particularly important for the first day or two to reduce swelling and pain. Ice or cold packs are also useful to help to decrease swelling. The incisions and the dressing over the knee need to be kept clean and dry. The outer crepe bandage and Velband (padding) may be removed after the third day but the waterproof dressings must be left intact until the patient is seen for post-operative visit.
Pain medication is given to the patient on discharge from hospital. Generally, the pain is minimal after knee arthroscopy.
Gentle exercises can begin once the swelling and the pain has decreased.
After the first week exercises and physiotherapy can be commenced. Driving is generally safe one week following the procedure. Returning to work and returning to sport will occur under the guidance of the surgeon and sometimes a physiotherapist.
Patients will attend for a follow up visit at the Knox Orthopaedic Group consulting rooms in Melbourne one to two weeks after the procedure. A specialist nurse will remove the dressings and check the wound. The treating orthopaedic surgeon will also assess the patient’s progress.
Risks and Complications of Knee Arthroscopy
Complications are rare following this procedure. Potential post-operative problems include:
- bleeding (haemarthrosis)
- blood clots (deep venous thrombosis)
These are not common, but may need urgent attention. The patient should contact the orthopaedic surgeon immediately if any of the following symptoms occur:
- Warmth or redness around the knee
- Fever, sweats or shakes
- Significant pain not responding to rest, elevation and simple painkillers
- Pain in the calf muscle at the back of the knee
The outcome of knee arthroscopy depends on what the orthopaedic surgeon has found within the knee joint and the degree of damage present in the knee. If there are significant degenerative changes to the knee joint (osteoarthritis) full recovery may not occur. Most patients who have meniscal tears or simple removal of loose bodies make a full and complete recovery following surgery.