Arthroscopy is a common surgical procedure in which a joint is viewed by means of a small camera. The camera is inserted after the surgeon makes a small incision. The arthroscope allows the orthopedic specialist a clear view inside the knee to help diagnose and treat knee conditions.
Technological medical advances have afforded our surgeons high resolution cameras and high definition monitors. These and other advancements have made arthroscopic knee surgery an effective means for repairing damage to the knee and treating common knee problems.
What is involved with knee arthroscopy?
During an arthroscopic knee procedure, your orthopedic surgeon will insert a small camera instrument the size of a pencil into your knee joint. This device is called an arthroscope and it sends the image of the inside of your knee to the TV monitor the doctor watches. On this monitor, he can see the knee structures in great detail. This allows him to feel, remove, and repair damaged tissues and structures.
How do I prepare for this surgery?
Be assured, almost all knee arthroscopies are done on an outpatient basis. If your doctor recommends a knee arthroscopy, you may need to undergo a complete physical examination with your family doctor prior to the surgery. He will check your health status and identify any problems that would interfere with the procedure. Before surgery, you should tell the orthopedic specialist about any medications or supplements you are taking. He may tell you to stop taking these a few days before the procedure. You can expect that your surgeon will order some pre-operative tests before the surgery, too. These may include blood counts, X-Rays, and electrocardiogram (EKG).
What type of anesthesia will the surgeon use?
When you arrive to the outpatient surgery center, a member of the anesthesia team will want to speak with you. Knee arthroscopy can be done under regional or general anesthesia. While local anesthesia alone can be used for knee arthroscopy, it is not recommended because of more discomfort during the procedure and the lack of relaxation of the muscles during the procedure which you do get with regional or general anesthesia. Regional anesthesia will numb you below your waist and general anesthesia puts you to sleep. The anesthesiologist will help you decide which type of anesthesia is best for you.
What can I expect during the procedure?
After you receive your anesthesia, the orthopedic specialist will make a few small incisions in your knee. Then, he will inject a sterile solution into the knee joint to rinse away any cloudy fluid that will obscure his view. First, the surgeon will introduce the arthroscope into the knee and use the TV monitor to guide him.
If your doctor sees that surgical repair is necessary, he will insert tiny instruments through other small incisions to do this. These could include scissors, graspers, and motorized shavers. Overall, the procedure generally lasts around 30 minutes to an hour. How long it takes really depends on what the surgeon finds and the treatment that is necessary.
Your surgeon will close your incisions with stitches or Steri-Strips and cover them with a dry, clean bandage. You will be moved to a recovery area for about an hour before being released. You will need to have someone there to drive you home.
Knee arthroscopy is most commonly used for:
Removal or repair of torn meniscal cartilage
Removal of loose fragments of bone or cartilage
Reconstruction of a torn anterior cruciate ligament
Trimming of torn pieces of articular cartilage
Removal of inflamed synovial tissue
What can I expect during the recovery period?
You will recover from arthroscopic knee surgery quicker than from traditional open knee surgery. It is very important for you to follow your orthopedic surgeon’s instructions carefully after you go home.
Dressing Care – When you leave the hospital, you will have a dressing covering your knee. Be sure to keep this clean and dry. Your surgeon will tell you when it is alright to bathe or shower and when and how to change the dressing. Don’t remove the stitches or Steri-Strips.
Swelling – Keep your leg elevated as much as possible for the first couple of days after your arthroscopic knee procedure. You can apply ice as recommended by your doctor to relieve pain and swelling.
Bearing Weight – Most patients will not need crutches or a cane after knee arthroscopy. Your orthopedic specialist will tell you when you are to put weight onto the leg and foot.
Driving – Your doctor will tell you when you may drive. This decision will be based on several things, including your level of pain, the nature of your procedure, the knee that is involved, whether you have a stick shift or automatic car, and how well you can control your knee. Generally, patients can drive within a few days after this procedure.
Medications – Your doctor will give you medications to help relieve discomfort following your knee arthroscopic procedure. Sometimes, a medication like aspirin is recommended to lessen your risk of blood clots.
What exercises can I do to strengthen my knee?
Your doctor will recommend an exercise program for you following your arthroscopic knee surgery. This is done to restore motion and strengthen the muscles of your knee and leg. Therapeutic exercises are important for a speedy recovery. Sometimes, the surgeon finds it necessary to set you up for formal physical therapy to improve your final result.
When can I get back to my normal routine?
Typically, you are able to return to your normal physical activities within 4 to 8 weeks. Higher impact activities, such as running and aerobics, may need to be avoided for a longer periods of time. You will need to discuss this with your orthopedic specialist to make sure you don’t further damage your knee joint. The final outcome of your surgery is largely determined by the degree of damage to your knee.