Knee Arthroscopy
Knee arthroscopy is a surgical procedure that employs a miniature camera to examine the inside of the knee. The surgeon makes small cuts to insert the camera and surgical instruments into the knee joint. During the procedure, the arthroscope transmits pictures of the knee joint to a video monitor, which guides the surgeon in using miniature surgical tools. Because the surgical instruments and arthroscope are slender, the surgeon can make tiny incisions instead of larger incisions required for open surgery. Consequently, patients experience less pain and joint stiffness, and their recovery time is often shorter. If nonsurgical treatments such as rest, physical therapy, and medications have failed, a doctor may recommend knee arthroscopy. The procedure can alleviate painful symptoms of many knee problems that damage the cartilage surfaces and soft tissues surrounding the joint.
Diseases treated
Arthroscopy is a recommended procedure for various knee problems, which may include:
- A torn meniscus, which refers to the cartilage that cushions the space between bones in the knee. Surgery may be necessary to repair or remove it.
- A torn or damaged anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL).
- A swollen or damaged synovium, which is the lining of the joint.
- A misaligned kneecap (patella).
- Small broken pieces of cartilage within the knee joint.
- Removal of a Baker cyst, which is a fluid-filled swelling behind the knee. Sometimes, this occurs due to inflammation and pain from other conditions, such as arthritis.
- Repairing a defect in cartilage.
- Certain fractures in the bones of the knee.
Preparation
for Knee Arthroscopy
Before your knee arthroscopy, your orthopedic surgeon may recommend that you see your primary doctor for a general health check-up to ensure that there are no underlying health issues that could impact the surgery. If any health risks are identified, further evaluation may be required. Preoperative tests such as blood tests or an electrocardiogram may be ordered to help plan the procedure. If you are generally healthy, you can expect the surgery to be an outpatient procedure, meaning you will not need to stay overnight in the hospital. It is important to let your surgeon know about any medications or supplements you are taking, as you may need to stop taking them before the surgery. The hospital or surgery center will provide you with specific details about your procedure and when to arrive. The anesthesia team will discuss with you the different types of anesthesia that can be used during the surgery, including local anesthesia, regional anesthesia, or general anesthesia. Your surgeon and anesthesiologist will help you decide which method is most appropriate for you.
Knee Arthroscopy
Procedure
After being brought into the operating room, anesthesia will be administered to you. Your knee will be cleaned to prevent infection, and then surgical draping will be used to expose the area where the incision will be made. Sometimes, a positioning device will be placed on your leg to help keep your knee steady during the procedure. The surgeon will make small incisions called portals in your knee, and a sterile solution will be used to rinse the cloudy fluid from your knee joint. This will enable the surgeon to get a clear and detailed view of the structures in your knee with an arthroscope. If surgical treatment is required, small instruments will be inserted through other incisions. Specialized instruments will be used for tasks such as shaving, cutting, grasping, and meniscal repair. Stitches or steri-strips may be used to close the incisions, and a soft bandage will be wrapped around your knee. If necessary, braces may be used to protect a repair or reconstruction.
After the procedure, you will be moved to the recovery room and should be able to go home within 1 or 2 hours. It is important to have someone drive you home and check on you that first evening. While recovery from knee arthroscopy is faster than traditional open knee surgery, it is important to follow your doctor’s instructions carefully after you return home. You should regularly exercise your knee for several weeks after surgery, as this will help restore motion and strengthen the muscles of your leg and knee. A formal physical therapy program may also help improve your final result.
Benefits
of Knee Arthroscopy
The duration and extent of your recovery after arthroscopy will depend on the specific damage to your knee. In most cases, if you did not have ligament reconstruction, meniscus repair, or cartilage restoration, you should be able to resume most physical activities within 6 to 8 weeks or possibly sooner, but you may need to avoid high-impact activities for a while. If your job involves heavy work, it may take longer for you to return to work, and you should discuss with your doctor when it is safe to do so. In some cases, lifestyle changes may be necessary to protect the joint, such as switching from high-impact exercises to lower impact activities, and your surgeon will provide guidance in making these decisions. Sometimes, the damage to your knee can be significant enough that it cannot be completely reversed with arthroscopic surgery. More extensive operations may be needed in the future for these more severe conditions.
