What is Knee Arthroscopy?
Knee arthroscopy is an operation that uses a specially designed telescope called an arthroscope. This is inserted into your knee through a small incision (“key-hole” surgery).
The arthroscope utilizes a digital camera through which the inside of your knee can be thoroughly inspected. If needed, any necessary procedures (e.g. removing torn cartilage, ligament reconstructions) can be carried out at this time through separate small incisions.
When is this operation helpful?
There are two main reasons to have a knee arthroscopy:
- To repair or remove damaged structures in the knee. This may include removing torn pieces of cartilage or meniscus (the knees shock absorbers), removing loose pieces of cartilage or bone, repairing a torn meniscus or damaged cartilage or cleaning out infection within the knee joint
- To confirm the clinical diagnosis and to assess the quality of the remaining structures inside the knee joint. This is not a common reason to undergo knee arthroscopy surgery
Knee arthroscopy may be of benefit if you have symptoms such as catching, locking, swelling or persistent pain to a localized area of the knee. Knee ligament reconstruction can also be performed using arthroscopic techniques and is described separately.
What happens on the day of your operation?
On the day of your operation you will be admitted to the hospital day-surgery unit. Your surgeon will visit you before the operation and mark the affected knee with an ink marker. Your anaesthetist will also visit you before the operation. You will be given a surgical gown to change into, and you will then be transferred to the operating room.
After you have received your general (full) anaesthetic, a tight band (tourniquet) will be placed around your upper thigh to prevent bleeding during the operation. Sterile drapes are placed around the operated leg once it has been painted with disinfectant.
Usually 2 small incisions are made for this operation. The arthroscope is introduced into the knee joint through one incision. The surgical instruments needed for the operation are inserted through the other incision. Photographs are taken during the operation and your surgeon will discuss these with you at your post-operative visit.
Once your operation is completed your knee will be injected with local anaesthetic to reduce the pain you experience immediately after the operation. Sutures (stitches) or surgical tape (“steristrips”) will be used to close the incisions. Your knee will then be wrapped with sterile bandages.
You will wake up in the recovery ward where you will be closely monitored until you are ready to return to the day surgery unit. Here you will continue to be observed until you are fully awake.
A physiotherapist or trained nurse will spend time with you to teach you how to walk safely, and give you exercises for you do at home to help regain your knee movement and keep the strength in the muscles around your knee. Generally, you will not require crutches or walking aids. You will be discharged home once you are walking safely and have recovered from the effects of the anaesthetic. You will need to arrange to have a responsible adult take you home, as you will not be permitted to drive following an anaesthetic.
What happens after you go home?
Unless instructed otherwise by your surgeon, you will be allowed to put all of your weight through the operated leg. You must leave your bandages in place for 48 hours. You should then apply a compression stocking (“Tubigrip”) to your knee to assist in swelling reduction. This will be provided for you upon discharge from the hospital.
Ice should be applied to the knee for 20 minutes every hour whilst you are awake. This is excellent in reducing pain and assists in minimising swelling. Ice should also be applied for 20 minutes after performing your exercises.
You will be able to wash your leg but care should be taken to ensure that the wounds are kept dry. If your dressings fall off or you notice a significant amount of blood soaking through, the incisions should be re-covered with a new waterproof dressing. During the first post-operative week your knee may be swollen and stiff. It is also normal to require regular pain medication during this period.
You will have been given an instruction sheet with series of exercises whilst in hospital. It is very important that you perform these exercises regularly whilst at home. A copy of your exercise sheet with post-operative instructions can be downloaded from this web site.
A post-operative visit to your surgeon will be organised approximately 10-14 days following your surgery.