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Knee arthroscopy is a technique used
to inspect the inside of the joint cavity to diagnose and assess damage
and, where possible, to treat this damage. Arthroscopic knee surgery
involves a small telescope, video equipment and instruments. Arthroscopic
knee surgery is used to treat any number of conditions that occur
within the knee from simple cartilage tears to removal of loose bodies
and anterior cruciate ligament reconstruction. At the same time all
of the other structures within the knee can be clearly viewed and
probed.
« A diagram of arthroscopic knee surgery»
Arthroscopic knee surgery requires a hospital operating theatre and
is usually performed as day case surgery. arthroscopic knee operation
is normally done under a general anaesthetic but may be done under
epidural, spinal or occasionally a local anaesthetic if necessary.
Typically the patient might come into hospital shortly before the
arthroscopic knee operation having been pre-assessed as fit for surgery.
The arthroscopic knee operation requires two or three small incisions
in the knee joint to allow insertion of fluid, the arthroscope [attached
to a camera] and instruments. The length of these incisions is approximately
5-7 mm. Occasionally an incision will have to be enlarged in order
to remove a fragment from the knee.
The length of time the arthroscopic knee surgery takes depends on
the procedure which is being performed. Simple arthroscopic knee surgery
(i.e. excluding more complicated arthroscopic procedures such as arthroscopic
ACL reconstruction) usually takes between 10 and 30 minutes.
Following the arthroscopic knee surgery, a local anaesthetic solution
is normally injected into the joint to assist with pain relief.
The small incisions rarely require stitches, and will usually have
a simple dressing applied with a bandage wrapped around the knee.
Once the patient has recovered from the anaesthetic and started to
mobilise, they are normally safe to be discharged from hospital.
Typically this may be two hours after arthroscopic knee surgery but
some patients take longer to recover.
It is essential that the patient has somebody else to drive them home.
The patient should undertake essential walking only for the first
two to three days.
For the first couple of days, the leg should be rested and elevated
as much as possible. Simple painkillers and cold packs may be used
as required.
The large bandage around the knee is normally removed 24-48 hours
after arthroscopic knee surgery. There are usually no stitches to
be removed and the wounds should be kept clean and dry until they
have completely healed. A small dressing or plaster can be placed
on these wounds for a few days following arthroscopic knee surgery.
Bathing and showering: The wounds should be kept
clean and dry until at least four days following arthroscopic knee
surgery when, providing the wound has sealed, bathing or showering
is permitted.
In the first few days following arthroscopic knee surgery, simple
rehabilitation exercises including straight leg raising, knee and
ankle movements and tensioning of the quadriceps [thigh] muscles should
be undertaken as recommended by your Surgeon/Physiotherapist.
Physiotherapy: Some patients require physiotherapy following arthroscopic
knee surgery. This may take place either before or after the first
post-operative check-up depending on individual need.
(related topic >
physiotherapy)
Generally, a return to activities takes between two and six weeks
following arthroscopic knee surgery. Recovery, however, depends on
the extent of damage found within the knee, the treatment performed,
the type of activities to which the patient wishes to return and the
general fitness of the patient. Approximate recovery times following
simple arthroscopic surgery are:-
- Sedentary (office type) work 2-5 days
- Physical work 1-3 weeks
- Light training 3 weeks
- Return to full impact activities 4-6 weeks
- Driving 2-4 days
The small wounds can remain tender and thickened for a few weeks following
arthroscopic knee surgery. Occasionally, a lump remains under one
or other of the puncture holes for several weeks – this will
slowly resolve.
Knee arthroscopy is not itself damaging to the knee joint. Any ongoing
symptoms following arthroscopic knee surgery are usually the result
of the problem within the knee joint for which the surgery was recommended
and not as a result of the arthroscopy itself.
Arthroscopy has a very low complication rate. However, complications
such as infection, excessive swelling and pain can occur along with
rare general complications such as blood clots and anaesthetic risks.
In general, the risk of major problems is much less than 1%.
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