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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. The technique involves
a small telescope, video equipment and instruments. Arthroscopy 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»
This surgery requires a hospital operating theatre and is usually
performed as day case surgery. The 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 operation having been pre-assessed
as fit for surgery.
The 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 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 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 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 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 surgery.
Bathing and showering: The wounds should be kept
clean and dry until at least four days following 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
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 arthroscopy 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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