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What is a knee arthroscopy?
An arthroscopy allows your surgeon to see inside your knee to help them diagnose and treat knee problems.
During the procedure your orthopaedic surgeon will make some small incisions into the skin and insert an arthroscope (a small camera instrument about the size of a pencil) into your knee joint. The arthroscope then sends the images to a screen for the doctor to examine. On this screen the doctor can see the structures of the knee in great detail and can assess the amount or the type of injury.
Along with the arthroscope fine instruments for trimming and irrigating can be inserted through the incisions (portals) in the knee. These can then be used to trim any damaged ligaments or remove loose bodies.
What are the benefits of surgery?
The main benefit from arthroscopy surgery is to confirm exactly what the problem and, in many cases, to treat the problem at the same time. An arthroscopy can provide relief from knee pain and improve mobility. Maintaining a normal and active lifestyle with greater comfort and quicker recovery times is a key benefit of arthroscopic or keyhole surgery.
Are there alternatives to surgery?
Problems within the knee can sometimes be diagnosed using a magnetic scan (MRI scan) and sometimes your surgeon will request a scan prior to surgery to identify injuries to the knee, however you may then need an arthroscopy to treat the problem.
Damage inside the knee does not usually heal without treatment, although sometimes a course of physiotherapy can help relieve pain. However, if you have a torn cartilage or loose bodies in the knee these defects can occasionally move out of place and cause your knee to lock. If your knee does not unlock again on its own you will need an urgent arthroscopy.
What do I need to do to prepare for surgery?
Prior to your surgery your will need a medical assessment to determine if you have any problems which may affect your surgery. If you develop any health changes prior to surgery, such as cold, fever, infection, rash etc you should contact your surgeon’s office and anaesthetist prior to surgery.
Make sure the surgeon is aware of all medications you are taking, including any herbal medicines or vitamins.
You will need to arrange for a responsible adult to drive you home after the surgery. Please pack loose fitting pants or shorts that will fit over your dressing after surgery.
What does the operation involve?
Almost all knee arthroscopic procedure is done as a day surgery procedure. You will likely be asked to arrive at the hospital an hour or two before your surgery. The hospital will contact you the day prior to your surgery to confirm what time you will need to present to the hospital and when you will need to fast (nothing to eat or drink).
The healthcare team will carry out a number of checks to make sure you have the operation you came in for and on the correct side. You can help by confirming this with the surgeon and the healthcare team when they ask.
The anaesthetist will discuss anaesthetic options and recommend the best form of anaesthesia for you. You may also have injections of local anaesthetic to help with post-operative pain.
Your surgeon will examine your knee ligaments whilst you are under the anaesthetic and relaxed. They will make some small incisions and a sterile solution will be used to fill the knee joint and rinse away any cloudy fluid. This helps your orthopaedic surgeon see your knee clearly and in greater detail.
The surgeon’s first task is to properly diagnose your problem. They will examine the inside of your knee for damage to cartilages, joint surfaces and ligaments. They will wash out any loose material caused by wear of the joint surfaces. It is usually possible for your surgeon to trim or repair a torn cartilage arthroscopically.
At the end of your operation your surgeon will close the skin with stitches or sticky stitches and a dressing will be applied.
What happens after surgery?
Following surgery you will moved to the recovery room and, once comfortable, able to walk on crutches, take fluids orally and able to urinate you will be allowed to go home.
A dressing will be applied to the knee to protect the knee and minimise swelling and pain. Patients should leave this dressing in place until their post-operative appointment with their surgeon. You will also be given pain medication after surgery to reduce the knee pain.
The recovery period after arthroscopy depends on the patient and his or her condition. For most cases patients can return to office work following their post-operative visit 7 – 10 days following surgery. Many patients return to a more active and normal lifestyle within one to two months.
Recovery from knee arthroscopy is much faster than traditional open knee surgery. However, it is important to follow your orthopaedic surgeon’s instructions carefully after you return home.
Keep your leg elevated as much as possible for the first few days after surgery.
Apply ice as recommended by your doctor to reduce swelling and pain. Keep your incisions clean and dry and leave the dressings on until you see the doctor.
Your surgeon will see you in our rooms at 70 Bridge Road, Nowra for a post-operative consultation to check your progress, review the surgical findings and begin your postoperative treatment program.
What can I do to help make the operation a success?
If you smoke stopping smoking several weeks or more before an operation may reduce your chances of complications and will improve your long term health.
Try to maintain a healthy weight. You have a higher chance of developing complications if you are overweight.
To reduce the risk of infection in the surgical wound:
- In the week before your operation do not shave or wax the area where a cut is likely to be made.
- Try to have a bath or shower either the day before or on the day of your operation
- Keep warm around the time of your operation . Let a member of your healthcare team know if you are cold.
What complications can occur?
As with any surgery, there are risks associated with a knee arthroscopy. Your healthcare team will try to make your operation as safe as possible. Knee arthroscopy is a very safe procedure; however there are some rare post-operative problems with knee arthroscopy which include:
- Pain, which happens with every operation. Your surgeon may inject painkillers into the knee to help reduce the pain. You will be given medication to control the pain and it is important that you take it as advised.
- Severe pain, stiffness and loss of use of the knee (known as complex regional pain syndrome). The cause of this is not known and this is very rare. If this happens you may need further treatment including painkillers and physiotherapy. This can take months or years to get better.
- It is usually safe to shower after 48 hours, being careful to keep the dressing clean and dry. If you do develop an infection you will. Usually need another operation to wash out the knee and a long course of antibiotics. Infection may cause permanent damage. The risk of this type of infection is less than 1 in 3000.
- Bleeding, during or after surgery. If you get blood in your knee following surgery (haemarthrosis) it will be swollen and painful. You may require another operation to wash the blood out.
- Unsightly scarring of the skin, although arthroscopy scars are usually small and neat.
- Blood clots in the legs which can move through the bloodstream to the lungs. The healthcare team will encourage you to get out of bed soon after surgery and may give you special stockings to wear. (risk: 1 in 750)
- Damage to nerves around the knee leading to weakness, numbness or pain in the leg or foot. This usually settles on its own but may be permanent. (risk: 1 in 1500)
Please notify your surgeon or your GP if you notice any of the following symptoms: increasing drainage on the dressing, elevated temperature, pus-like drainage from any of the incisions, breathing difficulties, pain in your calf when you flex your foot up and down that is unrelieved by rest or elevation, warmth or redness around the knee, or swelling in your calf, foot or ankle.
This document is intended for information purposes only and should not replace advice that your relevant health professional would give you.