Knee arthroscopy

Arthroscopy is a surgical procedure that allows the doctor to view the joints of the body with a miniature video camera. Arthroscopy gives doctors a clear view inside the knee. This helps them diagnose and treat knee problems.

Technical advances have led to high resolution and high performance monitors and cameras. These and many other improvements have made arthroscopy a very effective tool for treating knee problems. According to the American Society of Orthopaedics in Sports Medicine, more than 4 million knee arthroscopies are performed annually worldwide.

Description

Arthroscopy is done through small incisions. During the procedure, the orthopaedic surgeon inserts the arthroscope (a miniaturized video camera about the size of a pencil) inside the knee. The arthroscope sends the image to a monitor. On the monitor, the surgeon can see the structure of the knee in minute detail

The surgeon may use arthroscopy to visualize, repair or remove damaged tissue. To do this, small surgical instruments are inserted into the knee through other incisions.

Hospital admission

The hospital or orthopedic surgery clinic will contact the patient for more appointment details. The patient will probably be asked to arrive at the hospital or clinic an hour or two before the operation. The patient is also not allowed to eat or drink liquids the night before the operation.

Anesthesia

Once admitted for surgery, the first medical professional to talk to the patient will be the anesthesiologist.
Arthroscopy can be performed under local, regional or general anesthesia.
– Local anesthesia is performed only on the knee
– Regional anesthesia means numbing from the waist down
– General anesthesia means numbing the patient for a period of time (one hour, two hours)

The anesthesiologist will help the patient decide the most effective method.
If you opt for local or regional anesthesia, you will be able to follow the procedure on a monitor.

Procedure

The orthopedist will make a few small incisions in the knee.A sterile solution (saline) will be used to loosen the knee joint. This helps the surgeon get a clear and detailed view of the knee.

The surgeon’s first task is to correctly diagnose the patient’s problem. The surgeon will insert the arthroscope and use the image projected on the screen for guidance. If surgical treatment is needed, he will introduce the necessary instruments through another small incision: scissors, palpator, shaver.
This procedure usually takes 30 minutes to an hour.
Knee arthroscopy is most commonly used for:
– Removing or suturing a torn meniscus
– Reconstruction of the anterior cruciate ligament
– Removal of pieces of articular cartilage
– Removal of loose fragments of bone or cartilage
– Removal of inflamed synovial tissue

The surgeon may close the incisions with a suture or apply sterile strips (small bandages).

Recover

Recovery from knee arthroscopy is much faster than recovery from traditional open knee surgery. However, it is important that the patient follows the orthopedist’s instructions carefully after returning home.

Knee swelling

The leg should be elevated for as long as possible during the first few days after surgery. Ice should be applied to relieve swelling and pain.

Postoperative wound care

From the hospital or orthopedic clinic where the arthroscopy will be performed, the patient will leave with a dressing covering the knee. The incision should be kept clean and dry. The doctor will decide when the patient will be able to shower or bathe and when the dressing should be changed.

A few days after the surgery, the doctor will call the patient for a check-up to see the results of the surgery and to start the postoperative treatment program.

Walking after surgery

Most patients need splints or other types of assistance after arthroscopy. The c doctor will decide when it is safe for the patient to leave the weight on the leg.

Driving the car

The doctor will discuss with the patient when they will be able to drive. This decision is based on a number of factors, including:
– Involvement of the knee
– Type of automatic or manual machine
– Nature of the procedure
– Level of pain
– Medication
– How well you can control the knee.

Patients are usually able to drive within a week to three weeks after surgery.

Medication

Your doctor will prescribe painkillers to help relieve discomfort after surgery. He or she may also recommend medications such as aspirin/oral anticoagulants to reduce the risk of blood clots and various antibiotics.

Exercises for knee recovery

After surgery, the patient should do knee exercises for several weeks in a row. This will lead to recovery of function and strengthening of the leg and knee muscles.

Therapeutic exercise will play an important role in knee recovery. A physiotherapy/kineiotherapy program will visibly improve the outcome

Complications and warning signs

As with any surgery, there are risks associated with knee arthroscopy. These are rare, minor and treatable.

Complications

Potential postoperative problems after knee arthroscopy are:
– infections
– deep and superficial venous thrombosis
– blood pooling in the knee

Warning signs

The patient should call the orthopedic surgeon if any of the following problems occur:
– fever
– chills
– persistent warmth or redness around the knee
– persistent pain
– significant swelling of the knee

Results

If the patient has not had a cruciate ligament reconstruction, they should be able to return to usual physical activities after 6 to 8 weeks or sometimes much sooner. Higher impact activities should be avoided for a longer time.
If the patient’s job involves hard labor, it may take a longer period of time to return to the patient.
The final outcome of surgery will likely be determined by the degree of damage to the knee. For example, if the articular cartilage in the knee has been completely removed, then full recovery is not possible. The patient may also need to change lifestyle. This may mean limiting activities and finding low-stress exercises.