This is a minimally invasive surgical procedure in which a miniature telescope-like instrument is passed into the joint so that the surgeon can see the inside of the knee in great detail, and operate through just two small incisions.
An arthroscopy can be for diagnosis or treatment. Some conditions that may require this procedure include:
1. Meniscal tears
Tearing of the cartilage that cushions the knee joint can cause a number of symptoms, including pain and swelling. An arthroscopy may be performed to remove part of the damaged meniscus (cushioning cartilage), or in some younger patients the meniscus can sometimes be repaired. This procedure may require a separate incision and take longer before full activities can be resumed.
2. Cruciate ligament reconstruction
The operation involves replacing the torn cruciate ligament with either the hamstring tendons or patella tendon from the same leg.
Read more about Anterior Cruciate Ligament Reconstruction here
Occasionally, arthritis can be helped by arthroscopy. Often it is performed as a “grease and oil change” for a knee that will eventually require a knee replacement. An arthroscopy cannot cure arthritis and sometimes results can be disappointing.
Read more about Knee Arthritis here
4. Loose bodies
Loose pieces of cartilage or bone can occur due to a variety of causes. They can be removed during arthroscopy.
5. Diagnosis or assessment
Arthroscopy is useful to assess the inside of the knee to determine the suitability for other surgical procedures.
6. Knee cap pain
A painful patella (knee cap) may be an indication for arthroscopy after treatment with physiotherapy. If there are loose fragments of carilage behind the kneecap these can be removed during an arthroscopy. Another treatment of patella pain is to perform a lateral release. This is a procedure where tight structures pulling the wrong way on your kneecap are released.
7. Cartilage biopsy
If you are a candidate for cartilage transplant A specimen may be taken at the time of your arthroscopy which may be used at a later time. This may avoid a repeat operation to take a sample of cartilage.
Your surgeon will discuss the surgery with you in detail at your appointment. Please bring any x-rays, MRI scans or other investigations you have had done which may be relevant to your surgery, and a list of any medications that you are taking. Notify your surgeon if you have any abrasions or pimples around the knee.
Changes in your medications
You will be admitted to the hospital and asked a series of questions. An anaesthetist will discuss your past medical history and previous anaesthetics. The operation is usually performed under a general anaesthetic but the final decision rests with the anaesthetist.
Following surgery, you will wake up in recovery with your knee bandaged. Most patients will go home on the day of surgery, but some may require an overnight stay. You will require pain killers and may have crutches to go home with if required .You should make arrangements to get home, as you will not be able to drive.
You will be seen before you go home to explain the results of the operation. This will be further discussed at your follow up visit.
Listed below is some information and instructions that will assist you in the recovery period after your knee surgery.
DRESSING:You should have Tubigrip on with 2 or 3 small dressings under it. You usually have NO stitches. The wound is held together with paper tape called “steri-strips”. If you still have a crepe bandage and velband on your knee please remove and discard them the day after your surgery. Leave the small dressing on. If the dressings start to come off please replace them. If you do not have a replacement dressing please use a normal bandaid.
SHOWERING: You may get the dressing wet in the shower. Gently pat the dressing dry after showering. You do not need any special soap or antiseptic. If the dressing or steri-strip comes off after the shower please cover with a bandaid. Please avoid having a bath or going swimming until after your post-operative visit with your surgeon and have made sure the wound is clean and dry.
CRUTCHES: You will be assessed by the physiotherapist as to whether or not you require crutches. If you do have crutches you can go off your crutches as soon as you feel confident or are instructed to do so by your surgeon.
EXERCISES: Please do the post surgery knee exercises as shown here or as instructed by the doctor. Please ice your knee for 15-20 minutes following your exercises. Continue doing the exercises until you see your surgeon for your post-operative appointment. You will not require formal physiotherapy until being assessed by your surgeon at your post-operative appointment.
ICING: Apply an ice pack to the front and back of the knee joint to help swelling. This can be applied for 20 minutes every 2 hours during waking hours as tolerated. The more you can reduce the swelling, the quicker your recovery will be.
SWELLING: You may find your knee swells after surgery and/or after doing your exercises. Swelling may also occur as you start doing more of your usual activities. If swelling occurs try to rest and ice your knee. You should elevate your leg so that your heel is higher than your hip.
PAIN: Expect some pain or discomfort following the surgery. Take the prescribed medication as instructed or as required. Unless you are unable to take them, anti-inflammatories are particularly helpful.
FOLLOW-UP: Your check-up is usually 7-14 days after the surgery where the wounds will be inspected.