Knee arthroscopy is a surgical technique that can diagnose and treat problems in the knee joint. During the procedure, your surgeon will make a very small incision and insert a tiny camera — called an arthroscope — into your knee. This allows them to view the inside of the joint on a screen.The surgeon can then investigate a problem with the knee and, if necessary, correct the issue using small instruments within the arthroscope.
Why Do I Need Knee Arthroscopy?
Your doctor may recommend that you undergo a knee arthroscopy if you’re experiencing knee pain. Your doctor might have already diagnosed the condition causing your pain, or they may order the arthroscopy to help find a diagnosis. In either case, an arthroscopy is a useful way for doctors to confirm the source of knee pain and treat the problem.
Arthroscopic surgery can diagnose and treat knee injuries, including:
- torn anterior or posterior cruciate ligaments
- torn meniscus (the cartilage between the bones in the knee)
- patella that’s out of position
- pieces of torn cartilage that are loose in the joint
- removal of a Baker’s cyst
- fractures in the knee bones
- swollen synovium (the lining in the joint)
How Do I Prepare for Knee Arthroscopy?
Your doctor or surgeon will advise you how to prepare for your surgery. Be sure to tell them about any prescriptions, over-the-counter medications, or supplements that you’re currently taking. You may need to stop taking certain medicines, such as aspirin or ibuprofen, for weeks or days before the procedure.
You must also refrain from eating or drinking for six to 12 hours before the surgery. In some cases, your doctor may prescribe you a pain medication for any discomfort you experience after the surgery. You should fill this prescription ahead of time so that you have it ready after the procedure.
What Happens During a Knee Arthroscopy?
Your doctor will give you an anesthetic before your knee arthroscopy. This may be:
- local (numbs your knee only)
- regional (numbs you from the waist down)
- general (puts you completely to sleep)
If you’re awake, you may be able to watch the procedure on a monitor.
The surgeon will begin by making a few small incisions, or cuts, in your knee. Sterile salt water, or saline, will then pump in to expand your knee. This makes it easier for the surgeon to see inside the joint. The arthroscope enters one of the cuts and the surgeon will look around in your joint using the attached camera. The surgeon can see the images produced by the camera on the monitor in the operating room.
When the surgeon locates the problem in your knee, they may then insert small tools into the incisions to correct the issue. After the surgery, the surgeon drains the saline from your joint and closes your cuts with stitches.
What Are the Risks Associated with a Knee Arthroscopy?
There are risks associated with any type of surgery, though they are rare. Every surgery has the following risks:
- excessive bleeding during the procedure
- infection at the site of the surgery
- breathing difficulties caused by anesthesia
- allergic reaction to anesthesia or other medications administered during surgery
There are also risks specific to a knee arthroscopy, such as:
- bleeding inside the knee joint
- formation of a blood clot in the leg
- infection inside the joint
- stiffness in the knee
- injury or damage to the cartilage, ligaments, meniscus, blood vessels, or nerves of the knee
What Is Recovery Like After a Knee Arthroscopy?
This surgery isn’t very invasive. For most people, the procedure takes only an hour or two. You will likely go home on the same day for recovery. You should use an ice pack on your knee and a dressing. The ice will help reduce swelling and minimize your pain.
At home, you should have someone look after you, at least for the first day. Try to keep your leg elevated and put ice on it for a day or two to reduce swelling and pain. You’ll also need to change your dressing. Your doctor or surgeon will tell you when to do these things and for how long. You will probably need to see your surgeon for a follow-up appointment a few days after the procedure.
Your doctor will give you an exercise regimen to follow at home to help your knee recover, or will recommend a physical therapist to see until you’re able to use your knee normally. The exercises are necessary to help restore your full range of motion and to strengthen your muscles. With the proper care, your outlook after having this procedure is excellent.
Three different types of pain relief (anesthesia) may be used for knee arthroscopy surgery:
- Local anesthesia. Your knee may be numbed with pain medicine. You may also be given medicines that relax you. You will stay awake.
- Spinal Anesthesia This is also called regional anesthesia. The pain medicine is injected into a space in your spine. You will be awake but will not be able to feel anything below your waist.
- General Anesthesia You will be asleep and pain-free.
- Femoral nerve block. This is another type of regional anesthesia. The pain medicine is injected around the nerve in your groin. You will be asleep during the operation. This type of anesthesia will block out pain so that you need less general anesthesia.
A cuff-like device may be put around your thigh to help control bleeding during the procedure.
The surgeon will make two or three small cuts around your knee. Salt water (saline) will be pumped into your knee to inflate the knee.
A narrow tube with a tiny camera on the end will be inserted through one of the cuts. The camera is attached to a video monitor that lets the surgeon see inside the knee.
The surgeon may put other small surgery tools inside your knee through the other cuts. The surgeon will then fix or remove the problem in your knee.
At the end of your surgery, the saline will be drained from your knee. The surgeon will close your cuts with sutures (stitches) and cover them with a dressing. Many surgeons take pictures of the procedure from the video monitor, You may be able to view these pictures after the operation so that you can see what was done.
Why the Procedure is Performed
Arthroscopy may be recommended for these knee problems:
- Torn meniscus. Meniscus is cartilage that cushions the space between the bones in the knee. Surgery is done to repair or remove it.
- Torn or damaged anterior cruciate ligament (ACL) or Posterior cruciate ligament (PCL)
- Torn or Damage colateral ligaments
- Swollen (inflamed) or damaged lining of the joint. This lining is called the synovium.
- Kneecap (patella) that is out of position (misalignment).
- Small pieces of broken cartilage in the knee joint
- Removal of Baker’s cyst . This is a swelling behind the knee that is filled with fluid. Sometimes the problem occurs when there is swelling and pain (inflammation) from other causes, like arthritis.
- Repair of defect in cartilage f the knee
The risks for anesthesia and surgery are:
- Allergic reactions to medicines
- Breathing Problem
Additional risks for this surgery include:
- Bleeding into the knee joint
- Damage to the cartilage, meniscus, or ligaments in the knee
- Bloods clots in the leg
- Injury to a blood vessel or nerve
- Infection in the knee joint
- Knee stiffness
Before the Procedure
Always tell your health care provider what medicines you are taking, even drugs, supplements, or herbs you bought without a prescription.
During the 2 weeks before your surgery:
- You may be told to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other blood thinners.
- Ask which medicines you should still take on the day of your surgery.
- Tell your provider if you have been drinking a lot of alcohol (more than 1 or 2 drinks a day).
- If you smoke, try to stop. Ask your provider for help. Smoking can slow down wound and bone healing.
- Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you have before your surgery.
On the day of your surgery:
- You will most often be asked not to drink or eat anything for 6 to 12 hours before the procedure.
- Take the medicines you been told you to take with a small sip of water.
- You will be told when to arrive at the hospital.
After the Procedure
You will have an ace bandage on your knee over the dressing. Most people go home in same day or next day of surgery then slowly and gradually wight bearing and exercise are recommended as per protocol .
Full recovery after knee arthroscopy will depend on what type of problem was treated.
Problems such as a torn meniscus, broken cartilage, Baker’s cyst, and problems with the synovium are often easily fixed. Many people stay active after these surgeries.
Recovery from simple procedures is fast in most cases. You may need to use crutches for a while after some types of surgery. Your provider may also prescribe pain medicine.
Recovery will take longer if you have had a more complex procedure. If parts of your knee have been repaired or rebuilt, you may not be able to walk without crutches or a knee brace for several weeks. Full recovery may take several months to a year.
If you also have arthritis in your knee, you will still have arthritis symptoms after surgery to repair other damage to your knee.