Knee arthroscopy is a minimally invasive surgical technique used to evaluate and treat a variety of conditions affecting the knee. This technique involves 2 or 3 small (1-2 cm) incisions. Fluid is pumped into the knee to distend space within the knee joint. A small camera (known as an arthroscope) is inserted into the knee via one of the incisions. Small instruments, such as a probe, scissors, or shavers, are inserted into the other incision(s) to perform the surgery.
What conditions can be treated by a knee arthroscopy?
Knee arthroscopy is commonly used to evaluate and treat meniscal tears. It can also be used to treat lesions involving the articular cartilage. Knee arthroscopy is also used to assist with ligament reconstructions of the knee, such as ACL reconstruction. In addition knee arthroscopy can be used for diagnostic purposes in patients who fail to respond to non-surgical treatments.
What can you expect when undergoing knee arthroscopy?
Although knee arthroscopy is a very common and safe procedure, it is still a surgical procedure which requires general anesthesia. As a result your orthopedic surgeon in Phoenix will typically require that pre-operative blood work be obtained prior to undergoing surgery. In addition for patients over the age of 40 or with history of medical problems, often medical clearance obtained from your primary care physician will be required. Once blood work and/or medical clearance has been obtained then the surgery is scheduled.
Prior to surgery patients taking any anti-inflammatory medications (such as Advil, ibuprofen, or Naprosyn) should discontinue these for 1 week prior to surgery to decrease the risk of bleeding intra-operatively. In addition blood thinners (such as aspirin, Plavix, or Coumadin) will also need to be discontinued for 5-7 days prior to surgery to decrease the risk of bleeding.
You should have nothing to eat or drink after midnight the night prior to your surgery. Typically you will be instructed to arrive at the surgery center 90 minutes prior to the surgical procedure. You will check in at the surgery center and an IV will be placed.
Knee arthroscopy is typically performed under general anesthesia. Typically local anesthetics are used as a supplement at the completion of the procedure. It is important to be aware that these will provide short-term pain relief after the surgery but will wear off within 6-12 hours post-operatively.
Surgery typically takes 30-90 minutes to complete depending upon the amount of damage within the knee and the nature of the procedure that is being performed. During the knee arthroscopy, the surgeon will take pictures of the structures within the knee, including the chondral surfaces, ligaments, and menisci. Your surgeon will review these photographs with you during your first post-operative follow-up appointment, which should occur approximately 7-10 days following the surgery.
Nearly all arthroscopic knee surgery is done on an outpatient basis. Most patients recover in the recovery room for 45-60 minutes before being allowed to go home. Be sure to have someone with you to drive you home.
The post-operative instructions will depend upon the nature of the procedure performed. For detailed instructions regarding routine knee arthroscopy see the post-op knee arthroscopy instructions.
What are the potential complications associated with the arthroscopy?
As with any surgery, there are risks associated with knee arthroscopy. These occur infrequently and are minor and treatable. Potential problems associated with knee arthroscopy include infection (< 1%), inadvertent damage to the cartilage surfaces of the knee during the procedure, blood clots (< 0.5%), failure to eradicate symptoms, and medical complications associated with anesthesia.
Warning signs that suggest a potential complication is occurring include the presence of fevers greater than 101.5°, persistent warmth or redness around the knee, increasing or uncontrollable pain, significant swelling in the knee, calf pain, chest pain, or shortness of breath.
What is the long-term prognosis after knee arthroscopy?
Unless a ligament reconstruction has been performed, most patients are able to return to most physical activities within 6 to 8 weeks, or sooner. Higher impact activities may need to be avoided for a longer time. The final outcome of your surgery will be determined by the amount of damage within the knee, which is best assessed at the time of surgery.