Knee Arthroscopy

Knee arthroscopy can be effective for treating a variety of problems. Common problems treated using this technique include:

• • Torn meniscus: A meniscus is a ring of cartilage in your knee that acts as a shock absorber. It can be torn, often during sporting activities, and cause symptoms of clicking or locking of the knee. A torn meniscus can be trimmed or repaired together during an arthroscopy

Knee arthroscopy for meniscal tears

• Loose bodies: Small pieces of cartilage can break off from joint surfaces or meniscus. These can float around in the knee causing pain, locking or clicking. These loose bodies can be removed during an arthroscopy.
• Cartilage trimming: Cartilage that lines the joint surfaces may become frayed and worn out. This can be trimmed during an arthroscopy, which is called “chondroplasty”. Unfortunately the worn out cartilage can’t be replaced or repaired.
• ACL reconstruction: A ruptured Anterior Cruciate Ligament can be reconstructed via knee arthroscopy.

Does knee arthroscopy work for a worn out knee (also known as osteoarthritis)?
If you have advanced wear and tear of the knee joint, known as osteoarthritis, an arthroscope is probably not for you. The only surgery that will probably help is a knee replacement. If you have a worn out knee but also have a torn meniscus or a loose body, then an arthroscope may be helpful.

Features of knee osteoarthritis

Admission

Most people are admitted to hospital on the day of their surgery. For a knee arthroscopy you can usually go home on the day of your surgery.

Anaesthesia

The anaesthetist will see you and decide the type of anaesthetic that’s best for you.

The different types of anaesthesia include:

• General Anaesthetic. This type of anaesthetic puts you asleep during the whole procedure and a machine controls your breathing. The vast majority of knee arthroscopies are performed under a general anaesthetic.
• Spinal Anaesthetic. An injection is placed into your back to numb your hip and legs. You will be awake during the procedure, however a sedative can be given to you to help you doze off.

If you have any questions or concerns about your anaesthetist, we would encourage you to contact your anaesthetist before the operation, with the contact details that we are provided to you.

You will go home with some pain relief medications to help with the pain for the first few days. Try to keep the leg elevated in the first few days after the operation to help limit swelling.

In the first week, the knee should be regularly iced to reduce swelling.

Try to bend your knee and keep your thigh muscles active in the first two weeks after an arthroscopy in order to avoid stiffness.

Gentle cycling is very helpful in reducing your swelling and increasing your recovery.

Wound care

Although the wounds are small, they still need to be carefully looked after. The dressing over the wound should remain in place for 7 days.

Rehabilitation

The rehabilitation program varies depending on what was operated on during the arthroscopy.

Your physiotherapist will give you exercises to help to improve the flexibility and strength of the knee. It is important to follow the advice of the physiotherapist and make sure that you complete the recommended exercises in order to get the best outcome from the operation.

Back to work and sport

If you work in an office environment your should be able to return to work within a week of the operation. Unless you have had your ACL reconstruction during an arthroscopy, you should be able to return to most physical activities 6 – 8 weeks after the operation. An ACL reconstruction takes longer to recover from.

If you have a heavy manual job, or participate in high impact sports, you may need to wait longer before returning to these activities. Most people are able to return to manual duties after 4 -6 weeks.

Driving

Most people are able to drive a few days after the operation. The length of time it will take to get back to driving depends on which leg was operated on, the problem that was operated on and how much pain you have after the operation.

The complication rate following knee arthroscopy is very low. However like all surgery, there are risks that need to be considered when deciding to have knee arthroscopy surgery.

Side effects
Side effects are symptoms that occur due to the surgery and are a normal part of the recovery from the operation. The main side effects of knee arthroscopy are:

• A sore knee which may last for several weeks after the operation.
• Swelling of the knee which may last for several weeks.

Complications
Complications are problems that occur during or after the operation. Most people having knee arthroscopy surgery aren’t affected and complications are a rare event. There are some complications that may occur for any operation. These include:

• A reaction to the anaesthetic
• Infection of the wound or joint
• Excessive blood loss
• A blood clot, usually in a vein of the leg (known as a deep vein thrombosis or DVT)

Specific complications of knee arthroscopy are very uncommon, but can include the following:

• Bleeding into the knee joint (haemarthrosis): Occasionally a blood vessel may be damaged during the arthroscopy leading to bleeding into the joint after the operation. This will result in swelling of the knee which may be stiff and painful. This is a rare complication, occurring in roughly 0.46% of cases.
• Chronic Regional Pain Syndrome: A rare complication is ongoing knee pain following knee arthroscopy. This occurs in less than 1% of people having the operation.
• Stiffness: Sometimes you may be left with stiffness of the knee joint following the operation. This is a rare complication, happening in only 0.11% of people having an arthroscopy.
• Accidental damage to structures inside the knee joint: Occasionally cartilage or ligaments of the knee joint may be damaged during an arthroscopy. This is a very rare complication.