What is this operation?
The term arthroscopy refers to a type of “keyhole” surgery that is used to diagnose and treat joint problems. By far the most common joint to undergo this procedure is the knee. The operation may be carried out under general or spinal or even local anaesthetic depending on the indication for surgery, patient factors, and the surgical team’s preference. During the procedure small incisions are made on either side of the knee joint. An arthroscope (a small metal tube with a camera, which projects images to a TV screen) is inserted through one of the incisions allowing the surgeon to examine the knee joint from the inside. Specially developed instruments such as probes and precision tools may be inserted through other incisions allowing the surgeon to treat a range of conditions that occur within the knee joint.
What are the benefits?
Knee arthroscopy is a safe procedure with complications reported to be fewer than 1%. As it is minimally invasive this offers additional advantages to open surgery including reduced pain, reduced risk of infection, and faster healing time ensuring that you can return to your normal activities as soon as possible.
What are the risks?
It is common to experience some pain and swelling after knee arthroscopy. This settles down with time. Sometimes one of the small nerves supplying the skin is cut when the camera goes into the knee: This results in a lasting numb patch on the front of the knee. In addition, there is a very small risk of infection after knee arthroscopy. Symptoms of an infection include pain that gets worse, a fever, and redness spreading from the sites of the incision. Infection is a rare problem but if you experience these symptoms in the days following a knee arthroscopy you should seek urgent medical attention.
Who should consider this operation?
There are many indications for knee arthroscopy. The procedure is mainly used to diagnose and treat soft tissue knee injuries including ligamentous and meniscal injuries. Generally you should have a trial of non-operative management before opting for surgery. The surgeon will suggest surgery if symptoms are persisting despite non-operative management and he feels that an operation can help. The decision to undergo the operation however will ultimately lie with you.
What happens in the postoperative period?
An arthroscopy is usually performed as a day case procedure. Depending on the anaesthetic used and the time of day the procedure was undertaken, you will usually be discharged from hospital on the day of surgery or on the day after. In the early stages after the operation you will experience pain and swelling of the knee. Advice on the application of ice packs, elevation and the use of simple analgesia will be given on an individual basis by the surgeon. Before leaving hospital you will be seen by the physiotherapist to discuss various exercises and how to use crutches. Dressings should be kept dry until they are removed.
Rehabilitation plays a huge role in the success of any orthopaedic operation. You should be aware of what to expect before you undergo an operation, and surgery should be avoided if you are not motivated or are unable to comply with the rehabilitation programme. Rehabilitation is usually led by the physiotherapist and the emphasis of the programme will depend on the injury and surgical procedure performed. These factors will also influence the length of recovery, which may vary from weeks to months.
Please refer to the physiotherapy section of this website to view a range of rehabilitation programmes and time scales. Driving should be avoided until you feel confident to make a safe emergency stop, without hesitation and without damaging the affected knee.
The video below shows a detailed explanation of the causes and presentation of Knee Arthroscopy. They show a basic outline of the procedures used by Amir Qureshi and after care required in order that you, the patient, may recover to your full fitness once again.