Knee Arthroscopy

Knee arthroscopy is a procedure that allows your doctor to see and examine the inside of your knee joint with an instrument called an arthroscope. The arthroscope is made of a tube about the size of a drinking straw with a tiny camera at the end. The tube is inserted into the knee joint and the camera records an image that can be seen by your doctor on a TV monitor.

When is it used?
Knee arthroscopy is used to learn more about an injury or condition in order to diagnose the pain or weakness in the knee, to learn more about the injury, and to help make small repairs to the injury area. In contrast to open knee surgeries that require large incisions, arthroscopy requires only a couple of small incisions, which reduces scarring, recovery time, discomfort, and expenses. Knee arthroscopy is most commonly used for:

• Meniscal injuries
• Anterior cruciate ligament (ACL) reconstruction
• Join cartilage injuries
• Loose "bodies" in knee
• Infection

Before Surgery
Talk with your doctor before surgery about the arthroscopy procedure and find out what kind of anesthesia (numbing agent) you will have. The extent of the injury and procedure will effect what kind of anesthetic your doctor will select for you. It may also be important to ask a friend or family member to be available after your surgery to assist with daily activities such as driving until you are able to do things completely on your own.

During Surgery
Your doctor will give you an anesthetic agent to numb the area. Both regional and local anesthesias can be used and will allow you to remain awake during the procedure. The use of general anesthesia causes you to go into a deep sleep during the entire surgery.

After the anesthesia has taken effect, your surgeon will make 2 small incisions. The tube of the arthroscope is filled with a saline solution and is set up to flows through the knee during surgery. Your doctor will then be able to see the inside of your knee joint on the TV monitor.<.p> There are three bones that work together to create the knee joint and that can be seen during arthroscopy: the femur (thigh bone), the tibia (leg or shin bone), and the patella (kneecap). During arthroscopy, your doctor will be able to see the white, smooth cartilage that covers the ends of these bones. Cartilage can be worn down due to overuse, injury, and aging and this results in arthritis.

Your doctor will also be able to see the medial and lateral meniscal cartilages (which act as shock absorbers for your knee), as well as the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), which help stabilize the knee during lateral movements.

By using tiny instruments and the arthroscope, your doctor may be able to make some small repairs to tissues that are torn and can remove extra pieces of cartilage that might be causing problems with the joint. After the arthroscopy procedure, the doctor will bandage the small incisions with stitches or tape.

Complications/Risks
Talk with your doctor about the risks associated with this surgical procedure and how they apply to you. Risks and complications are low as compared with an open surgical procedure. There is a possibility of discomfort during the arthroscopy procedure due to a low level of anesthetic. In extremely rare incidences, there is a possibility of nerve or artery damage in the area of the arthroscope incision, which can cause tingling and weakness in the leg.

It is important to understand the risks associated with general anesthesia. Be sure to talk with your doctor about the different anesthesia choices and the risks involved with each.

After Surgery
The time for recovery from arthroscopic surgery depends on the injury or condition and the extent of the surgery. Commonly, patients can return home from the hospital the day of the procedure. Crutches may be used for several days until full body weight can be put on the knee joint without pain.

Recovery
The most important element for recovery initially is rest. Elevation and use of ice packs may be recommended to help reduce swelling and pain, and exercises may be suggested to help begin to strengthen the muscles surrounding the knee. Patients can normally return to very light work after a week, and a typical complete recovery time for returning to daily activities is three weeks. It is normally suggested that patients avoid athletic activities for several months in order to give the tissues time to heal and strengthen properly.