Knee arthroscopy, also called keyhole surgery, is a less invasive form of surgery than conventional open surgery. The surgeon investigates and corrects the problem using a precision tool called an arthroscope which has a tiny camera attached that is used to inspect the joint for damage. Similar keyhole instruments can then be introduced into the joint and used to operate on the damaged area.
Benefits of Knee Arthroscopy
The arthroscope is inserted into the knee via a small cut (usually about 5mm in length) in the skin. This means there is less risk of infection and a shorter recovery time than with more invasive open forms of surgery.
Wherever possible, surgeons will use knee arthroscopy because it results in less tissue damage and trauma to the knee. Patients recover faster and with less pain. Recovery can often be speeded up by keeping the leg elevated for a few days after surgery, applying ice packs to reduce swelling and resting frequently.
The surgeon may use a blood thinning injection before hospital discharge or recommend taking aspirin to reduce the risk of blood clots and may prescribe painkillers to manage the mild post-operative pain. Normally it is possible to return to light activity within 1-2 days and other more physical activities after 2-6 weeks, depending on the surgery.
What is it used for?
Knee arthroscopy is used for a wide range of conditions, including:
- Joint pain and stiffness
- Floating fragments of bone or cartilage following trauma
- Fluid build-up
- Damaged cartilage
- Fracture surgery
It is not suitable for every type of condition, however, and people with degenerative diseases and severe osteoarthritis have been shown to potentially derive little benefit from knee arthroscopy.
Risks of Knee Arthroscopy
The procedure is not without risks although serious complications are uncommon. As with any surgery, there is a risk of infection and bleeding, and a very small risk with any anaesthetic. The arthroscopic procedure itself may rarely result in:
- chronic stiffness of the knee
- accidental damage to tissues and nerves
- bleeding in the joints
- blood clots
What to expect
If you are having a knee arthroscopy, your surgeon may recommend a ‘pre-habilitation’ regime including some gentle exercises.
You may need to stop taking certain medications before the procedure, such as blood thinners, ibuprofen or prescription medicines, and you will be advised to stop eating up to 12 hours beforehand. Your surgeon will provide detailed instructions for you to follow.
You will normally be given a short light general anaesthetic before the procedure. In certain situations you may be given a spinal anaesthetic – which will numb you from the waist down.
The surgeon will begin by making a few small cuts in the knee. Next, they will insert the arthroscope. Medical saline solution will be pumped into the joint to expand the knee capsule and make it easier for the surgeon to see what they are doing.
The camera will allow them to see what is going on inside the knee and confirm the diagnosis. Normally, the problem will be fixed there and then using small tools inserted through another small cut in the skin, and used in conjunction with the arthroscope. Once any repairs have been made, the tools will be removed and the saline will be drained from the knee. Any small incisions will be stitched up. Often the procedure takes 30 minutes or less.
Outlook
Many people regain full use of their knee following arthroscopy but this will depend on the severity of the problem and the type of knee problem being treated. It is important to follow the discharge instructions and recovery plan recommended by your surgeon to give yourself the best chance of making a full recovery.
If you are considering knee arthroscopy or would like more information about the procedure or diagnosis of your knee problem, contact us.
