Knee Arthroscopy

Step by step procedure of knee arthroscopy:

• 1. What is Knee Arthroscopy?
• 2. Why is Knee Arthroscopy Required?
• 3. Pre-operative Preparation
• 4. Day Before Surgery
• 5. Procedure Day
• 6. Methods/Techniques of Knee Arthroscopy
• 7. Post Procedure
• 8. Risks and Complications

What is Knee Arthroscopy?

It is a technique used for the treatment of knee joint problems. For diagnosis of the intra-articular knee disorders, such as synovial, meniscal, ligamentous and articular cartilage pathology, diagnostic arthroscopy is mandatory. The Mastery of diagnostic arthroscopy is important for orthopedic surgeons while treating knee disorders.

Knee arthroscopy is an important therapeutic procedure for treating knee disorders of various types. It is a surgical procedure which undertakes a small incision making and insertion of small camera called as arthroscope into the knees. Insertion of the arthroscope helps in observing the inside view of the joints on the screen of computer. It helps in identification of all knee problems. In some cases, problems knee can be corrected with the help of small instrument within the arthroscope.

• 1. Anterior Cruciate ligament reconstruction
• 2.Torn surface or articular cartilage
• 3. Patello-femoral (knee-cap) disorders
• 4. Removal of cysts
• 5.Broken or damaged
• 6. Torn floating cartilage or meniscus
• 7. Damaged Washout of infected knees

Recovery time and prognosis (likely outcome of medical condition) is based on the nature of knee problem and type of treatment used.

Pre-operative Preparation

It is advised not to take Aspirin and other anti-inflammatory drugs 5 days before knee arthroscopy. In case pain medications are required, consulting your doctor for the same is recommended. Routine medications if any are allowed to consume with the advise of the surgeon prior to few days of knee arthroscopy. Smoking needs to be stopped before some days of knee arthroscopy.

Day Before Surgery

A day before surgery, patients need to follow the instructions given by their surgeon. Records of the medical reports and diagnostic tests need to be kept handy so that there will not be any further complications.

Procedure Day

On the day of knee arthroscopy, the patient gets admitted to the hospital based on the advice of the surgeon. This may vary from one hospital to another hospital. Fasting is required for a minimum of 6 hours before surgery. And There will be a marking done on the limb undergoing surgery for the identification purpose. After giving the anesthesia, the knee area needs to be sterilized. For making the process “blood-free,” a tourniquet is applied on the thigh of the patient. A tourniquet is a type of bandage used for controlling venous and arterial circulation for prolong period of time. Prior to surgery, an anesthetic is given to the patients. This can be:

• 1. General anesthesia: For complete sleep or unconsciousness.
• 2. Local anesthesia: For making knees numb
• 3. Reconstruction of anterior cruciate ligament in knee
• 4.Regional anesthesia: For making the waist area numb

Methods/Techniques of Knee Arthroscopy

The process of knee arthroscopy usually takes at least 30 minutes for completion. It mostly depends on the amount of a surgical work required to be carried out by the surgeon inside the knee joint of a patient.

Small incisions will be made by the surgeon at the start of knee arthroscopy. After this, saline or sterile salt water is pumped inside for expanding the knees. An arthroscope enters inside one of the incisions made and a surgeon can see inside with the help of camera attached. After identification of problem inside the knees, insertion of small instruments is carried out by the surgeon for correcting the trouble.

After completing the surgical process, The surgeon carries out drainage of saline from the joints of the patient. Once this is done, Then stitching of cuts is carried out.

Post Procedure

Once the surgical process is completed, Then patients are taken to the recovery room. The operated knee is covered with a bandage. The bandage around the wound can be removed in 24 hours and waterproof dressings can be used to cover the wounds. Swelling is normal to observe post knee arthroscopy. Use of the ice packs for a minimum of 20 minutes, three to four times a day is recommended to reduce the swelling.

Post recovery, patients can return to their normal routine with the advice of the surgeon. Post surgery, follow up appointments are required to be taken for monitoring the health of the knees.

Post - Operative Exercises and Physiotherapy

After completion of the knee arthroscopy, Exercise and physiotherapy treatments are advised to the patients. Thigh muscle strengthening is important in these cases. Muscle build up can be achieved by cycling and swimming. These activities need to be done only after consulting with your surgeon.

Pain Management

The post-surgical process, Medications are given to patients for short-term pain. These include Opioids, non-steroidal and anti-inflammatory drugs (NSAIDs) as well as local anesthetics. Combination of these medications can be used by the surgeon as per the need. Opioids, though effective, can be addictive. This happens because they are narcotic in nature. This is why it is recommended to stop using the opioids once the pain is relieved.

Risks And Complications

In general, Risks which are associated with knee arthroscopy are less. In case of knee damage such as partially worn out knee cartilage, chances of improvement are around 65% for short term. No improvement is reported in patients with Osteoarthritis even after arthroscopic surgical treatments. Arthroscopic knee surgery is associated with following risks and complications.

• 1. Post operative bleeding
• 2. Stiffness
• 3. Infection
• 4.Numbness near the incision site
• 5. Injury to nerves and vessels
• 6. Deep vein thrombosis
• 7. Chronic pain syndrome