Arthroscopic knee surgery

What is arthroscopic knee surgery (keyhole surgery)?

It is usually a day case surgical procedure in which the inside of the knee is examined with a camera inserted through small cuts in the skin (usually one cut on each side of the knee cap). In most cases, performing the corrective surgery at the same time can solve the problem. In some cases further operation may be required.

 

Why should you have an arthroscopy?

In the majority of cases, surgery for torn meniscus, removal of a loose piece of bone, biopsy and articular cartilage lesions can be performed using special instruments. The advantage of arthroscopic surgery over conventional surgery is less pain and usually quicker recovery.

 

Investigation required before surgery

• a magnetic scan (MRI) to identify the problem affecting the knee.
• an x-ray of the knee joint may be needed.
• in some cases a simple blood test and ECG (tracing of heart) may be required.

 

Types of anaesthesia

Various anaesthetic techniques are used and the consultant anaesthetist will recommend the best type after discussing the options with you before surgery. Be assured, you will not feel any pain during the operation.

 

What happens on the day of operation?

You will be admitted to hospital 1 to 2 hours before surgery. The consultant surgeon and the anaesthetist will once again explain the procedure to you in detail. You’ll have the chance to ask them any questions about the surgery or aftercare.

You’ll then be asked to sign a consent form and the surgeon will put an arrow mark on your leg, which requires surgery. A nurse will also ask you certain questions about your general health.

Depending on the specific procedure, surgery can take between 20 and 90 minutes. After the operation, the surgeon will explain the findings and discuss options for further care. A physiotherapist will also advise you about an exercise plan.

Please take time to read the leaflet provided about the surgery and aftercare.

 

Aftercare following arthroscopy

Your knee will have a support bandage, which should be removed after 48 hours.

You’ll need to attend a follow-up appointment two weeks after surgery when your stitches will be removed.

You should walk naturally as soon as possible and try not to limp.

A physiotherapist will give you a sheet of exercises. These are designed to strengthen your thigh muscles. It is important that you do them regularly.

Keep your wound and dressing clean and dry till the stitches are removed.

Keep your leg elevated on a footstool while sitting to avoid swelling.

Take painkillers regularly as prescribed. Do not consume alcohol, drive or operate any machinery.

If you had a general anaesthetic then it is advisable to take rest and a responsible adult should stay with you overnight.

Take one - two weeks off work.

It is advisable not to drive for two weeks. Please check with your insurance company.

Your knee may have some swelling for 3-6 weeks depending upon the type of surgery.

 

Possible complications

1. Bleeding - It is not uncommon to see dry blood on the dressings after 48 hours.  However, if you see fresh blood coming from the wound then you should contact the hospital.

2. Infection - The risk is extremely low (1 in 1000). You will receive one dose of intravenous antibiotic during your operation. If you start to run a temperature or if your knee becomes hot, painful, red and swollen then you should immediately contact the hospital.

3. Blood clots (Thrombosis)- The risk is 1-2%. If the calf muscles become swollen and painful then you should contact the hospital.

4. Numbness around the scar - This is rare and should recover with time.

 

How can you help?

1. If you are overweight, then try to lose weight. It reduces the risk of complications.

2. If you’re prescribed warfarin then you should stop taking it at least three days before surgery. Make sure your surgeon knows that you take warfarin.

3. It is advisable to try to stop smoking at least 6 weeks before surgery. It reduces the risk of complications after general anaesthesia.