| 
Knee
Arthroscopy
What is Knee Arthroscopy
Arthroscopy is a surgical procedure orthopaedic surgeons use to visualise,
diagnose and treat problems inside the knee joint.
The word arthroscopy comes from two Greek words, "arthro" meaning joint, and "skopein"meaning
to look. The term literally means "to look within the joint." In an arthroscopic
examination, an orthopaedic surgeon makes a small incision 1 to 1.5 cm in length, then inserts
tubes through the incision in which a fibre optic camera and instruments can be inserted.
This enables the surgeon to see the interior of the knee joint and undertake certain procedures,
through this very small incision rather than a large incision needed for surgery.
The television camera displays the image of the inside surfaces of the joint on a television
screen, allowing the surgeon to see the cartilage and ligaments. The surgeon can then determine
the amount or type of injury, and sometimes undertake repairs or clean out any debris from
the joint.
When is a Knee Arthroscopy used
An arthroscopic examination of the knee can be used to
- Look inside the knee to find out exactly what is causing a problem
- To investigate and repair a tear in a cartilage. These are half moon
shaped pieces of gristle cushioning the bones in the knee.
- To investigate and repair torn ligaments within the knee joint. These
are strong bands of gristle similar to elastic bands holding the bone ends together inside
the joint. When the ligaments are damaged teh knee joint becomes unstable and can move
lateraly.
- To remove loose pieces of bone in the knee joint.
- To remove arthritic growth in the knee.
The Operation
The procedure is performed under a general anaesthetic. The arthroscope
is a telescope about as wide as a pen, connected to a television. The surgeon will insert
the arthroscope through one or two tiny cuts (about half an inch 1.2cm) around the knee.
If you have torn a cartilage, the surgeon will trim the torn edges of cartilage
using fine instruments. Occasionally he has to make a bigger cut to remove part of the cartilage.
This would be about three inches (7.2cm) long. If you have torn a ligament within the knee,
he may repair or reconstruct it during this operation. It may be that a further procedure
will be required to reconstruct a badly damaged ligament. the surgeon will discuss the possiblilty
of this treatment with you after your arthroscopy. If the surgeon finds loose bone fragments,
he will remove them. If you have arthritis, he can see how severe it is. He will wash out
the knee with salt water. This often improves your symptoms for some months. The incisions
will be closed with paper tapes or stitches.
After the Procedure
You will be kept in the hospital overnight to be sure that there are no
side effects from the anaesthesia. You can return home the day after.
You will have a bandage on your knee. Usually the wound is pain-free but you may feel some
discomfort and your knee may feel a bit stiff. This will quickly get better. You will be
given painkillers to take home. They should easily control this discomfort. A general anaesthetic
will make you slow, clumsy and forgetful for about 24 hours. The nurses will help you with
everything you need until you are able to do things for yourself. Do not make important
decisions, drive a car, use machinery, or even boil a kettle during this time.
You may take bandages and dressings off 10 to 12 days after the operation.
Wash around the dressing for the first 10 days. You can wash the wound area with soap and
warmwater as soon as the dressing has been removed.
After you return Home
You should not drive for two weeks after your operation as you will not
be able to perform an emergency stop as quickly as normal before then. How soon you can
return to work depends on your job. If you mainly sit at work, you may be able to return
to work immediately after your operation. If your job is manual you will be unable to work
for 2 - 3 weeks. You may swim and play most sports 3 weeks after your operation. When you
start playing, you will not be able to play for as long as normal. Your knee may ache at
the end of a game however it will gradually improve.
Possible Complications
As with any operation under general anaesthetic there is a very small risk
of complications related to your heart or your lungs. The tests that you will have before
the operation will make sure that you can have the operation in the safest possible way
and will bring the risk for such complications very close to zero.
Complications are rare and seldom serious. Bleeding into the joint and infection of the
joint may rarely happen after the arthroscopy.
More serious complications happen very rarely. You can develop a blood clot in one of your
calf veins (deep vein thrombosis - DVT). This can be very dangerous because it can travel
to your lungs. You will be given medication (injection of blood thinners), and this in combination
with the use of compression stockings and foot pumps, will protect you and help minimise
the risk of DVT.
|
