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Knee Arthroscopy

Arthroscopy is a type of keyhole surgery used to correct joint deformities or preserve joint function. The procedure involves examining the joints with an arthroscope, which is a thin metal tube of a similar size to a drinking straw that contains a camera. Images are sent to the surgeon so they can diagnose what is wrong with the joint.

About the procedure

Prior to the operation, you will attend an appointment to determine your general health and decide whether you are ready for the surgery. During this appointment, you will be told how to prepare for the surgery (e.g. what you can eat and drink, what medicines you can take, etc.), your expected recovery time and whether any rehabilitation will be necessary.

You will also be asked to sign a consent form to confirm that you have a full understanding of the procedure, including the risks and benefits, and agree to go ahead with it.

The procedure is usually carried out by general anaesthetic, however, it is not uncommon to be given a spinal anaesthesia or local anaesthetic. The anaesthetist will explain which type is to be used and you may be given a choice.

During the procedure, a small incision is made so the arthroscope can be inserted - one or more other incisions may be made for the other surgical instruments. The surgeon will examine the joint, determining the best course of action and implementing it. Once the procedure is complete, any excess fluid is drained and the incisions are closed up.

Why is arthroscopy used?

There are many reasons why arthroscopy would be prescribed to treat joint problems and conditions, and the procedure can be performed for various surgical procedures including:

  • Lavage - washing out loose cartilage and inflammatory chemicals
  • Debridement - smoothing the surface of the cartilage
  • Meniscectomy - removing some or all of a torn cartilage
  • Synovectomy - removing all or part of the synovial membrane

A synovectomy is only carried out when inflammation of the synovial membrane doesn’t respond to conservative treatment over a long period of time. The synovial membrane will regrow within a few weeks.

Many conditions, along with osteoarthritis, can be treated using arthroscopy, including carpal tunnel syndrome, Baker’s cyst, frozen shoulder, bone spurs and synovitis.

Advantages of arthroscopy

Keyhole surgery, such as arthroscopy, has many benefits compared to open surgery, including:

  • Reduced postoperative pain
  • Faster healing
  • Less risk of infection
  • Return to day-to-day activities quicker

In some cases, it’s possible you will be able to go home on the same day.

Risks of arthroscopy

Like all types of surgery, there are certain risks involved with procedures. This includes expected symptoms of surgery, such as swelling, bruising, stiffness and discomfort, which usually improve days or weeks after your procedure. However, there are less common side effects that can cause problems later in life, including:

  • Developing a blood clot, also known as deep vein thrombosis
  • Getting an infection, also known as septic arthritis
  • Bleeding inside the joint, causing pain and swelling
  • Damaging the nerves, causing permanent or temporary loss of sensation

Recovery

The recovery times for arthroscopy can vary depending on your general health. Painkillers will be used to provide relief from discomfort in the joint, and if you feel better, you could leave on the same day or the following day. It is important that you arrange to be picked up after the operation as you are likely to feel tired and lightheaded for up to 48 hours.

Depending on where your arthroscopy was performed, you may have to wear a sling or use crutches temporarily. You will also be given an appointment with a physiotherapist to discuss exercises to do at home. Other recovery aids include keeping the joint elevated and applying cold packs to reduce swelling and keeping any dressings as dry as possible.

If you should experience any of the following symptoms, you should contact your GP or the clinic you had your operation at:

  • A high temperature
  • Further pain
  • Further swelling
  • Discoloured or smelly wound
  • Numbness

When you’re returning to normal activities, it’s important to take it easy. Listen to the advice of the surgeon and the physiotherapist about what activities you can and cannot do.

Useful Links

You may find the following information useful which relates to the use of Arthroscopy in the management of osteoarthritis of the knee:

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