- What is knee arthroscopy?
- What kinds of procedures can be performed with a knee scope?
- What are some of the possible complications of arthroscopic knee surgery?
- What kind of anesthesia is used?
- How to prepare for arthroscopic knee surgery?
- How long will I be in the hospital?
- What happens on the day of arthroscopic knee surgery?
- What should I do for knee surgery aftercare?
- What will rehabilitation involve?
- When can I return to sports or full duty at work?
What is knee arthroscopy?
The arthroscope is a fiber-optic instrument (narrower than a pen) that is put into the knee joint through two small incisions. A camera is attached to the arthroscope, and the image is viewed on a TV monitor. The arthroscope allows the surgeon to fully evaluate the entire knee joint, including the knee (patella), the cartilage surfaces, the meniscus, the ligaments (ACL & PCL), and the joint lining. Small instruments ranging from 3-5 millimeters in size are inserted through the incisions to enable the surgeon to feel the joint structures for any damage, diagnose the injury, and then repair, reconstruct, or remove the damaged tissue. Before the development of arthroscopy, large incisions had to be made over the knee joint to treat or diagnose injuries. Today’s arthroscopic techniques allow more complete evaluations of the knee joint while accelerating the rehabilitation process.
What kinds of procedures can be performed with a knee scope?
Knee scoping, or knee arthroscopy, allows the surgeon to view the inside of the knee joint and perform a variety of surgeries. These surgeries include:
- Complete evaluation of the joint (diagnostic arthroscopy)
- Removal of damaged or torn cartilage (partial meniscectomy)
- Repair of torn cartilage (meniscus repair)
- Smoothing of damage to the cartilage surface in arthritis (chondroplasty)
- Realignment of the patella in patellar mal-tracking (lateral release)
- Removal of joint lining (synovectomy)
- Replacement of articular cartilage (cartilage transplant)
What are some of the possible complications of arthroscopic knee surgery?
While complications are not common, all surgery has associated risks. Possible complications include stiffness of the knee after surgery or continued pain. The use of arthroscopic techniques attempts to limit these complications. Other complications include infection, bleeding, nerve damage, blood clots, or problems with the anesthesia. If a meniscus repair is performed, it is possible that the torn area will not heal. This would require a second surgery to remove the torn meniscus. Even though this is possible, it is better to attempt to repair a meniscus that may heal, in order to preserve the normal meniscus function.
What kind of anesthesia is used?
Knee arthroscopy can be performed with general anesthesia (going to sleep) or regional anesthesia (spinal or epidural block). It is your choice. The anesthesiologist will discuss your options the morning of surgery.
How to prepare for arthroscopic knee surgery?
Our staff will help to set up the surgery through your insurance company and will instruct you on any paperwork that may be necessary. If you are over the age of 50 or have significant health conditions, you may need an EKG and chest X-ray. You may also need to see your internist or family doctor to obtain a Letter of Medical Clearance. The day before the surgery, a member of the hospital or surgery center staff will contact you about what time to arrive for surgery. Do not eat or drink anything after midnight before your surgery.
How long will I be in the hospital?
Knee arthroscopy is an outpatient procedure and most patients go home the same day.
What happens on the day of arthroscopic knee surgery?
When you arrive at the hospital or surgery center, you will be admitted and taken to a preoperative holding area where you are prepared for surgery. You will be asked several times which extremity the surgeon will operate on, this question is asked many times on purpose. Anesthesia will be administered and the surgery is then performed.
After the operation, you will be taken to the recovery room to be monitored. Once the effects of the anesthesia have worn off and your pain is under good control, you will be given your postoperative instructions and a prescription for pain medication. Please be aware that the process of checking in, preparing for surgery, undergoing the operation, and recovering from anesthesia takes the majority of the day. It is recommended that your driver bring some reading material for the duration.
What should I do for knee surgery aftercare?
Prior to your discharge, you will be given specific instructions on how to care for your knee. In general, you can expect the following:
You will be given a prescription for pain medication.
You may shower, but you should keep the dressing dry. After your dressing is removed, you may get your knee wet. You cannot take a bath until the wounds are completely sealed, which is usually 2-3 weeks after surgery.
You will be instructed how to use crutches before the surgery. You should bring a set of crutches with you to the surgery. The longevity of crutches will depend on the type of surgery performed. Crutches are commonly required for a couple of days — unless you had a meniscus repair. In this case, the surgeon will let you know how long you should stay on your crutches to protect the repair.
If a meniscus repair is performed, you will receive a brace to restrict the motion of your knee. This is to protect the repair for the first 4-6 weeks and allow the area to heal.
Resume your regular diet as soon as tolerated. It is best to start with clear liquids before advancing to solid food.
You should apply ice over the dressing for 20-30 minutes every hour for several days. Do not use heat for the first 48-72 hours.
Some stitches are absorbable and do not need to be removed. However, if there are stitches, they will be removed on your first postoperative visit.
You will be instructed on exercises you can begin immediately after the surgery. You will begin physical therapy 2-3 days post-op.
Return to work or school:
You can return to school or work anywhere from 2 days to 2 weeks. If your job involves extended walking or heavy activity, you may be out of work or school for a longer period of time.
What will rehabilitation involve?
The rehabilitation is based on several goals:
- Allowing the tissue to heal
- Regaining your range of motion
- Regaining strength
- Returning to full duty at work or returning to sports
After partial meniscectomy, rehabilitation generally occurs very rapidly. Most patients can return to strenuous work in 4-6 weeks. However, complete recovery may take 2-3 months to get all your strength back. Following meniscus repair, you will be restricted from performing certain activities. Your specific, personalized rehabilitation protocol will be reviewed with you after surgery.
When can I return to sports or full duty at work?
Your return to your desired activity level will depend on the extent of damage and the procedure performed on your knee. In general, you will be allowed to return to sports in 4-8 weeks after surgery. You must have good motion, strength, and control of your knee. How quickly you return depends on several factors, including:
- Your own rate of healing
- The damage found at surgery
- If you have any complications
- How well you follow the postoperative instructions
- How hard you work in rehabilitation
Knee Doctor St. Louis
Mark Miller, MD is committed to you — the patient. It is understandable to be anxious about your injury and the need for surgery. As one of the leading knee specialists and orthopedic surgeons in the St. Louis area, Dr. Mark Miller has expertly managed countless patients’ knee injuries with arthroscopic surgery. You can trust us to answer all questions and provide you with the highest-quality care.
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