Preparing for arthroscopic knee surgery

Evaluations and tests

Your orthopedic surgeon may recommend that you see your primary care physician for a general health evaluation before surgery. The doctor will identify any problems that may interfere with the procedure. If you have certain health risks, a more extensive evaluation may be necessary before surgery.
To help plan your procedure, your knee specialist may order preoperative tests. These may include blood tests or an electrocardiogram (EKG).

Admission instructions

If your overall health is good, the arthroscopy will be performed on an outpatient basis , meaning that you will not have to stay in the hospital overnight.
If you use medicine or supplements, you must inform your orthopedic surgeon. You may need to stop taking some of these medications before surgery. The hospital or surgery center will contact you ahead of time to provide specific details about your procedure. You should also make sure that you follow the instructions regarding the time to arrive at the hospital and the time to stop eating and drinking before the surgery.

anesthesia

Before surgery, a member of the anesthesia team will talk to you. Arthroscopy knee surgery can be done under local, regional or general anesthesia.
In local anesthesia, only the person's knee is numbed.
In regional anesthesia, the legs below the waist are numbed.
In general anesthesia, you fall asleep.
The orthopedic surgeon as well as the anesthesiologist will provide you with the necessary guidance on the most appropriate operation.

Arthroscopic knee surgery

As soon as transfer to the operating room, anesthesia is performed. To prevent infection of the surgical site, the skin on the knee will be cleaned. Next, your leg will be covered with surgical drapes facing the area prepared for the incision.
At this stage, sometimes, a positioning device is placed on the leg to help stabilize the knee while the arthroscopic procedure is performed.

Action

To start the procedure, the surgeon will make several small incisions in your knee to modify the "portal". A sterile solution will be used to fill the knee joint and flush out any cloudy fluid. This will help the orthopedic surgeon see the structures inside your knee clearly and in full detail.

 

Your surgeon will insert the arthroscope and surgical instruments through small incisions called portals.

The first task of the surgeon is to correctly diagnose your problem. The doctor will insert the arthroscope and use the image displayed on the monitor screen to guide it. If surgical treatment is needed, your surgeon will insert very small instruments through other small incisions. Special instruments are used for tasks such as shaving, cutting, grasping and repairing the meniscus. In many cases, special tools are used to secure the sutures to the bone.

 

A photograph of a bucket handle tear taken with an arthroscope (right) - A common type of meniscus tear is a "bucket handle" tear (left).

Most knee arthroscopy procedures take less than an hour. The length of the surgery depends on the findings and the necessary treatment. The surgeon may close each incision using stitches or steri strips (small wound adhesives) and then cover your knee with a soft bandage.

What happens during knee arthroscopy?

Before the surgery, the doctor may prescribe some type of anesthesia for you.
If you are awake, you may see the action on the monitor. In arthroscopy, first several small incisions are made on the skin. Sterile salt water or saline is poured on your knee. This makes it easier to see inside the joint. The arthroscope enters one of these incisions and the surgeon looks inside the joint using a camera attached to the arthroscope. The surgeon can view the images recorded by the camera on the monitor in the operating room. Once the surgeon finds the location of the knee problem, he can fix it by inserting a small instrument. After the surgery, salt water is poured on the person's knee and the incisions are connected through stitches.

 

 

Wearing a soft bandage will protect your wound while it heals.

Complications

The rate of complications after arthroscopic knee surgery is very low. If complications occur, they are minor and easily treated. Possible problems after knee arthroscopy are:

• infection
• Blood clots
• knee stiffness
• Accumulation of blood in the knee

What are the risks associated with knee arthroscopy?

There are several types of risks that can be seen in any type of surgery, however, these risks are rare. Any surgery carries the following risks:

• Excessive bleeding during the procedure
• Infection at the surgical site
• Breathing problems caused by anesthetics
• Allergic reaction to anesthetics or drugs prescribed during surgery.

Also, there are risks that are specific to knee arthroscopy. Among these factors, the following can be mentioned:

• Bleeding inside the knee joint
• Blood clots in the legs
• Intra-articular infection
• knee stiffness
• Injury or damage to the cartilage, ligaments, meniscus, blood vessels or nerves of the knee