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Knee arthroscopy is a common minimally invasive surgical procedure. These procedures require smaller incisions (cuts) than traditional surgery, and the incisions are usually about the size of a keyhole. The healthcare expert uses tiny tools through another incision to treat injuries or structural issues. The tools are used to either remove or restore damaged tissue.
A wide range of knee injuries is diagnosed and treated by medical professionals using knee arthroscopy. The doctor makes an incision and inserts a tiny camera during arthroscopic knee surgery, which enables them to view the inside of the patient's knee on a screen in the operation room and diagnose any knee-related issues.
When Is Knee Arthroscopy Required?
If nonsurgical therapy for your knee comfort is ineffective, the doctor may advise knee arthroscopy. Rest, ice, nonsteroidal anti-inflammatory medications, and physical therapy are examples of nonsurgical therapies.
What Conditions Does Knee Arthroscopy Treat?
One may need knee arthroscopy in case of:
- Soft tissue injuries: Injuries to soft tissues include tendons and ligaments, which join bones together (they connect muscles to bones). Bursitis, torn meniscus, patellar tendonitis, tears of the medial collateral ligament, and anterior cruciate ligament (ACL) tears are some of the most frequent knee injuries.
- Fractures: Bones can break or chip inside of your knee. Sometimes, cartilage, the supple substance that allows bones to glide past one another easily, can break off when the bone fractures.
- Inflammation: Synovium is the soft tissue inside a joint. A joint's synovium can become inflamed (swollen and irritated). This illness is known as synovitis among medical professionals.
Who Is the Best Candidate for Knee Arthroscopy?
The best candidates for knee arthroscopy are individuals with a specific knee problem that can be treated with this procedure. Knee arthroscopy may be recommended for conditions such as:
- Meniscal tears: A common injury, it can cause pain, swelling, and stiffness in the knee joint.
- Torn ligaments: Anterior cruciate ligament (ACL) or medial collateral ligament (MCL) can cause instability and pain in the knee.
- Cartilage damage: Damage to the articular cartilage, which covers the ends of the bones in the knee joint, can cause pain, swelling, and stiffness.
- Loose bodies: Small fragments of bone or cartilage that have broken off and are floating around in the knee joint can cause pain, swelling, and catching.
- Synovitis: Inflammation of the synovial lining of the knee joint can cause pain and swelling.
Who Is Not the Best Candidate for the Procedure?
Some factors that may make a person a less ideal candidate for knee arthroscopy include:
- Advanced arthritis: Knee arthroscopy may not be effective in treating advanced osteoarthritis or other degenerative joint conditions.
- Obesity: Being overweight might strain the knee joint more and increase the probability of complications after surgery.
- Blood-clotting disorders: Individuals with blood-clotting disorders may not be good candidates for knee arthroscopy due to the increased risk of bleeding.
- Severe ligament or cartilage damage: If the damage to the knee ligaments or cartilage is severe, knee arthroscopy may not be the most appropriate treatment option.
Contraindications for Knee Arthroscopy
While knee arthroscopy is generally considered a safe procedure, certain contraindications may make it unsuitable for some patients.
- Blood clotting disorders: Patients with blood clotting disorders or those taking anticoagulant medication may be at increased risk of bleeding during knee arthroscopy.
- Morbid obesity: Severe obesity may make it difficult to position the patient properly for knee arthroscopy and increase the risk of complications.
- Advanced arthritis: Knee arthroscopy may not be effective for patients with advanced arthritis and may even worsen their condition.
- Nerve damage: Patients with a history of nerve damage in the knee area may be at increased risk of further nerve damage during knee arthroscopy.
- Psychological issues: Patients with certain psychological issues, such as severe anxiety or claustrophobia, may not be suitable candidates for knee arthroscopy as the procedure is performed under anaesthesia and in a confined space.
What Happens Before Knee Arthroscopy?
Inform the doctor about the medication intake before having a knee arthroscopy. Before surgery, one might need to stop taking a few drugs (such as blood thinners). The healthcare provider will brief on when to stop eating and drinking the night before the treatment.
Knee arthroscopy can be performed at a hospital on an inpatient basis. To ensure one does not experience discomfort, the doctor may recommend the following:
- Local anaesthetic to numb the area.
- Regional anaesthetic to numb the entire lower body.
- General anaesthetic to assist one to sleep for the procedure.
What Happens During a Knee Arthroscopy?
During the procedure, the doctor:
- Cleans the leg and places a stabilising device around the knee, which helps the knee to be in the correct position during the treatment.
- Makes a small cut in the knee and inserts a long metal instrument called an arthroscope into the cut. On the end of the arthroscope is a camera that captures and displays the images on a screen in the operating room.
- Examines the visuals displayed on the monitor and uses them to identify injuries and direct the process. The doctor makes more incisions in the knee and inserts tiny tools through them if surgery is needed.
- Repairs torn tissues, eliminates inflammatory or damaged tissues, and removes damaged bone or cartilage with the help of specially designed tools for these tasks.
- Closes the incisions with stitches or small bandages and wraps the knee with a larger bandage or dressing.
What Happens after Knee Arthroscopy?
The majority of knee arthroscopies are daycare procedures that allow one to return home the same day. Sometimes, a hospital stay is necessary after a knee arthroscopy (in case of an inpatient procedure).
Usually, a patient will need a driver to drive back home. One may feel little pain after surgery. Following the surgery, while the patient is still healing, one should:
- Be mobile as per advice from your doctor: It can range from weight bearing as per tolerance or to weight bearing on the operated leg, depending upon the procedure.
- Elevate their knee: Try to place the knee above the heart while resting in order to minimize swelling and relieve pain.
- Use painkillers: The doctor may advise taking NSAIDs (over-the-counter nonsteroidal anti-inflammatory medicines) or prescription painkillers. When taking painkillers, be careful to follow the directions provided by the doctor. One might also require medication to lessen swelling or prevent blood clots.
- Keep the incision covered: Keep the area clean and tidy, and make sure the bandage stays on the knee. After the procedure, consult the doctor when it is the right time to take off the dressing and bathe or take a shower.
The doctor may advise physical therapy once the patient has had time to recover from the treatment. The patient can improve strength and mobility with the aid of a personalised PT programme. The physical therapist will demonstrate specific exercises to improve flexibility, strengthen the muscles supporting the knee, and prevent further injury.
What Are the Advantages of Knee Arthroscopy?
Recovery times from minimally invasive procedures like knee arthroscopy are typically shorter than those from conventional (open) surgery.
Additionally, one is more likely to recover faster because a few small stitches are required for the procedure. One may also experience less pain and a low risk of infection.
What Are the Risks Associated with Knee Arthroscopy?
Knee arthroscopy complications are extremely uncommon. It has similar risks to other surgeries, such as bleeding and infection. Following the treatment, some patients might have:
- Blood clots
- A stiff knee
- Swelling in the knee due to blood clotting (this complication is uncommon).
Every patient responds to the surgery differently. Consult the arthroscopic surgeon when one can resume regular activities, such as driving and walking independently. The surgeon might advise waiting a few weeks before engaging in more physically demanding activities.
At times, a patient needs to adjust their activity level and way of life. The knee may be damaged by several activities, particularly ones that call for running or jumping. Choose lower-impact sports and activities that are easier on the knees after speaking to the doctor.
Review
Reviewed by Dr. Ramneek Mahajan - Senior Director, Orthopaedics & Joint Replacement, Arthroscopy & Sports Injury.
Frequently Asked Questions
What is the duration of recovery from an arthroscopic knee surgery?
The recovery time from an arthroscopic knee surgery can vary from person to person, but it typically takes several weeks to a few months to fully recover. This can depend on factors such as the extent of the surgery, the individual's overall health, and their physical therapy program.
Is knee arthroscopy a major surgery?
It is considered a major surgery. Arthroscopic knee surgery is considered a minimally invasive procedure and is generally considered less invasive than traditional open knee surgery.
Is arthroscopic knee surgery painful?
There is an amount of pain and discomfort associated with the procedure, but the doctors ensure the patients have a comfortable recovery and provide appropriate pain medications. Pain is a common side effect after knee arthroscopy and can vary depending on the individual and the extent of the surgery. Pain medication and physical therapy can help manage the pain and speed up the recovery process.
Can you walk right after arthroscopic knee surgery?
You would be able to walk, but you should first undergo a few days of physiotherapy and walking with the help of a walker. The exact timeline for when you can start walking again will depend on the individual and the extent of the surgery.
Is walking good after knee arthroscopy?
Walking is generally considered a good exercise after knee arthroscopy, as it can help improve circulation, reduce swelling, and strengthen the knee muscles. However, it's important to follow your physical therapist's guidelines and not push yourself too hard, as this can slow down the recovery process.
Is it better to repair or remove the meniscus?
The decision to repair or remove a torn meniscus depends on factors such as the size, location, and type of tear, as well as the individual's age, overall health, and level of activity. A repair is generally preferred, as it helps to preserve the knee's natural shock-absorbing function.
How long does a knee scope take?
The length of a knee arthroscopy procedure can vary, but it typically takes two hours or more, depending on the extent of the condition. What can you not do after knee arthroscopy? After knee arthroscopy, avoiding certain activities, such as high-impact sports, deep knee bending, and heavy lifting for a period, is necessary. A physical therapist will provide specific guidelines and recommendations for what one should and shouldn't do after the surgery.
Review
Reviewed by Dr. Jatinder Bir Singh Jaggi, Director - Orthopaedics & Joint Replacement, Arthroscopy & Sports Injury and Dr. Ramneek Mahajan, Senior Director, Orthopaedics & Joint Replacement, Arthroscopy & Sports Injury.