Arthroscopy of the Knee Joint
What is knee arthroscopy?
Knee Arthroscopy is a common surgical procedure performed using an arthroscope, a viewing instrument, to look into the knee joint to diagnose or treat a knee problem. It is a relatively safe procedure and a majority of the patient's discharge from the hospital on the same day of surgery.
What are the indications for knee arthroscopy?
The knee joint is vulnerable to a variety of injuries. The most common knee problems where knee arthroscopy may be recommended for diagnosis and treatment are:
- Torn meniscus
- Torn or damaged cruciate ligament
- Torn pieces of articular cartilage
- Inflamed synovial tissue
- Misalignment of patella
- Baker's cyst: a fluid filled cyst that develops at the back of the knee due to the accumulation of synovial fluid. It commonly occurs with knee conditions such as meniscal tear, knee arthritis and rheumatoid arthritis. It is important to note that most often it is NOT necessary to operate on the cyst but merely to correct the problem causing the excess fluid.
- Certain fractures of the knee bones
What is the procedure for knee arthroscopy?
Knee arthroscopy is performed under spinal, or general anaesthesia. Our anaesthetist will decide the best method for you depending on your age and health condition.
- I will make two (occasionally 3) small 5mm incisions around the knee.
- A sterile fluid solution is injected into the knee to push apart the various internal structures to provide a clear view and more room to work.
- An arthroscope, a narrow tube with a tiny video camera on the end, is inserted through one of the incisions to view the knee joint. The structures inside the knee are visible to me on a large video monitor in the operating room.
- I will first examines the structures inside the knee joint to assess the cause of the problem and take detailed photo images which you will later see.
- Once I make/confirm the diagnosis, surgical instruments such as scissors, motorized shavers, or electro-surgery (similar to lasers) are inserted through another small incision, and the necessary work is performed based on the diagnosis.
The repair procedure may include any of the following:
- Removal or repair of a torn meniscus
- Reconstruction of a torn cruciate ligament
- Removal of small torn pieces of articular cartilage and smoothing of the defect to promote healing
- Removal of loose fragments of bones
- Removal of inflamed synovial tissue, plicas or fat pad/alar folds
- Removal of baker's cyst (very rarely necessary)
- Realignment of the patella or simple lateral release
- Making small holes or microfractures near the damaged cartilage to stimulate cartilage regrowth (called "Pick Microfracture")
- After the repair, the knee joint is carefully examined for bleeding or any other damage.
- The fluid is then drained from the knee joint. If minor bleeding occurs in the knee a drain will be inserted and removed in 2nd stage recovery.
- Finally, the incisions are closed with sutures or steri-strips, and the knee is covered with a sterile dressing.
What post-operative care may be necessary following the procedure?
Most patients are discharged the same day after knee arthroscopy. Recovery after the surgery depends on the type of repair procedure performed. Recovery from simple procedures is often fast. However, recovery from complicated procedures takes a little longer. Recovery from knee arthroscopy is much faster than that from an open knee surgery. Remember full soft tissue healing takes 6 weeks so be patient!
Pain medicines are prescribed to manage pain. Crutches are rarely necessary.
You will see our physiotherapist in 2nd stage recovery who will give you a recovery rehab program sheet tailored to your condition
A more formal rehabilitation program may also be advised for a successful recovery.
What are the risks and complications associated with knee arthroscopy?
Knee arthroscopy is a safe procedure and complications are very rare.
Complications specific to knee arthroscopy include bleeding into the knee joint, infection, knee stiffness, blood clots or continuing knee problems. Very occasionally poor healing occurs in some patients (no fault on the patient or the surgeon: just ‘bad luck') requiring a second arthroscopy.