Knee arthroscopy is considered for surgical management of knee pain after conservative measures have resulted in little improvement in symptoms. The specific procedure will be decided upon by you and your healthcare provider and scheduled at a hospital or outpatient surgical center in advance.
Make sure to give yourself plenty of time to arrive at the hospital by the designated time in preparation for your scheduled surgery, including parking, finding the surgery suite, and filling out all necessary paperwork.
Before the Surgery
On the day of your knee arthroscopy, you will be taken to a pre-operative room where you will be asked to change into a gown. You will undergo a brief physical examination and answer questions about your medical history from the surgical team.
You will then be taken into the operating room equipped with an operating table and several screens, monitors, and medical technology for assessing your status before, during, and after the operation.
The surgical team will assist you onto the operating table and you will be given anesthesia medication depending on what type is determined appropriate by your surgeon. The type of anesthesia used during your knee arthroscopy will be one (or a combination) of the following:
- Local anesthesia: Anesthesia can be injected into the knee joint to numb only the area for the procedure. With local anesthesia, you will be awake for the procedure. You may feel a little pressure in the knee but should not feel any pain due to the numbing agents in the anesthesia.
- Regional anesthesia: Anesthesia is injected into the lower back or leg to numb your body from the waist or leg down. With regional anesthesia, you may be awake for the procedure but should not feel any pain.
- General anesthesia: Anesthesia is delivered intravenously through an IV in either your arm or hand to put you to sleep for the operation.
In some cases, if you receive local or regional anesthesia, you may be awake for the procedure and may be able to watch the operation on a monitor that will display an image from the inside of your knee from the camera of the arthroscope. In other cases, this type of anesthesia is combined with sedation or general anesthesia so that you may be asleep during the procedure.
If you receive general anesthesia, a nurse will place an IV in your arm or hand before you are brought into the operating room. General anesthesia will then be delivered through the IV in the operating room before the surgery begins.
Once sedated and asleep under general anesthesia, you will be intubated with an endotracheal tube that will be connected to a ventilator to assist you with breathing during the surgery. You will not feel anything.
During the Surgery
The skin of your knee will be sterilized with an antiseptic solution to kill bacteria and prevent the risk of infection. Sterilized linens will be placed around your knee to only expose the area where incisions will be made. A positioning device is sometimes placed on the leg to stabilize the knee and prevent movement during the operation.
There are several different techniques that can be performed during knee arthroscopy depending on what surgical work needs to be completed. Knee arthroscopy may include one or more of the following:
- Anterior cruciate ligament (ACL) reconstruction: To reattach a torn ACL ligament
- Posterior cruciate ligament (PCL) reconstruction: To reattach a torn PCL ligament
- Meniscus repair: To reattach a torn meniscus
- Meniscectomy: To remove either an entire or partial meniscus
- Lateral release of the patellar retinaculum: To loosen the patellar retinaculum to decrease pulling of the kneecap out of alignment
- Plica removal: To remove irritated synovial membrane folds
- Microfracture surgery: To drill holes into bone to increase blood flow and stimulate new cartilage growth
- Autologous chondrocyte implantation: To remove cartilage tissue, grow it in a lab, and implant it back into the knee joint
- Osteochondral autograft transplantation: To transplant healthy cartilage tissue from one area of the knee joint to another damaged area
Make sure to discuss with your surgeon what type of procedure you are having performed and the associated benefits and risks of undergoing surgical treatment for your condition.
To begin any of the arthroscopic procedures, your surgeon will make a few small incisions, called portals, about a centimeter in length around the knee. These portals will allow the surgeon to insert surgical instruments like scissors, clamps, and lasers, as well as the arthroscope which contains a camera and a light to see inside your knee joint and guide the operation.
A sterile solution will be injected into the knee to rinse out the joint to be able to see the structures of the knee joint more clearly. Your surgeon will then perform the necessary surgical procedures to help repair or remove damaged structures in the knee joint, such as reattaching a torn ligament or meniscus, removing damaged cartilage, or grafting and implanting healthy cartilage tissue.
After the surgeon is done removing and/or repairing damaged structures in your knee, the fluids will be drained from your knee. The portal incisions will be closed with either stitches, staples, and/or small surgical tape called steri-strips. Your knee will then be covered with a soft bandage to protect the incisions while they heal.
After the Surgery
After your knee arthroscopy, you will be brought to a recovery room where your vital signs will be monitored as the effects of the anesthesia begin to wear off. You will typically be able to go home one or two hours after the operation once you are awake and are able to stand and walk or move from a bed into a chair.
Make sure to arrange for a friend or family member to drive you home after your knee arthroscopy, as you will not be allowed to drive immediately following the operation. Your surgeon will determine when you will have clearance to safely resume driving.
A Word from Get Meds Info
Knee arthroscopy is a minimally invasive procedure that usually requires a short time in the operating room and a short time in the recovery room. Most patients are able to go home the same day of the surgery and can expect the entire process to only take a few hours from start to finish.
The smaller incisions from knee arthroscopy compared to more extensive, open procedures for the knee often result in decreased pain, stiffness, and swelling after the surgery as well as quicker time to resume certain functions.
Like any other surgery, however, the benefits and risks of undergoing knee arthroscopy should be thoroughly discussed with your healthcare provider to determine if you are an appropriate candidate for surgery. Conservative measures should always be considered first before surgery, even if it is a minimally invasive procedure.