Knee arthroscopy is sometimes called a "knee scope" or "keyhole knee surgery". The procedure involves making two small incisions (less than 1cm long) on the front of the knee to create portal. A small telescopic camera (‘scope’) is inserted into one of the portals and this provides a view inside the knee joint. The other portal is used for passing in small surgical instruments.
In addition to being able to directly assess the cause of knee pain, there are many procedures that can be performed using arthroscopic technique including
Repair or removal of torn cartilage
Repair meniscal tear
Removal loose body
Smoothing of rough joint surfaces (arthritis)
Reconstruction of damaged ligaments
Arthroscopy is a quick and effective procedure. The majority of surgeries go very smoothly without any major complications.
Commonly, patients experience bruising and swelling around the knee which can take several weeks to settle.
Serious complications such as infection and blood clots are rare.
Some patients may still have pain following surgery. This more likely in patients with significant arthritis in their knee. Additionally, the locking or catching feeling may resolve, but with only partial resolution of the pain.
Simple arthroscopy takes about 30 minutes to perform. The joint is visually examined, and pictures/video inside the joint are taken. If a repair or reconstructive procedure is needed, the operation may take 90 minutes.
Generally, arthroscopy is performed as Day Stay Surgery and you may go home the same day as your procedure. You will need someone to drive you home, and a responsible adult to be with you overnight as you may still be sleepy and require oral pain medications.
DO NOT EAT OR DRINK from midnight, unless otherwise instructed.
Dr Schluter will meet with you, answer any further questions, check the consent form and mark the operative leg. You will also meet the anaesthetist (specialist doctor) who will be providing the anaesthetic. In most cases the procedure is done under a general anaesthetic. An IV line (drip) will be inserted and you may be given some premedication.
After the operation you will go to the recovery room where nursing staff will monitor you until you are awake. You will notice a tubigrip stocking or bandage around your knee and small number of patients may also have a brace on their knee.
As you wake up you may experience discomfort or a tight/full feeling in the knee, which should be easily managed with pain medication. Once you are alert, you will be encouraged to get up and mobilise slowly.
Depending on the operation that has been performed, you may require crutches for 1- 2 weeks. Dr Schluter will outline instructions specific to you, both before and after the operation.
You will be given a disc with pictures taken inside the knee joint to take home with you. The pictures can be confusing to understand, but Dr Schluter will discuss these in detail at your follow up visit.
Dr Schluter will review you at a follow up appointment approximately 2 weeks after your surgery. He will review your wounds and remove any sutures. You will be able to discuss the findings of the arthropscpoy and talk through the photos/video taken during the procedure.
At this appointment, Dr Schluter will also discuss your ongoing rehabilitation programme.
For the first 5 – 7 days it is very important to elevate the leg when you are resting. Rest is important to allow the swelling and inflammation to settle.
Using an ice pack, or pack of frozen peas, during the first 3 days can help in reduce the swelling and discomfort. Ice can be applied for 20 mins every 2-3 hours. To prevent ice burn, please make sure there is a barrier such as a hand towel between the ice and the skin.
Walking and gentle movement are encouraged to prevent stiffness during the first 2 weeks. After this, a rehabilitation programme supervised by a physiotherapist is recommended. Remember not to work too hard however, as this can cause more swelling.
The incisions (portal wounds) should be kept dry for 3 weeks. Your dressings are waterproof and its fine to shower with them. Please change the dressing if the dressing becomes soaked.
It is normal to have a small amount of bleeding into the dressing. If there is ongoing bleeding enough to soak the dressing, this may need review – please contact Dr Schluter’s room for advice.
It is also very normal to have some bruising and swelling around the knee which may take several weeks to settle.
The discomfort in your knee will improve each day, but you may experience soreness for 4 – 6 weeks after the procedure, especially with deep knee bends. It is important to take the prescribed pain medications regularly as instructed. In general, patients need pain medication for around 5 days.
If you have had a simple arthroscopy, you may not need crutches when you go home.
Crutches are used to help control the amount of weight that is put on the operated knee. This helps the healing process by controlling swelling. The time until you can fully weight bear (put your full body weight on the operated knee) will depend on the operation performed.
When using crutches, it is important to actively contract the thigh muscles (quadriceps) on the operated leg every time you put weight on it.
It is quite normal to have swelling, bruising, clicking and discomfort in your knee for 6- 8 weeks after the operation. These ongoing symptoms are generally related to the underlying condition of the knee, the extent of the surgery and the amount of activity you have been doing.
If you are concerned about any of these symptoms please contact Dr Schluter’s rooms.
Please do not hesitate to contact Dr Schluter’s rooms or your GP if you develop any of the following:
Heavy bleeding from the incision
Sudden severe pain or tenderness at the wound site or in the joint.
Swelling in the calf or thigh, especially if associated with pain or heat
Redness around the incision that continues to spreads.
Temperature higher than 38.5 °C (fever) or chills.
Worsening flexibility or an inability to bend the knee.
Any concerns you may have regarding your recent surgery