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Your surgeon has advised that you might benefit from an operation called an arthroscopy of your knee joint.
What is an arthroscopy?
An arthroscope is a small telescope for looking inside a joint. It is approximately 5mm wide and contains a fibre optic light system and a number of small lenses. When attached to a miniature television camera it allows a surgeon to look inside your knee joint through very small incisions about 1cm long (so called “keyhole surgery”). Two or three small incisions are commonly used around the kneecap. The operation is usually performed under a general anaesthetic but can be done by a regional anaesthetic that just numbs the legs. Salt solution is washed through the joint to improve the surgeon’s view. A tourniquet is sometimes used to prevent bleeding during the operation.
What can be done?
An arthroscopy can be performed just to look inside your knee joint to see what is causing your symptoms (diagnostic). More commonly the arthroscope is used in conjunction with other small specialist instruments that are introduced into the joint through other small incicions. Using the arthroscope the surgeon can guide these small instruments and perform a number of procedures. These include washing out fluid or tissue debris, removing or reattaching loose fragments, repairing or removing torn cartilage, drilling or grafting defects in the joint surface and reconstructing the ligaments in your knee. The small skin incisions will need paper or nylon stitches.
How long will I be in hospital?
This depends on what was done during your arthroscopy and on your general health. The operation is usually performed as a day case but in some circumstances may require an overnight stay. If you have had more major surgery you may need to stay for 1 or 2 days.
The knee will be bandaged after surgery. You may need to use crutches for a few days when you get home. You will not be discharged until the physiotherapy or nursing staff are happy that you are able to move around safely. Any stitches need to be removed at 2 weeks.
How long will I be off work?
Most people return to office type work within four days. People with more physically strenuous jobs may need longer. Driving short distances may be possible after a week, depending on the type of surgery and the speed of recovery.
What can go wrong?
All operations have a small risk of complications. All the complications outlined below are more likely if you are very overweight, smoke, suffer from chronic systemic illness or are taking steroids.
You will have an anaesthetic which is generally very safe. Your anaesthetist will explain any risks to you.
Any lower limb operation increases the risk of a blood clot in the veins (a thrombosis). This can vary from small, less important clots to a serious thrombosis which may become dislodged and travel to the lungs – an “embolus” (occurs in 1 patient in a 1000). An embolus can be fatal. The use of certain HRT and oral contraceptive pills may increase the risk of thrombosis and may need to be stopped up to four weeks before surgery. Consult your surgeon if in doubt.
The risk of infection in the knee joint following arthroscopy is very small (less than 1 chance in 200). It can however be very serious requiring emergency treatment. It can lead to a prolonged hospital stay and irreversible damage to the knee joint.
Bleeding into the joint can sometimes occur after your surgery and if severe this may require a return to the operating theatre for removal of the blood. The risk of this sort of bleeding is less than 1 chance in 100.
5. Failure to improve
Despite the surgeon’s efforts an arthroscopy may not cure your symptoms, particularly if the problem is too advanced. If this is the case, the surgeon will discuss other options for treatment with you.
We hope this leaflet has answered any questions you might have. If you have any further queries please feel free to discuss them with any of the medical or nursing staff either in the Clinic or on your arrival in Hospital.