The arthroscope is a fibre-optic telescope that can be inserted into a joint (commonly the knee, shoulder, hip and ankle) to evaluate and treat a number of conditions. A camera is attached to the arthroscope and the picture is displayed on a TV monitor.
The arthroscope is an excellent means of examining the whole of the knee and most conditions can be treated at the same time. Knee arthroscopy is one of the most common orthopaedic operations performed worldwide.
There are many indications for undertaking arthroscopy of the knee:
Most arthroscopic surgery is undertaken as a day-case procedure and is usually performed under general anaesthesia. Patients are admitted on the day of surgery and need to remain fasted for 6 hours prior to the procedure. The knee undergoing the procedure will be identified and marked prior to the anaesthetic.
During the operation a tourniquet is placed around the thigh to permit better visualisation of the knee. The arthroscope is introduced through a small (approximately 0.5-1.0cm) incision on the outer side of the knee. A second incision on the inner side of the knee is made to introduce the instruments that allow examination of the joint and treatment of the problem
Local anaesthetic is administered into the knee by the surgeon at the end of the procedure. This usually provides 8-12 hours of pain relief. A bandage is wound around the knee.
Following surgery patients are given an instruction sheet showing exercises that are helpful in speeding up recovery.
Strengthening the thigh muscles (quadriceps and hamstrings) is very important; cycling (stationary or road) and swimming are excellent ways to build these muscles up and improve movement.
Return to driving and work is variable and usually at the patient’s discretion.
General Anaesthetic risks are extremely rare. Occasionally patients have some discomfort in the throat as a result of the tube that supplies oxygen and other gases.
The risk of complication from arthroscopic knee surgery is extremely low. However complications specific to Knee Arthroscopy can include:
Occasionally there is more damage in the knee than was initially thought; this can affect the recovery time.
If the cartilage in the knee is significantly worn out then arthroscopic surgery has only about a 75% chance of improving symptoms in the short to medium term; more definitive surgery (e.g. knee replacement) may be required in the future.
In general arthroscopic surgery does not improve knees that have well established osteoarthritis but may give symptom relief for a period of time. This is useful in young patients who are not keen on joint replacement.