Knee Arthroscopy

Introduction

Knee arthroscopy is a type of keyhole surgery which enables Mr Hull to see what’s going on inside the knee joint using a small flexible tube called an arthroscope.

The arthroscope

An arthroscope is a thin tube which contains optical fibres, lenses and a light source which lights up and magnifies the structures inside a joint, displaying the images on a tv monitor. This way Mr Hull can investigate symptoms such as pain, swelling, or instability of a joint.

As well as seeing the inside of the joint, Mr Hull can also see the ends of the operating instruments, so for much of the time, he will watch the TV monitor to guide him during the procedure.

The size of the arthroscope is about 5 millimeters in diameter and it’s also possible for tiny surgical instruments to be passed through it to allow Mr Hull to treat the knee joint if necessary. This is called arthroscopic surgery. Conducting procedures this way usually causes less tissue trauma, results in less pain and may lead to a quicker recovery compared to traditional surgical techniques.

Surgical procedure

Knee arthroscopy is normally done under general anaesthesia so that you sleep during the operation and don’t feel any pain or discomfort.

The procedure starts by Mr Hull making a small incision next to the knee joint so that the arthroscope can be inserted. One or more small incisions will also
be made to allow an examining probe or, if necessary, surgical instruments, to be inserted.

When the procedure is finished, the arthroscope and other instruments are removed. The incisions may need a stitch or two, but often they aren’t necessary because the incisions are so small. A sterile dressing is placed over the incisions and an ice pack may be applied for a while to minimise swelling. A large bandage may then be put over the knee for support .

Risks and complications

As with all operations, there is a possibility of a reaction to the anaesthetic, excessive bleeding, developing a blood clot and wound infection. A general anaesthetic may also make you feel temporarily sick after the operation.

During knee arthroscopy, there is also the risk of accidental damage to the inside of the joint, and bleeding inside the joint which can be very painful.

Infection inside the joint is another possibility as is a loss of feeling in the skin over your knee due to nerve damage but this is normally temporary.

Preparing for surgery

Mr Hull will talk to you about how best to prepare for surgery which may include stopping taking any anti-inflammatory medications such as aspirin to reduce the risk of blood clots and stopping smoking if you are a smoker to minimize the risk of infection.

If you're having a general anaesthetic, you will be asked to follow fasting instructions. This means not eating or drinking, typically for about six hours beforehand.

Mr Hull may also ask you to wear compression stockings to help prevent blood clots forming in the veins in your legs.

Recovery

Usually people can go home shortly after this procedure. It is important to follow the advice given about after-care by your nurse and the advice given by your physiotherapist about exercises to get the joint moving properly.

In most cases, this is a very successful and straightforward operation but like with all operations, they run the slight risk of a reaction to the anaesthetic, infections and excessive bleeding or blood clots. With knee arthroscopy, there is also a possibility of accidental damage to the knee joint and some loss of feeling in the skin over the knee. And in a few cases, the operation may need to be repeated if it wasn’t successful but this is very rare.

Further information

For further information please contact Mr Peter Hull FRCS, Consultant Trauma & Orthopaedic Surgeon.