Overview
General
Knee arthroscopy is a technique used to inspect the inside of the joint cavity to diagnose and assess damage and, where possible, to treat this damage. Arthroscopic knee surgery involves a small telescope, video equipment and instruments. Knee Replacement is used to treat any number of conditions that occur within the knee from simple cartilage tears to removal of loose bodies and anterior cruciate ligament reconstruction. At the same time all of the other structures within the knee can be clearly viewed and probed.
Tunnels are then drilled through the bone in the femur and the tibia so that the graft can be placed in the center of the knee in the same position as the original ACL. A separate incision that is about 2 to 3 inches long also has to be made in order to harvest the graft from either the patellar tendon or the hamstring tendons. After the graft has been harvested, it is then prepared by placing several very strong surgical sutures through the graft that are used to fix it in place. acl knee surgery, graph secured with screws (Image Credit: Seif Medical Graphics)Some surgeons will also braid the graft before passing it through the tunnels.
After the graft is passed through the tunnels, it is then tensioned and fixed in place. A variety of fixation techniques have been developed to anchor the graft to the bone. Different techniques are used for different types of grafts, and today, fixation failures, though possible, are very rare.
Once the graft has been fixed in place and any additional damage has been addressed, the incisions are closed and a sterile dressing is used to cover the knee. This dressing will usually stay on for several days while the wound begins to heal.
Procedure for arthroscopic knee surgery
Arthroscopic knee surgery requires a hospital operating theatre and is usually performed as day case surgery. arthroscopic knee operation is normally done under a general anaesthetic but may be done under epidural, spinal or occasionally a local anaesthetic if necessary. Typically the patient might come into hospital shortly before the arthroscopic knee operation having been pre-assessed as fit for surgery.
The arthroscopic knee operation requires two or three small incisions in the knee joint to allow insertion of fluid, the arthroscope [attached to a camera] and instruments. The length of these incisions is approximately 5-7 mm. Occasionally an incision will have to be enlarged in order to remove a fragment from the knee.
The length of time the arthroscopic knee surgery takes depends on the procedure which is being performed. Simple arthroscopic knee surgery (i.e. excluding more complicated arthroscopic procedures such as arthroscopic ACL reconstruction) usually takes between 10 and 30 minutes.
Following the arthroscopic knee surgery, a local anaesthetic solution is normally injected into the joint to assist with pain relief.
The small incisions rarely require stitches, and will usually have a simple dressing applied with a bandage wrapped around the knee.
Once the patient has recovered from the anaesthetic and started to mobilise, they are normally safe to be discharged from hospital.
Return to activity
Generally, a return to activities takes between two and six weeks following arthroscopic knee surgery. Recovery, however, depends on the extent of damage found within the knee, the treatment performed, the type of activities to which the patient wishes to return and the general fitness of the patient.
Approximate recovery times following simple arthroscopic surgery are:-
- Sedentary (office type) work 2-5 days
- Physical work 1-3 weeks
- Light training 3 weeks
- Return to full impact activities 4-6 weeks
- Driving 2-4 days
Risks
Arthroscopy has a very low complication rate. However, complications such as infection, excessive swelling and pain can occur along with rare general complications such as blood clots and anaesthetic risks. In general, the risk of major problems is much less than 1%.
What is arthritis?
Arthritis is a group of conditions where there is progressive damage to one or more joints. The most common type of arthritis is osteoarthritis, where there is progressive wear and tear of a joint. Some other types of arthritis are associated with inflammation of the joints.
What complications can happen?
General complications of any operation
- Pain
- Bleeding
- Infection in the surgical wound
- Unsightly scarring
- Blood clots
- Difficulty passing urine
- Chest infection
- Heart attack or stroke
Specific complications of this operation
- Damage to nerves
- Loosening
- Damage to blood vessels
- Infection in the knee
- Severe pain, stiffness and loss of use of the knee (Complex Regional Pain Syndrome)
How soon will I recover?
You should be able to go home after five to seven days.
You will need to use crutches or walking sticks for a few weeks.
Most people make a good recovery, with much less pain and better mobility.
However, an artificial knee never feels quite the same as a normal knee. Kneeling down is not recommended and is usually uncomfortable. A knee replacement can wear out with time.
Other Related Links
| Meniscus repair |
| Broken Bones and Injury |
| Common Knee Injuries |
| Hamstring Muscle Strain |
| Thigh Muscle Strains |
| Anterior Cruciate Ligament Injuries |
| Patellar Tendon Tear |
| Unstable Kneecap |
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