Knee Arthroscopy

Knee arthroscopy is performed to diagnose and treat various knee joint problems. Some common reasons for undergoing this procedure include:

• Torn Meniscus
  The meniscus is a piece of cartilage that acts as a cushion between the thigh bone (femur) and the shin bone (tibia). Tears in the meniscus are often caused by twisting or rotating the knee, particularly during sports. This can cause pain, swelling, and difficulty moving the knee. Depending on the location and severity of the tear, the orthopaedic specialist may trim or stitch the meniscus during arthroscopy.
• Damaged Cartilage
  Cartilage damage can result from injury or degenerative conditions like osteoarthritis, leading to pain, swelling, and joint stiffness. The orthopaedic specialist can use arthroscopy to remove loose cartilage pieces and smooth rough surfaces to reduce friction or create microscopic bone holes to stimulate cartilage growth.
• Ligament Injuries
  Ligament injuries, such as to the anterior cruciate ligament (ACL), can result from sudden stops or changes in direction, which commonly occur in sports. These injuries cause knee instability and may lead to further joint damage if untreated. Arthroscopy can assist in the reconstruction or repair of damaged ligaments.
• Synovial Problems
  The synovium is the joint lining that can become inflamed or develop abnormalities. Arthroscopy allows for removing inflamed synovial tissue or the treatment of synovial disorders, helps to relieve symptoms and prevents further joint damage.
• Loose Bodies
  Loose bodies are fragments of bone or cartilage that break off and float within the knee joint, often due to injury or arthritis. These fragments can cause the knee to lock and may lead to pain and swelling. Arthroscopy is effective in locating and removing these loose bodies.
• Patellar Problems
  The patella, or kneecap, can suffer from various issues, including misalignment (patellar tracking disorder), cartilage damage (chondromalacia patella), or dislocation. These conditions can result in pain, instability, and difficulty in movement. This can be addressed through arthroscopy to improve knee function and reduce pain.
• Unexplained Knee Pain
  When other diagnostic methods, such as X-rays or MRI scans, fail to identify the cause of persistent knee pain, arthroscopy can inspect the joint and potentially treat the underlying problem visually. This can include removing inflamed tissue, repairing small tears, or addressing other abnormalities not visible in imaging tests.

Patients should follow their orthopaedic specialist’s specific instructions, which may include the following steps:

Medical Evaluation: Before the procedure, a thorough medical evaluation is conducted to assess the patient’s overall health and suitability for surgery. This includes reviewing the patient’s medical history, medications, and allergies. Blood tests, imaging tests, and a physical examination of the knee may also be performed.

Medication Adjustments: Patients may need to adjust their medications before surgery. This includes discontinuing blood-thinning medications such as aspirin or anticoagulants, as these can increase the risk of bleeding. Patients should inform the orthopaedic specialist of all their medications, including over-the-counter drugs and supplements.

Fasting Instructions: Fasting is typically required before the procedure to minimise the risk of anaesthesia-related complications. Patients are usually instructed not to eat or drink anything after midnight on the night before the procedure. The orthopaedic specialist will provide specific fasting instructions.

Arranging Transportation: Since knee arthroscopy is often performed on an outpatient basis, patients must arrange for transportation to and from the surgical facility. Driving immediately after the procedure is unsafe due to the effects of anaesthesia and potential discomfort.

Pre-Operative Instructions: On the day of the surgery, patients should follow any specific pre-operative instructions provided by their orthopaedic specialist. This may include showering with a special antiseptic soap to reduce the risk of infection, wearing loose and comfortable clothing, and arriving at the surgical facility at the designated time.

Here are some of the most common risks and complications associated with knee arthroscopy:

• Infection
  Infections may develop at the incision sites or within the knee joint. Symptoms of an infection include increased pain, redness, swelling, warmth, or discharge from the incision sites, and fever. If an infection develops, it might be managed with medication or, in more serious situations, might need more surgery.
• Blood Clots
  Blood clots, or deep vein thrombosis (DVT), can form in the leg veins following surgery. This risk is higher if the patient remains immobile for extended periods. Symptoms include swelling, pain, and redness in the calf or thigh. Patients may be advised to wear compression stockings, do leg exercises, and take blood-thinning drugs to prevent blood clots.
• Knee Stiffness
  Some patients may experience stiffness in the knee following surgery. This can be due to scar tissue formation or insufficient rehabilitation. Regular physical therapy and exercise compliance can reduce the risk of stiffness and improve the knee’s range of motion.
• Persistent Pain
  Although knee arthroscopy aims to alleviate pain, some patients may experience pain after the procedure. Persistent pain can result from knee problems like arthritis or damage that could not be fully repaired during surgery. Follow-up consultations with the orthopaedic specialist are needed to address and manage ongoing pain.
• Nerve or Blood Vessel Damage
  During arthroscopy, there is a small risk of injury to the nerves or blood vessels around the knee. Such injuries can lead to numbness, weakness, or circulation issues. These complications are rare and often resolve over time, but they may require further treatments if they persist.
• Swelling and Bruising
  Swelling and bruising around the knee and incision sites are common after arthroscopy. These symptoms usually subside within a few weeks. Elevating the leg, applying ice, and following the orthopaedic specialist’s advice can help manage these symptoms.