Knee Arthroscopy

A knee arthroscopy is a surgical technique which involves looking inside the joint with a small camera (arthroscope). It is performed for diagnosing and treating knee joint disorders. By making small incisions into the knee, instruments can be inserted to repair or remove damaged structures. As it is less invasive than open surgery which requires a larger incision being made, there is usually less pain involved and patients experience a faster recovery. However, it is still a major surgical procedure which does involve some risks and still requires appropriate post-operative rehabilitation.

Why is Knee Arthroscopy Performed?

Knee arthroscopy surgery is commonly used to diagnose the following conditions:

Torn ACL

The anterior cruciate ligament (ACL) is one of two ligaments that cross in the middle of the knee, connecting the femur (thighbone) to the tibia (shinbone). The role of the ACL is to stop the top of the shinbone from slipping forwards. When damaged, there is usually a partial or complete tear of the tissue. A mild injury may stretch the ligament but leave it intact. When the ligament is torn, the ends can suddenly ping apart, often resulting in reconstruction of the ligament. The majority of ACL reconstructions are carried out arthroscopically.

Torn Meniscus

The meniscus, is made up of 2 C-shaped discs of cartilage (soft tissue) which connect your thigh bone to your shinbone. These are called menisci and they act as shock absorbers for the knees and help to keep the knee stable. Certain activities, particularly contact sports which involve a degree of twisting your knee, place a lot of stress on the knee which can result in a tear of the meniscus. Small meniscus tears can usually be trimmed to relieve the symptoms of a torn meniscus; however, meniscus repair is a major surgery which has a longer recovery period and is not always successful. When surgery can be performed to fully repair the meniscus and restore the normal anatomy of the knee, a better long-term prognosis is likely.

Misaligned Patella (Lateral Release)

The patella, or more commonly known as the kneecap is a separate bone that is attached to the thigh bone at the top, and the shinbone at the bottom. The patella is held together by strong tendons and ligaments which when working properly, glides in a groove or cutaway that is near the end of your thighbone, known as the trochlear groove. Patella misalignment means your kneecap moves sideways, often shifting outside of the leg, although it can also move towards the inside. Arthroscopic lateral release surgery is performed to loosen the ligaments that pull the kneecap towards the outside of the groove.

Microfracture

Microfracture surgery is usually performed arthroscopically to treat areas of damaged cartilage. Where there is a small area of damaged cartilage (not widespread arthritis), microfracture surgery can be performed to try and stimulate new cartilage growth. The procedure creates small holes in the bone. By penetrating the hard layer of subchondral bone which is hard and lacks good blood flow, the microfracture allows the deeper, more vascular bone to access the surface of the joint. As the deeper joint has a richer blood supply, the cells can get to the surface layer and stimulate cartilage growth.

Baker’s (Popliteal) Cyst

A Baker’s cyst, also known as a popliteal cyst is a fluid filled swelling that causes a lump behind the knee. It often causes a bulge and feeling of tightness, along with restricted movement. It can also be painful when the knee is bent or extended. There is usually an underlying cause to the cyst and treatment of this condition often alleviates the problem. Typical causes can include arthritis or cartilage injury. Although a popliteal cyst may not cause any long-term damage, it can be extremely uncomfortable.

Performing Knee Arthroscopy Surgery

Before undergoing a knee arthroscopy, you will be advised how best to prepare for surgery. You should inform your doctor of any prescriptive or over the counter medication you are currently taking, along with any supplements. You may be required to stop taking certain medication such as ibuprofen or aspirin for a number of days or weeks before your procedure.

It is important that you do not eat before knee arthroscopy surgery; usually twelve hours before. You can continue to drink water up until two to six hours before surgery. You will be advised of the correct length of time during your pre-assessment appointment.

Knee arthroscopy can be carried out under a general or local anaesthetic. A regional anaesthetic can also be used which numbs you from the waist down. Once your anaesthetic has taken effect, the surgeon will begin by making small incisions or cuts into your knee. The incisions are placed in specific locations to minimise the potential for injury to surrounding nerves. In order to make it easier for the surgeon to see inside the joint, saline (sterile salt water) is pumped in to expand the knee. The camera (arthroscope) is then placed inside one of the cuts so the surgeon can look at the joint. The images from the arthroscope are relayed to a monitor in the operating theatre for the surgeon to see in more detail.

The length of your knee arthroscopy surgery will vary depending on what the issue is, although as it is not a very invasive procedure, it usually takes less than an hour. Once the surgeon has located the problem in your knee, small tools will be inserted into the incisions to correct the damage. Once the problem has been addressed, the saline is drained from your knee joint and the incisions are closed with stitches. Your knee will then be bandaged and it is likely that you will be able to go home on the same day.

Post-Operative Recovery

Once you have returned home, you should arrange for someone to take care of you, at least for the first couple of days. It is important to try and keep your leg elevated to reduce pain and swelling. You will need to change your dressing and your doctor will tell you how often you need to do this.

Depending on the type of knee arthroscopy surgery performed, you may or may not be allowed to place weight on it. You will be required to undergo a length of rehabilitation, usually with a physiotherapist in help restore range of motion and retain strength of the joint. You will be given a set of exercises to perform at home to help your knee recover. It is important to do your exercises regularly as otherwise this will impede the speed of your recovery. With proper care and rehabilitation, the outlook for your knee arthroscopy is very good.

Risks and Complications

As with any invasive surgery, there are always risks involved, although most are rare. Risks associated with knee arthroscopy include:

• Bleeding inside the knee joint
• Blood clot in the leg
• Stiffness and swelling of the knee
• Infection inside the joint
• Damage to the ligaments, meniscus, cartilage, blood vessels or nerves of the knee

Risks associated with all surgeries include:

• Infection at the site of surgery
• Reaction to anaesthesia or other medications administered
  Excessive bleeding

Need Help?

Other than knee arthroscopy, at One Ashford Hospital we perform many different surgeries on patient’s knees, including minimally invasive knee replacements and revision of existing knee replacements.   At One Healthcare we can book you in to see a specialist Orthopaedic knee surgeon for an initial consultation, usually within 48 hours.   

You can use your private medical insurance or pay for your Knee Arthroscopy treatment. We offer competitive, fixed price packages. If you are using your health insurance, please contact your insurer first for approval and let them know you’d like to be treated at either the One Ashford Hospital or One Hatfield Hospital.

Why One Healthcare

• Modern purpose-built hospital opened in March 2016 (Ashford) December 2017 (Hatfield)
• Fast access to diagnostics including MRI, X-ray and Ultrasound
• 0% and low finance options**
• Private, spacious, en-suite rooms
• Specialist Physiotherapy and nursing teams
• Little or no waiting time
• ‘Ultra clean air’ theatres
• Freshly prepared food
• Calm, dignified experience

**Terms and conditions apply

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