Arthroscopy of the knee

Arthroscopy of the knee is a frequently performed procedure for diagnosis and treatment of conditions involving problems of the joint surface (true cartilage), menisci, and ligaments within the knee.

The most common reasons that we carry out this procedure is for meniscal tears, cartilage clean ups, and for the assessment of the knee for more complex procedures such as osteotomies, and joint replacement.
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Fig 1: Diagram of the knee.
Results of this surgery are dependent on what is found within the knee, although most patients will be back at work after 2 weeks.

Complications are rare, and include infection in about 1 in 1000, thrombosis about 1 in 1000. It is normal to have pain and swelling around the incisions, which can take up to 3 months to settle. Occasionally an area of numbness on the outside aspect of the knee is experienced. This usually resolves within 3 months, but in very rare cases may persist.
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Fig 2: The arthroscopy set up in Professor Yates' theatre.

Initial appointment

When we have agreed that you are suitable for arthroscopy of the knee you will be provided with printed information. Further information can be found on this web site. I will consent you for the procedure and in most instances be able to give you the date of your surgery. Investigations will be arranged as necessary and may include:
Radiology
Adequate up-to-date X-rays of the knee. MRI scan to confirm the diagnosis. We may also ask for a chest X-ray, which may be required by the anaesthetist.
Blood tests
Routine blood tests include a blood count to exclude anaemia and that you have adequate platelets; and electrolytes. Further blood tests may be requested depending on the presence of other medical problems.
Cardiology
A tracing of the heart may be done for anaesthetic safety. Further cardiology tests may be required if you have any pre-existing heart conditions.
Anaesthetic
Professor Yates usually uses Dr Alex Swann as his anaesthetist. Assoc Prof Gareth Prosser usually uses Dr Clinton Paine as his anaesthetist. Mr Gohil usually uses Dr Matt Harper as his anaesthetist.

The anaesthetist will contact you by phone before the surgery, to discuss the anaesthetic. Sometimes they will arrange to see you if there are particular worries. Occasionally, we will arrange for you to see another specialist in order to optimise your medical condition before the surgery.

Read more about Anaesthesia here.
Thrombosis (DVT) and pulmonary embolus (PE)
Thrombosis is an abnormal formation of solid blood constituents within the veins. This can move into the lung where it is called a pulmonary embolus. DVT or PE are very rare after arthroscopy as you are immediately mobile, and the surgery is very short. Prevention of these conditions is controversial, but we assess all my patients for risk of DVT/PE.

The day of surgery

You will normally be admitted through the day case unit, where the nurses will prepare you for surgery. You will need to have not eaten food for 6 hours before surgery and not drank water for more than 2 hours before surgery.

The anaesthetist will see you on the ward or in the holding bay in theatre. Pre medications are not prescribed routinely, but you can discuss this with the anaesthetist. We will usually see you in the holding bay, where all the documentation will be double checked, and you operative side will be marked.

Surgery is usually carried out as a day case, under a short general anaesthetic, and takes about 20 minutes. The skin is closed with steri strips, with a thick dressing that remains on for 24hrs. We will usually infiltrate the knee with local anaesthetic to reduce pain.

Post op

After the surgery is finished, you will be taken through to the recovery room, where you will be monitored until it is safe to return you to the day case unit. Anti sickness medication will be available if required.

Discharge

When you are ready for discharge, you will be given spare dressings for your wound and medications to take home, including those for pain relief. See Pain management after discharge.

The nurses will instruct you about wound care before you leave. Most patients go home 4 hours after surgery.

You may be seen by the physiotherapist, and outpatient physiotherapy arranged if appropriate.

Please see our Advice following Knee arthroscopy surgery.

Follow up

Orthopaedics WA rooms will contact you regarding your follow up appointment, which will be between 2–4 weeks. You will usually be able to drive after a day or so.

What you can do to optimize yourself

We will assess if any changes need to be made to your medications before admission. If you are on a single anticoagulant such as aspirin, for a medical condition, then we will usually continue with this. If you are on two anticoagulants, or warfarin, then they need to be stopped 5 days before surgery. Sometimes an alternative medication will need to be used in this period.

Stopping smoking will greatly reduce your risk of chest complications, infection, and poor wound healing, as well as benefit your long-term health.

Exercise, weight loss and healthy eating will all improve your outcome.

You may also like to view the most frequently asked questions about knees.
See the Related links on this page.