Pathway for arthroscopic knee surgery

This topic provides an overview of the process from the initial appointment to post-operative treatment and what happens after you are discharged from hospital.
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Initial appointment

When we have agreed that you are suitable for an arthroscopy, you will be provided with verbal and printed information. Further information can be found on this web site. Orthopaedics WA will consent you for the surgery, and in most instances be able to give you the date of your surgery. Investigations will be arranged as necessary. These may include:
Radiology
Adequate up-to-date X-rays of the knee. 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 adequate platelets, and electrolytes. Further blood test may be requested depending on the presence of other medical problems.
Cardiology
A tracing of the heart is usually done, again for anaesthetic safety. Further cardiology tests may be required if you have heart issues.

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.

Admission

You will be contacted by the hospital admissions to confirm your surgery date and to finalise a time for your arrival. Before admission you will need to arrange someone to collect you after your surgery, and to have someone at home with you, at least, for the first day.

If you require special help at home, then this needs to be fully arranged before you come into hospital. Please ask if you have any questions regarding this.

The day of surgery

Orthopaedics WA admit nearly all my patients on the day of surgery to the day case unit. The nursing staff will prepare you for theatre. 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 your operative side will be marked.

You will next be taken through to the operating room, given your anaesthetic. A routine arthroscopy takes about 15 minutes to perform. The skin is closed with sticky strips a dressing and a bandage. We will usually fill 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 ward. A pain control regime will be in place, and anti sickness medication will be available if required.
Physiotherapy
Our physiotherapist will review on the day of surgery and, if you have recovered from the anaesthetic and the power has returned to your leg, they will get you to stand.

The physiotherapists will see you twice a day, and teach you your exercises, how to move safely and to help you rehabilitate. They may arrange outpatient physiotherapy, depending on your needs and circumstances.
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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.
 

Advice following knee arthroscopy surgery

The bulky outer dressing is to be removed 48 hours after surgery and the inner dressings are to be left for 7 days and then removed. The Steri-Strips are to be left on and they will fall off in the shower.

The bulky dressing is not waterproof so you will be given a plastic bag to cover your knee when showering but the inner dressings are waterproof so it is safe to shower without covering them.

Swelling is common but will resolve, use ice therapy up to every 4 hours, 20 minutes at a time. If there is increasing swelling or calf pain please see your doctor.

Any sutures will be dissolving so they do not need to be removed.

Pain is common for several days and you will be given pain relief on discharge, and you may need to get a further prescription.

Bleeding – there will be some blood on the dressing. Rest the leg and keep the leg elevated.

Clear discharge and oozing can sometimes last up to 2–3 weeks. If this is discoloured or the wound is inflamed please see your doctor or contact the office.

Bruising can occur after an arthroscopy, but this will resolve over several days.

Follow up

Orthopaedics WA will contact you regarding your follow up appointment, which will be between 2–4 weeks.

What you can do to optimise 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 five days before surgery. Sometimes an alternative medication will need to be used in this period.

Stopping smoking will greatly reduce your risks 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.

What to bring

Overnight toiletries, all X-rays and other investigations, all medications, non-slip flat shoes.

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