Knee arthroscopy is a minimally invasive surgical procedure done to evaluate and treat a wide range of knee conditions. In arthroscopic surgery of the knee, very small instruments are used (only 3 to 4 mm in diameter) for the procedure. This means that knee arthroscopy is much less traumatic to the muscles, ligaments, and tissues than traditional surgical techniques because it does not require any large incisions.
To perform knee arthroscopy, a specially trained Orthopedic Specialist in Arthroscopic Knee Surgery will make small pinhole incisions (about 1/4 of an inch each) around the knee joint. A sterile solution is then pumped into one of the incisions to expand the joint, giving the surgeon more room to work and a better view inside the knee.
The orthopedic specialist then looks inside one of the incisions with an arthroscope, a thin telescope that holds a camera lens and a light source. The camera displays views of the knee joints, ligaments and cartilage on a television screen. This helps the surgeon see what he or she is doing during the knee operation.
To physically repair the knee joint through arthroscopic surgery, the doctor will utilize the incisions that have already been made as entry points for the small surgical instruments. After diagnosing and/or repairing the problem, the small holes are closed with absorbable sutures.
Arthroscopic surgery of the knee is typically performed after a history and physical examination, as well as, diagnostic imaging that include an X-ray and MRI, all confirm the diagnosis.
Who Needs Knee Arthroscopy?
There are certain knee injuries and conditions that respond well to conservative treatment, while some require surgical treatment. An experienced orthopedic surgeon will determine if a patient is a good candidate for knee arthroscopy. Some of the reasons a patient may undergo arthroscopic knee surgery include:
- To repair or remove a torn meniscus
- To reconstruct an anterior cruciate ligament (ACL) tear
- To fix misalignments of the patella (kneecap)
- To reconstruct a posterior cruciate ligament (PCL) tear
- Knee joint (damaged) cartilage removal
- To repair and assess various sports injuries
- To treat mild arthritis
- Loose bone fragment or cartilage removal
- To complete synovitis (swelling of the joint lining) treatment
Benefits of Knee Arthroscopy
Because knee arthroscopy is so minimally invasive, it offers many benefits to the patient over traditional surgeries. These benefits include:
- Less bleeding
- Less trauma to the muscles, ligaments and tissues
- Less scarring
- Minimal infection rate
- Less pain
- A faster recovery period
- Earlier mobilization following surgery
- Faster and less painful rehabilitation
Immediately following arthroscopic surgery of the knee, your orthopedic surgeon will close the incisions and place a dressing over the stitches. An ace bandage is often wrapped around your knee to cover the dressings.
All patients go home the same day they have arthroscopic surgery. Before you are discharged, your doctor may prescribe pain medication. Once you’re back home it is recommended that you keep your leg elevated as much as possible— at least for the first few days following discharge. Icing the knee is also important, as it can help relieve swelling and pain. Ask your physician how often you should be icing your knee.
Recovery from knee arthroscopy is much faster than recovery from traditional open knee surgery. Even so, how fast a patient recovers greatly depends on the area of knee that underwent surgery and the type of injury being treated. Typically the more complex the procedure is, the longer the healing and recuperation time will be.
It is important to follow your surgeon’s instructions carefully in regards to certain tasks after you are discharged from the hospital. Such tasks may include:
- Showering and bathing- Your doctor will ask that you keep your incisions clean and dry for the first 24 to 48 hours. Follow your doctor’s instruction about how he or she would like you to care for your wound and how long you will need to wait before getting the incision wet.
- Weight bearing activities- Most patients do not require crutches after arthroscopic surgery and are simply provided a cane for a day or two. Most patients are allowed to put full weight on the ground. Some patients do need crutches after knee surgery. Your surgeon will tell you when it is safe to put weight on the leg that has undergone knee surgery.
- Driving- Your doctor will let you know when it will be safe for you to drive. Instructions will vary greatly from patient to patient, as recommendations heavily depend on which knee underwent surgery, the type of car you drive, the reason your procedure was needed, your level of pain and which medications you are taking. Typically, however, patients are able to drive within days after the procedure.
- Athletic participation- Although recovery time varies from patient to patient, gentle activity can often be resumed shortly after surgery. However, patients who wish to partake in contact sports, such as basketball or soccer, may require additional recovery time and should follow the surgeon’s instructions prior to returning to full sports activities.
Physical Therapy for Knee Arthroscopy Recovery
Many orthopedic surgeons have their patients take part in formal physical therapy after any type of arthroscopy procedure. Typically, the more complex the surgery the longer the rehabilitation process will be. Some patients also have a pre-operative visit with their NY Bone and Joint Specialists physical therapist. They may learn some of the exercises that will be done throughout recovery.
Post-operative physical therapy protocols are very specific based on the procedure performed. Overtime, goals of physical therapy will expand to include:
- Improving range of motion (ROM) to the knee and leg
- Regain coordination and balance
- Improve muscular control in the operated leg
- Increasing knee and leg strength
- Improving exercise tolerance
- Returning to all physical and daily activities