Arthroscopy

Arthroscopy is an operation that I do frequently for joint pain and problems. Although there have been many wonderful advances in the diagnosis of joint problems, none of them offers the opportunity to actually see inside the joint and repair the damage at the same time.

WHAT DO X-RAYS SHOW?
X-rays are one way to get a "road map" of your knee. X-rays may show advanced arthritis, bone spurs, fractures, or other bony causes of pain, but do not show the actual joint surfaces, ligaments inside the knee, or the meniscus (shock absorber) which may also be damaged. The best way to evaluate these structures is by looking right at them with an arthroscope. Arthroscopy is usually performed as an outpatient, or same day surgery. Only rarely is it necessary to admit patients overnight (about 2 in 100). If you are concerned about your specific medial condition, it is best to ask me if an overnight stay might be recommended.

WHAT CAN I EXPECT?
You will go to the outpatient surgery center a few days before your arthroscopy, and you might have a blood count, a cardiogram, and a chest x-ray made if you have not had one recently. I will arrange this. On the day of your surgery, you will go to the outpatient surgery center about one hour before the scheduled time of your procedure. There the nurses will help you get ready for the arthroscopy. You will meet the anesthesiologist and the nurses who will be responsible for your anesthesia. Although most arthroscopies are usually done under general anesthesia, we can do them other ways. Ask me if you would like more information on this. The arthoscopy itself usually takes twenty to thirty minutes. Part of this time is spent preparing your leg with special soap and drapes to prevent infection.

WILL I HAVE AN INCISION?
When all is ready, I will make a tiny (Less than 1 inch) window called a portal on the outside of your knee to insert the arthroscope. This is a small telescope about the size of a ballpoint pen, which is attached to a tiny television camera. A second, or operative portal, will be made at the lower inside area of the knee where we can insert the special microscope tools to perform the cartilage repair or removal. We may use a special knife or scissors to trim or remove torn cartilages. Special suction devices allow us to smooth rough surfaces due to arthritic damage.

WILL IT HURT?
When the procedure is complete, we will put a long acting anesthetic into the joint to help relieve pain. It will last a few hours and you will take pills for pain when you get home. When you have completely recovered from the anesthetic, you will be discharged home from the outpatient surgery center. You will be given a written set of instructions, but generally we want you to go home, elevate your leg on a couple of pillows, and place ice on the knee area to prevent swelling. You should not take aspirin or related medications until you check with me.

HOW LONG WILL I BE LAID UP?
We usually recommend that our patients use crutches or a walker for a day or two until your knee feels stronger. Then you may walk without these for gradually increasing periods of time. Usually, you will be off all supports by a week after surgery. Depending on your job and the severity of your knee problem, you might expect to return to your usual activities in one to three weeks. Frequently, we recommend physical therapy for few weeks to help speed recovery.

See our animated knee anatomy (requires Shockwave)