Knee Arthroscopy
Overview
Arthroscopy of the knee is usually performed to diagnose and treat internal knee problems such as:
cartilage tears
loose bodies
a lead up for ligament damage surgery
On occasions, knee arthroscopy can be useful for other conditions, which will be explained to you by your knee surgeon.
What to Expect when having a Knee Arthroscopy
Simple knee arthroscopy procedures are carried out in hospital as a Day Case. Occasionally you may need to stay overnight for medical reasons.
On the day of your arthroscopy, you will initially meet the nursing staff in the Day Care Unit and have a brief check up by your anaesthetist. The surgical team will prepare your knee with hair removal and a wash. From the Day Care Unit, a nurse will take you to the operating theatre to meet your knee surgeon. In most cases, your knee arthroscopy will be carried out under a general anaesthetic.
Knee Arthroscopy Surgery – Outline of the Procedure
A theatre nurse will wash your knee with antiseptic solution to prevent infection, then applies a tourniquet to the thigh to prevent bleeding during the operation.
Your surgeon introduces an arthroscope into the knee through a small puncture wound beside the knee cap. First, they’ll perform a thorough examination of the entire knee. Then they’ll investigate the specific problem as discussed with you during your consultation visits.
Your surgeon treats any cartilage damage, loose bodies and arthritis with small instruments through a second puncture wound on the other side of the knee cap. Photos are taken of your knee during your procedure.
At the end of the operation, the small puncture wounds will be closed with steri strips and occasionally with sutures. The knee is then wrapped up with a sterile bandage.
AFTER KNEE Surgery
You will find 2-3 small puncture wounds under the compression bandage covering your knee. These are made by the surgical instruments used during the procedure and are closed by tapes called steri strips.
Although these wounds are only small, the surgery inside your joint is quite significant and your joint will take time to recover. It is important that you follow the instructions to help healing and to maintain the muscle strength and range of movement of your knee.
post-operative Recovery
After the surgery, you will be taken to the recovery room and eventually back to the Day Care Unit.
You will be given an instruction sheet outlining your post operative care and also a photo of your knee taken during the procedure. You’ll receive detailed findings of your surgery at your post operative appointment approximately 10 days following the surgery.
Discharge from Hospital
You will be required to stay in hospital for at least 2-3 hours following your procedure before you will be discharged.
You must have someone available to drive you home from hospital.
You must not operate machinery or drive a car for 24 hours after your procedure.
You should have a responsible adult with you at home for at least the first 24 hours.
Post-Operative Care
Your surgeon will make a post-operative appointment to see you in their consulting rooms, usually 10 days after your knee arthroscopy. It is important that you attend this appointment as part of your ongoing treatment and management.
Post-Surgery
You will be required to rest completely for the first 2-3 days following your knee arthroscopy.
This means:
sitting in bed or on the couch
doing some light exercises
icing the knee regularly
By the 3rd or 4th day you may start to walk around a little. If you work in an office you may then return to work. More active jobs may require longer periods off work. Manual labourers should expect up to 2-3 weeks off work following a knee arthroscopy.
Progress
It is very important not to push your knee too hard, as this will slow the healing.
Signs that indicate that you are doing too much include:
increased swelling
increased pain
increase in temperature in the joint
Puncture Wounds
This area should remain dry until your surgeon removes the tapes 10-14 days after your knee arthroscopy.
The areas may be slightly tender and puffy for 1-2 months after your knee arthroscopy and will benefit from gentle massage once healed. There may be some bleeding from the portal site. This is nothing to worry about in general. Excessive bleeding may require re-bandaging. Please call your knee surgeon if this happens.
knee Swelling
The amount of swelling following a knee arthroscopy varies with different people and tends to depend on the pre-operative state of your knee and on how much is done to your knee at the time of surgery.
An increase in the amount of swelling in the first few days after your knee operation indicates that you are progressing your activities too quickly. It is important to decrease the amount of swelling as quickly as possible, as it will cause problems with healing, strength and range of movement.
You can decrease the swelling in your knee by:
not overdoing things
using a compressing bandage
using crutches to reduce the weight
keep the leg elevated as much as possible
using ice at regular intervals.
Ice cubes should be wrapped in a wet towel and applied to your knee for 15 minutes.
You should frequently check your leg to ensure that it is pink in colour and not white or blue, as this will result in ice burn. You may apply ice for one 15 minute period every 3-4 hours.
knee Pain
Ensure that you take the tablets (Panadeine or Panadeine Forte) if you have knee pain.
If your pain is not controlled by tablets, please call your knee surgeon.
Activities
You may begin weight bearing activities after 1-2 days.
DO NOT DO TOO MUCH TOO SOON.
If you have knee pain or swelling, then rest is the best treatment early on.
Crutches
You can use crutches to control the weight bearing transmitted through your knee joint.
Full Weight Bearing
This means that you may take as much weight as comfortable through your operated leg. The crutches are used in this instance to help control swelling and pain and to assist in the healing and recovery of the knee joint. It is important that you contract your thigh muscles each time you take weight through your operated leg and to hop over it. You may discard your crutches when you can walk without pain and the swelling around your knee joint has reduced.
Stairs
It is extremely important to negotiate stairs slowly when you are on crutches.
Remember This Sequence:
WHEN GOING UPSTAIRS: Good leg to heaven, ie good leg, bad leg, then crutches
WHEN GOING DOWNSTAIRS: Bad leg to hell, ie crutches, bad leg, good leg
Bandage
Following the knee arthroscopy, your surgeon will bandage your leg. Please keep the bandage dry. It is common for the bandage to become spotted with a small amount of blood. About 3-4 days after surgery, you may remove the bandage and replace it with a tubigrip. 2-3 small puncture wounds will be covered with sticky-strips and dressing. Try to keep these dry until reviewed at your 10-day post-operative appointment.
Painkillers
Painkillers such as Panadeine or Panadeine Forte (1-2 tabs 4-6 hourly) are usually required for the first week or so.
A large ice bag applied to the knee (not directly on the skin!) for 30 minutes 4-6 times per day for the first 2-3 days will help reduce swelling and pain. It will also help to keep your leg elevated over this time.
Activity
We recommend resting with your leg elevated for the first 2-3 days. You may place as much weight on the leg as is comfortable, unless otherwise instructed. You may need crutches initially, and you can stop using them once you are walking comfortably.
Motion
You may bend and straighten your leg within pain tolerance. Simple quadriceps and range of motion exercises are suitable for most patients. An exercise bike on low resistance may be used after 5 days. If exercise causes pain and swelling, you should use rest, ice, compression, elevation and painkillers. Ankle movements should commence immediately to help circulation in the leg.
Driving
Do not drive under the influence of pain medication. You should not drive until reviewed by your surgeon.
when can I return to Work after a knee arthroscopy?
You may return to work as soon as your pain is tolerable. To some degree, return to work depends upon what was found and the surgery performed. Generally, if a job does not require prolonged standing and walking, you may return to work within a week. However, if your job requires prolonged standing or walking, it may be up to 2-4 weeks before you are able to return to work.
when can I return to Sport after a knee arthroscopy?
No running or impact sport until after the first review with your knee surgeon. You will be guided from there, according to your individual case.
Follow up Visit
This has been made for you at the time of booking your knee arthroscopy and is detailed on the sheet attached to your booking information.
Contact Park Clinic Orthopaedics
Please contact Mr Hayden Morris’s rooms on (03) 9853 5981, Mr Nathan White’s rooms on (03) 9853 5981, or Mr Robert Howells’ rooms on (03) 9419 2811 if you require further information.