How is arthroscopic surgery performed?
Arthroscopic surgery is a procedure that is used to look inside a joint. Through one small incision (about 1 centimeter) a small camera, about the size of a pencil, is inserted into the joint. Using one or more other small incisions, your surgeon places other instruments inside the knee to remove the torn cartilage.
How big are arthroscopic incisions?
Incisions for arthroscopy are quite small, usually about 1 centimeter each. The incisions are closed with one suture that is either outside or underneath the skin. A bandage is placed over the arthroscopic incisions for at least a day or two to keep the incisions sterile.
How is the damaged cartilage removed?
The torn meniscus can be removed using a number of instruments, including small shavers and scissors. The arthroscope will also allow your surgeon to inspect the rest of the knee joint, looking for signs of arthritis, loose pieces of cartilage in the knee, the ligaments of the knee, and other problems inside the joint.
Is arthroscopic knee surgery painful?
Usually, minimal pain is associated with arthroscopic knee surgery. An anesthesiologist will be with you for the entire procedure to ensure you are comfortable. Following the procedure, you will be given instructions on what type of pain medicine to take if you do experience discomfort. Icing the knee is helpful for the first few days after surgery, as is keeping the knee elevated.
Do I need crutches after surgery?
For most arthroscopic knee procedures, crutches are given only for comfort. Once you feel steady on your feet, you can discontinue use of the crutches. However, some procedures, such as ACL reconstruction and meniscus repair, may require longer use of crutches. Always check with your doctor before discontinuing crutch use.
What type of anesthesia is used for arthroscopic knee surgery?
There are several options, all of which can work for most arthroscopic procedures. These include:
- General Anesthesia
General anesthesia allows you to sleep through the procedure. An anesthesiologist monitors your breathing and vital signs throughout the surgery, and you are awakened once the procedure is completed.
- Regional Anesthesia
These include epidural and spinal anesthesia. These options are acceptable for most types of knee arthroscopy. They allow patients to remain awake during the procedure.
- Local Anesthesia
Local anesthesia is an option for some types of knee arthroscopy. The surgery is usually done with light sedation, and the patient may require general anesthesia if the procedure becomes uncomfortable.
When can I return to normal activities?
Patients who undergo arthroscopic knee surgery for treatment of a meniscus tear can usually return to normal activities quite quickly. Most patients take a few days or a long weekend off work. If the meniscus is removed (partial meniscectomy), then there are usually few activity restrictions. Patients can walk and move normally, so long as they don't have pain.
When can I return to sports?
It depends on your comfort level. For most meniscectomies, patients can resume their activities as tolerated. For most patients, this means returning to normal walking within a few days to a week, returning to jogging within a month, and returning to sports within 4 to 8 weeks. Some patients take longer, others are quicker.
You must check with your doctor about your specific rehabilitation, as there may be reasons to protect your knee for a longer period of time. Only your doctor can tell you exactly what your specific rehab should be.
Greis PE, et al. "Meniscal Injury: II. Management" J. Am. Acad. Ortho. Surg., May/June 2002; 10: 177 - 187.