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M.S. ORTH (Pune),M.Sc., ORTH. (London) Dipl. LAMP (CARDIFF)
Consultant Joint Replacement Surgeon
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Knee Arthroscopy
 

Is Arthroscopy for You?

 
revision knee surgery

Your family physician can refer you to an orthopaedic surgeon for an evaluation to determine whether you could benefit from arthroscopy.

Signs that you may be a candidate for this procedure include swelling, persistent pain, catching, giving-way, and loss of confidence in your knee. When other treatments such as the regular use of medications, knee supports, and physical therapy have provided minimal or no improvement, you may benefit from arthroscopy.

   
 
Most arthroscopies are performed on patients between the ages of 20 and 60, but patients younger than 10 years and older than 80 years have benefited from the procedure
 
The Orthopaedic Knee Evaluation
   
 
The orthopaedic knee evaluation consists of three components:
»
A medical history, in which your orthopaedic surgeon gathers information about your general health and asks you about your symptoms.
»
A physical examination to assess your knee motion and stability, muscle strength and overall leg alignment.
» X-rays to evaluate the bones of your knee.
nonsurgical treatment
 
  removal of torn meniscal cartilage
 

Your orthopaedic surgeon may also arrange for you to have an MRI to provide more information about the soft tissues of your knee. An MRI uses magnetic sound waves to create images. They are not X-rays. Blood tests may be obtained to determine if you have arthritis.

Your orthopaedic surgeon will review the results of your evaluation with you and discuss whether arthroscopy would be the best method to further diagnose and treat your knee problem. Other treatment options, such as medications or other surgical procedures also will be discussed and considered.

Your orthopaedic surgeon will explain the potential risks and complications of knee arthroscopy, including those related to the surgery itself and those that can occur after your surgery.

   
  Preparing for Surgery
 

If you decide to have arthroscopy, you may be asked to have a complete physical with your family physician before surgery to assess your health and to rule out any conditions that could interfere with your surgery.

Before surgery, tell your orthopaedic surgeon about any medications that you are taking. You will be informed which medications you should stop taking before surgery.

Tests, such as blood samples or a cardiogram, may be ordered by your orthopaedic surgeon to help plan your procedure.
  Your Arthroscopic Knee Surgery
 


Almost all arthroscopic knee surgery is done on an outpatient basis. Your hospital or surgery center will contact you about the specific details for your surgery, but usually you will be asked to arrive at the hospital an hour or two prior to your surgery. Do not eat or drink anything after midnight the night before your surgery.

After arrival, you will be evaluated by a member of the anesthesia team. Arthroscopy can be performed under local, regional, or general anesthesia. Local anesthesia numbs your knee, regional anesthesia numbs you below your waist, and general anesthesia puts you to sleep. The anesthesiologist will help you determine which would be the best for you.
 
  reconstruction of a torn cruciate ligament
 
trimming of torn pieces

If you have local or regional anesthesia, you may be able to watch the procedure on a TV screen, if you wish.

The orthopaedic surgeon will make a few small incisions in your knee. A sterile solution will be used to fill the knee joint and rinse away any cloudy fluid, providing a clear view of your knee.

The surgeon will then insert the arthroscope to properly diagnose your problem, using the TV image to guide the arthroscope.
  If surgical treatment is needed, the surgeon can use a variety of small surgical instruments (e.g., scissors, clamps, motorized shavers, or lasers) through another small incision. This part of the procedure usually lasts 45 minutes to 1 1/2 hours.
   
 

Common treatments with knee arthroscopy include:

 
» Removal or repair of torn meniscal cartilage.
» Reconstruction of a torn cruciate ligament.
»
Trimming of torn pieces of articular cartilage.
»
Removal of loose fragments of bone or cartilage.
»
Removal of inflamed synovial tissue.
   
 

At the conclusion of your surgery, the surgeon may close your incisions with a suture or paper tape and cover them with a bandage.

You will be moved to the recovery room. Usually, you will be ready to go home in one or two days. You should have someone with you to drive you home.

 
  removal of loose fragments of bone, removal of inflamed synovial tissue
 
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