The knee is not only the largest joint in the body, but it also takes the brunt of our daily activities. Every time we take a step, jump or cut left or right, our knees play an important role in allowing us to make those movements in a pain-free manner. The joint is made up of the lower portion thigh bone, known as the femur and the upper portion of the shin bone, known as the tibia. This is capped off with the patella, known as the knee cap. Within the knee joint, between the bones, there is cartilage that allows for the smooth movement of bone as we extend and flex the leg. The knee is also made up of ligaments in the front, ACL, and the back, PCL, of the knee, which create stability.
As a result of this complexity, any surgical treatment of the knee must be performed skillfully and ideally, minimally invasively, to ensure the greatest degree of painless motion after the procedure. Over the past several decades, a technique known as arthroscopy has become the gold standard of care for many knee procedures. Arthroscopy is a minimally invasive technique using a high definition camera allowing the surgeon to view the surgical area. Tiny specially made medical devices are then used to actually perform the procedure. This has led to much smaller incisions that generally lead to a faster recovery, fewer potential complications and better cosmetic results without compromising the safety or effectiveness of the procedure.
What Conditions are Suited to Arthroscopy?
Arthroscopy is used in many cases of knee dysfunction but is not ideal for all surgeries. However, typically, patients can expect to have an arthroscopic intervention for
- Meniscus tears
- Reconstruction of the anterior cruciate ligament or ACL
- Cartilage trimming
- Diagnostic testing of the knee
- Treatments involving the kneecap
- And much more.
While arthroscopic surgery is minimally invasive and generally comes with fewer risks than traditional open surgery, it still represents major surgery and should be treated very seriously. As such, employing an experienced knee surgeon such as Dr. Manning is critical to improving the safety and outcomes of the procedure.
Depending on the procedure being performed, we may employ local, regional or general anesthesia. You will receive a pre-operative packet which should be followed closely to ensure the best outcomes.
How Arthroscopy Works
Once in the operating room, the knee will be braced and immobilized to allow for the most precise operation possible. Small incisions are made, and sterile liquid will be inserted into the knee to improve visualization. The arthroscope is ideal for viewing the surgical field and, as such, is used as a diagnostic tool to understand how best to approach the surgery. If surgical treatment is needed and confirmed by the diagnostic arthroscopy, additional devices needed to complete surgery will be inserted into the knee through additional tiny incisions.
The majority of arthroscopic procedures are performed on an outpatient basis, which allows the patient to go home on the day of surgery. Depending on the complexity of the procedure, the entire process may take from forty-five minutes to an hour and a half, after which time, the patient is moved into the recovery room for 1 to 2 hours as the anesthesia wears off. On the day of surgery, the patient will not be able to drive themselves home or perform their daily activities until Dr. Manning has cleared them to do so.
Pain is typically manageable and NSAIDs or nonsteroidal anti-inflammatory drugs like ibuprofen are often sufficient to control it. Some patients may need prescription narcotics for a short period of time, but those should be discontinued as soon as possible due to the potential for dependence. Again, refer to your post-op packet for more.
Depending on the extent of the repair and the condition of the knee, return to normal activity and work can take some time. Dr. Manning will discuss your recovery process to ensure that it is swift, but also allows for maximum healing and improvement in the joint. The recovery process may also include physical therapy and an exercise regimen to strengthen the muscles around the knee, thus eliminating pressure on the joints for a faster more complete recovery.
Possible Complications and Considerations of Arthroscopy
For most knee conditions, the operation is relatively straightforward. Complication rates after an arthroscopic surgical procedure are low and are often treated swiftly without significant consequences. As with any surgical procedure, infection is a possible concern. Further, blood clots, hematomas and stiffness or reduced range of motion in the knee are also potential concerns. Certain procedures will have their own specific risks and considerations as well.
To learn more about whether arthroscopy is appropriate for your knee condition, please schedule a consultation with Dr. Manning.