If you’re being considered for knee surgery, the chances are you’ll be having an arthroscopy: it’s the most commonly performed procedure in orthopaedics. But hang on… what exactly is an arthroscopy? And what happens when you go through one? Most people, understandably, have little idea. So I’ve prepared a very quick guide to unpack the topic. Here’s what you need to know…
Why exactly would you have an arthroscopy?
Let’s start with the least common reason. Occasionally arthroscopies are used for diagnosis. It might be that the results of a scan are unclear (‘plicas’, a folding of the joint lining, can be hard to detect, for example, especially in young people). In this case we might use an arthroscopy to investigate further. In the majority of cases, however, knee arthroscopies are performed with a clear treatment in mind. The most common are for torn or worn cartilage, or for sprains and tears of the Anterior Cruciate Ligament (ACL). But arthroscopies can also be used to remove loose bodies, treat arthritis or drain excess fluid, amongst other treatments.
What are the advantages of having one?
Put simply, an arthroscopy is less invasive than traditional ‘open’ surgery. It’s called Keyhole Surgery for a reason – the incisions are usually only around 6mm long. That means less likelihood of pain following the operation, and a swifter recovery time. Arthroscopies also carry a lower risk of infection than traditional surgery. In 95% of cases, however, they are carried out under a general anaesthetic.
How does the surgery actually work?
The operation involves two small cuts just below and either side of the kneecap. A camera probe is inserted into one of the cuts – usually the outer, ‘lateral’ one. This relays footage to a TV monitor. An operating instrument goes into the other, ‘medial’ cut. The type of instrument deployed will vary depending on the surgery: a shaver is used for trimming cartilage; a resector is used to remove damaged tissue. Most arthroscopies take around half an hour to complete.
What happens on the day of surgery?
On the day, you will come into the hospital and meet your surgeon and anaesthetist. They will consult any scans, outline the operation and answer questions. You’ll then meet a nurse, who will take you through the necessary paperwork. Then you’ll be taken to the Anaesthetic Room and given an injection via a cannula to put you to sleep. A breathing tube enables you to breathe easily while under anaesthetic. When you wake up, you’ll be in recovery.
Will it be painful?
As with all forms of surgery, arthroscopies result in some discomfort after the operation. Happily there’s a lot we can do to help, using simple pain relief. Most of our patients receive codeine-based co-codamol for the first few days of their recovery. That deals very effectively with most post-operative pain. But paracetamol or ibuprofen can also be sufficient.
How long will it take to recover?
One of the most positive things about an arthroscopy is that swifter recovery time just mentioned. Most patients are able to go home on the same day as their operation, and are able to drive again within three to five days. You should be able to resume all normal activities within two weeks. For this reason, amongst others, it’s a very popular form of surgery.