Knee arthroscopy being an elective procedure, Patient must be completely healthy and adequately prepared for the operation. If Patient is being treated for any kind of disease, he/she should consultant with surgeon to know about it and surgeon will bring with patient to the hospital records of patient’s previous treatment as well as any medication he/she may be taking. All drugs that affect blood clotting must be stopped a week before the procedure. This is done in consultation with patient’s primary doctor, who will also remove a sample of patient’s blood for the basic laboratory tests (blood count, differential white cell count, ESR, CRP). The test results must not be more than 14 days old in order to reflect patient’s condition before the operation.
If the laboratory values are outside the normal range, the tests must be repeated just before patient’s admission into the hospital. Patient must bring health insurance card, a referral note from primary consultant doctor requesting admission for surgery, and items for personal care to the hospital. Patient should also bring all records of any previous treatment related to knee problem.
Patient will be admitted to the hospital on the day of the procedure. Before the operation, patient will be asked to sign a consent form for the surgery and anaesthesia, and patient will meet consultant surgeon, who will answer any questions patient may have. Knee arthroscopy is performed under local anaesthetic (injection of anaesthetic into the knee and area of the surgical wounds), or under spinal anaesthetic (injection of anaesthetic into the spinal canal). The method of anaesthesia is selected with regard to the type of procedure, concurrent diseases, expected postoperative pain, and patient’s preferences.
How is knee arthroscopy performed?
A knee arthroscopy takes between 30 and 90 minutes, depending on the type of the procedure and extent of pathological changes. The patient lies supine during the procedure. The arthroscopic camera and instruments are inserted through 1 to 1.5cm long incisions, made at the front side of the knee. Usually, two incisions are necessary, one for the camera and one for arthroscopic instruments (graspers, shaver, forceps, probes). A third incision is sometimes required. During the procedure, the knee is continually irrigated with an electrolyte solution, which distends the joint, controls bleeding and flushes out any loose debris to ensure good visibility. At the end of the procedure, a drainage tube is sometimes inserted to allow excess fluid and blood to drain from the operated area. The drain is left in place for a day.
This depends on various factors. If there are no complications, most patients are discharged after 1 to 3 days. After the operation, patient will return to the ward, where patient will receive pain medication, infusions of fluids, and a preventive antibiotic. The day after surgery, patient will start basic non-weight bearing range-of-motion exercises. Patient will be encouraged to put ice on the operated area and keep it elevated as long as possible. During hospital stay, patient’s wound dressings will be changed regularly, and blood tests will be performed as required. In case of major swelling, knee aspiration will be performed to remove excess blood and fluid from the joint.