Describing the Procedure

After inserting a miniature camera, less than a fourth of an inch in diameter, into an incision in the knee, it is attached to a monitor to allow the surgeon a view of the knee tissue. In some cases, the patient can also opt to observe the surgery from this monitor.

It is a simple surgical procedure requiring only local or regional anaesthesia to numb the operation site. Throughout the surgery, the patient remains lucid and responsive. However, extensive surgery will require a general anaethestic, rendering the patient to sleep without pain.

To expand the joint and help stop excessive bleeding, a saline solution is pumped under pressure consequent to the camera insertion. A tourniquet may also be applied to halt bleeding, as well.

After probing the knee to assess the damage, the surgeon will make up to four other additional cuts for the insertion of other instruments like:

• a blunt hook – for pulling on the knee and cartilage tissue
• a shaver – for the removal or smoothening of damaged and uneven soft tissues
• a burr – used to remove uneven or jagged particles of bone
• a heat probe – to eradicate synovitis (inflammation) from the joint

When surgery is completed, the saline solution is drained from the knee, the incisions are stitched closed, and a bandage or dressing is applied. A majority of surgeons document the procedure through pictures from the video monitor so the patient can see the steps undertaken during the surgery.

Reasons for the Surgery

Arthroscopy is undertaken for knee disorders which include:

• repair or removal of a torn meniscus
• mild forms of arthritis
• removal of loose fragments of bone or cartilage floating within the knee joint
• repairing a torn or damaged anterior cruciate or posterior cruciate ligament
• inflammation or damage of the synovium (joint lining)
• alignment of a skewed patella (knee cap)

Risks of Surgery

Anaesthesia risks include:

• allergic reactions to the anaesthetic
• respiratory impairment

Surgery risks include:

• excessive bleeding
• onset of infection

Other risks involve:

• Hemarthrosis, or bleeding into the joint
• cartilage, meniscus, or knee ligament damage
• symptoms remain unresponsive despite surgery
• stiffness of the knee

Prognosis (Outlook) of Arthroscopy

Arthroscopy has:

• eliminated the need for surgically opening up the knee joint
• diminished pain and stiffness
• minimal complications
• earlier recovery time
• shorter hospital stay

When a patient unencumbered by other arthritic complications undergoes surgery to repair a meniscal tear or to remove loose fragments of bone or cartilage, the procedure is simple and full recovery is expected. The presence of arthritis can greatly diminish arthroscopy effectiveness, and almost half of all patients do not experience improvement even after the surgery.

However, removal of the synovium in an arthroscopic synovectomy procedure has proven to improve symptoms in patients suffering from Rheumatoid arthritis. Arthroscopic-assisted surgery for the repair of the meniscus or knee ligament involves a more complex procedure and results in longer recovery time, with varied outcomes.

Recovering from Surgery

Recovery from a simple debridement (meniscal cleaning) procedure is quick, although crutches are required to keep the weight off the knee and lessen pain. Painkillers are also prescribed for pain control.

Other complicated surgical procedures involving repair and reconstruction will result slower recovery time and the inability to walk for up to several months to a year.

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