Knee Arthroscopy

What is Knee Arthroscopy?

Knee arthroscopy is a surgical procedure where doctors diagnose and treat knee problems without making a large cut through your skin and soft tissues. The surgery can help treat a wide array of knee joint problems. As discussed, the surgeon uses very small incisions to insert an arthroscope and other surgical instruments to make necessary changes in your knee joint. As it is a minimally invasive surgery, the patient experiences benefits like less pain, a shorter recovery time, and a quicker return to daily and favorite activities.

Who Qualifies for Knee Arthroscopy?

Arthroscopic knee surgery is recommended when the nonsurgical forms of treatment such as physical therapy and medications fail to provide relief. Knee arthroscopy is recommended in the following cases:

• Persistent knee pain: Patients with ongoing knee pain can get any underlying issue identified and possibly corrected using knee arthroscopy. 
• Limited Mobility: Because the procedure can address mechanical problems, individuals with reduced knee mobility, unable to climb stairs, walk, or perform daily activities can undergo this surgery.   
• Diagnosed Knee Conditions: Those diagnosed with knee conditions like ACL injuries, meniscal tears, or cartilage damage can choose this procedure to get multiple problems treated at one time. 
• Good Overall Health: Good health is required because it minimizes the risk of complications and allows faster recovery post-surgery. 
• Activity Level: This surgery can assist you in getting back to your activity levels, whether it be sports or anything else, as it restores knee function. 

A thorough evaluation by a healthcare provider, including physical examination, imaging studies (e.g., MRI), and discussion of treatment options, helps determine if knee arthroscopy is appropriate for an individual's specific condition and circumstances.

Differences Between Knee Replacement, Robotic Knee Replacement and Knee Arthroscopy

Here are the major differences between a knee arthroscopy and knee replacement. It is important to note that all aspects of a robotic knee replacement are similar to the steps involved in a standard knee replacement surgery except for the fact that the procedure will be performed by a robotic arm that is controlled by the surgeon.

Anatomy of the Knee

The knee is the largest joint in the human body. It is also one of the most complex ones. The bones that form a part of the knee joint can be named the lower end of the femur (thighbone), the patella (kneecap), and the upper end of the tibia (shinbone). Other knee joint structures are:

• Articular cartilage: The cartilage covers the ends of the two bones, the tibia, and the femur, as well as the back of the patella. It is a slippery tissue that helps the knee bones glide smoothly across each other during a movement. 
• Synovium: It’s a thin lining that surrounds the joint and releases fluid to lubricate the cartilage. It also reduces friction during movements, that is when you bend the knee or try to straighten your leg.
• Meniscus: The meniscus cartilage is a crescent-shaped piece of cartilage that lies between the tibia and the femur acting as a shock absorber. It is tough and rubbery and aims at cushioning and stabilizing the joint.
• Ligaments: There are four main ligaments that strongly connect the bones of the knee joint together and keep the knee stable. There are two collateral ligaments (MCL and LCL) on either side of the knee and the two cruciate ligaments inside (ACL and PCL) of the knee joint that cross each other to form an ‘X.’

What Conditions are Treated with a Knee Arthroscopy?

A knee arthroscopy is recommended for the following conditions:

• Meniscus Tears: Damage to the menisci, the cartilage pads cushioning the joint 
• Ligament Tears: Sprains or tears of the ligaments like the ACL (anterior cruciate ligament) that maintain the knee joint stability 
• Synovitis: Inflammation of the lining of a knee joint called synovial membrane
• Cartilage Damage: Damage to the articular cartilage that can lead to pain and arthritis
• Patellar (kneecap) Damage: Damage to the patella’s underside or its alignment, causing mobility issues and pain
• Loose Fragments: Small pieces of cartilage or bone floating in the joint space

These are just a few examples of the conditions that can be treated with knee arthroscopy. The specific treatment approach will depend on the individual patient's diagnosis, symptoms, and overall health, and will be determined by the orthopedic surgeon following a thorough evaluation.
 

How to Prepare for Knee Arthroscopy Surgery?

Preparing for arthroscopic knee surgery involves the following:

Evaluations and Tests: A general health checkup is done to find out any existing health problems that can interfere with the surgery. An extensive evaluation is required in case the patient has certain health risks. Preoperative tests include blood/urine tests and imaging tests as required.

Medications: The doctor should be pre-informed about any medications that you are on, as some may need to be stopped before surgery. This includes drugs such as blood thinners which can cause complications such as bleeding during or after the procedure.

Fasting Instruction: You will be given fasting instructions. Generally, you will be instructed to avoid food and drinks for around 7 to 8 hours before the surgery. 

Lifestyle Changes: If you are a smoker, make sure that you quit before the surgery as it can interfere with the healing process. Also, limit the intake of alcohol for the same reason.

Arrange Help: Arrange a friend or a family member to drop you at the hospital and back home. Arthroscopy is a minimally invasive procedure, which is why there are high chances that you can go home the same day.

These are the basic instructions given before the surgery and there could be additional different instructions based on your specific case. Therefore, make sure that you follow them diligently.

Risks and Benefits of Knee Arthroscopy

Risks

As with any surgery, there are some risks associated with knee arthroscopy. Some rare but possible risks of arthroscopic surgery for the knee are:

• Bleeding and infection
• Blood clots in the leg
• Stiffness in the knee
• Breathing difficulties due to anesthesia
• Allergic reaction to anesthesia or other medicines administered during the surgery
• Swelling that leads to blood pooling in the knee (very rare)
• Damage to cartilage, ligaments, blood vessels, meniscus or nerves in the knee

Benefits

Knee arthroscopy may not be for everyone. However, having gone through the risks, it is also important to know the many benefits knee arthroscopy brings. 

• It’s a minimally invasive procedure that repairs damage that happened to your knee
• It helps diagnose a range of problems
• Because arthroscopy is minimally invasive and usually outpatient, you have to undergo less pain
• Only a few small incisions and stitches are required
• Recovery is quick when compared to traditional surgery
• Tissue damage is less
• The risk of infection is also low