Arthroscopy is a minimally invasive surgical method for gaining vision within a joint, and is commonly utilised now for knee conditions such as meniscal repairs or excisions, removal of loose bodies, and ACL reconstructions. It allows your surgeon to treat pathology that would have previously required larger incisions, longer surgical times, and longer, more painful recovery.
What is involved with an arthroscopy?
Performed under general anaesthetic, an arthroscopy involves making 2-3 small (1cm) incisions in the knee and looking inside the knee using a camera. This allows Dr Host to directly visualise and diagnose your condition. Abnormalities identified can be treated through these small holes using specialised instruments.
Why is it performed?
It offers a less invasive method for treating common knee conditions than conventional open surgery. The majority of patients report decreased pain, decreased swelling, and a quicker return to function following arthroscopic surgery over conventional open surgery.
There are many reasons to perform an arthroscopy, and these include cartilage reshaping (chondroplasty), removal of a torn meniscus (meniscectomy), removal of inflamed joint lining (synovectomy), removal of a loose body, joint washout for infection or inflammation, and as part of a ligament reconstructive procedure, such as an ACL reconstruction.
What is a chondroplasty?
A chondroplasty is a procedure in which roughened areas of cartilage are reshaped to a smooth surface, with the aim being of decreasing friction between the surfaces, decreasing pain, and slowing further wear of the surface. Unfortunately, a chondroplasty by definition removes some cartilage, and this can lead to worsening of arthritis in the long run, so it is always a balance between improving function now, and what we have to pay for later.
What is a meniscectomy?
A meniscectomy involves removal of part or all of a meniscus. What is a meniscus most people then ask? The easiest way to think of them is as the shock absorbers of the knee. There are two C-shaped menisci in each knee, and they sit between the tibia (shin) and femur (thigh) on the edges of your knee. When torn, they can get pinched in the joint, causing symptoms such as locking, catching and giving way, as well as substantial pain. The meniscus has limited healing potential, so most tears cannot be repaired. The only treatment is then removal of the torn fragment, and reshaping of the remaining meniscus back to a C shape.
What is a loose body?
Simply put, it is something that is loose or “floating” in the knee joint that is causing pain and/or catching. There are many causes, but most commonly they result from a small piece of cartilage that is sheared off the joint surface. Much like a snowball down a hill, the small fragments can gradually enlarge to a size that they cause problems. Arthroscopy is a simple method that can be used to remove such offending loose bodies.
Do I need to do anything to prepare for my surgery?
Ensure that the limb to be operated on does not have any cuts or grazes prior to surgery. Should you sustain any of these, contact Dr Host’s rooms for a review. Breaks in the skin can increase the risk of infection, and surgery would be best delayed until these have healed.
How long does it take and how long am I in hospital?
These are generally quite quick procedures, most taking less than 30 minutes to perform. An arthroscopy is performed as day surgery, with patients discharged home the same day if there are no complications.
How quickly will I be able to return to work or sports?
The million dollar question. It all depends on the condition treated and what was done, but as a general rule we expect patients to be walking immediately, have recovered 70-80% by 2 weeks, and be fully functional by 6-12 weeks. Notable exceptions are meniscal repairs and ligament reconstructions, which will have extended and specific rehabilitation programs that must be followed for a successful outcome. Dr Host suggests planning for 2 weeks of leave from work to allow you to adequately recover.
When can I drive after surgery?
You can drive when you are safely able to control the vehicle, and Dr Host suggests avoiding driving until the wounds have healed. You can recommence driving within 1-2 weeks of surgery.
What can I expect after the surgery?
There will be some pain, but this should be minimal
What should I be concerned about following surgery?
If you have any of the following signs or symptoms, please contact Dr Host or your local GP for review:
- Increased redness, heat or swelling around your wounds.
- Raised temperature/fever.
- Persistent ooze from your wounds.
- Calf pain or swelling.
- Chest pain, chest tightness, shortness of breath or a very rapid breathing rate.