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Knee Arthroscopy

An arthroscopy means “looking into a joint” with a camera. It is also known as the keyhole operation. It allows the surgeon to examine the knee joint and perform some operations without having to open the knee completely.

Anaesthetic will be administered in theatre and a tight inflatable band (tourniquet) will be placed across the top of your thigh to limit the amount of bleeding.

Your skin will be cleaned with anti-septic solution and clean towels (drapes) placed around your knee. The surgeon will make up to four small incisions (cuts) either side of the knee cap. These are generally no more than 1 centimetre in length.

Through the first incision, the surgeon will pass a telescope with a camera. This shows pictures on a nearby television screen. The second or third incision may allow tools or drains to be passed into the joint. The tools include probes, shavers, scissors and punches.

The surgeon might not be able to say exactly what needs to be done until they are looking inside the knee but the surgeon will try and treat most abnormalities found during the operation.

The skin cuts will be repaired with stitches which will need to be reviewed around ten days after the operation. Your nurse practitioner at your GP practice can do this for you (make an appointment). When finished, the wounds are dressed and local anaesthetic may be injected into the wounds.

When you wake up, you will have a padded bandage around your knee. Later the same day, when you feel well enough, and you have been shown how to use crutches, you may go home. You should not drive yourself home.

You may remove the padded bandage within a couple of days, but the plasters beneath should remain for around 14 days and the wounds be kept clean and dry. Do not be alarmed if you see small dried spots of blood through the dressings. Any continuing fluid discharge should however be reported to your doctor.

Exercises will be shown by the physiotherapist before your discharge. The most important of these are the straight leg raising drills.

You may be able to drive within a week and may return to work as soon as walking long distances is comfortable. Returning to work naturally depends upon your profession. You may be told to avoid sport for a period of time, but talk to your surgeon after the operation.

As with all procedures, this carries some risks and complications.

COMMON (1-5%)

  • Swelling: The knee may fill with fluid or rarely, blood. This usually resolves on its own however may occasionally require a second operation or draining of the fluid.
  • Persistent pain: the symptoms may carry on despite the procedure. A repeat arthroscopy or other knee operation may be required.

RARE (<1%)

  • Infection: the wound sites may become red, painful and hot. There may also be a discharge of fluid. These are signs of infection and can usually be treated by antibiotics. Very rarely, the infection may spread to the knee joint itself (requiring a washout) and/or the blood (sepsis) requiring intravenous antibiotics.
  • Damage to structures within or around the knee: this is rare, but may cause further injury and symptoms. This may need further treatment including operation.
  • Damaged instruments: these may break within the knee and require an opening of the joint to remove them.
  • Abnormal wound healing: the scar may become thick, red and painful (keloid scar). This is more common in Afro-Caribbean’s and Asians. There may also be some oozing of clear fluid.
  • Numbness: the skin around the knee and shin may be temporarily or more permanently numb due to damage of small superficial nerves.
  • Blood clots: a DVT (deep vein thrombosis) is a blood clot in a vein. These may present as red, painful and swollen legs (usually). The risks of developing a DVT are greater after any surgery (and especially bone surgery). Although they are painful, a DVT can also pass in the blood stream and be deposited in the lungs (a pulmonary embolism –PE). This is a very serious condition which affects your breathing.