Patient education: Knee arthroscopy (The Basics)

What is knee arthroscopy? — Knee arthroscopy is a type of "minimally invasive surgery." During the procedure, the doctor looks inside the joint to see what is causing a knee problem (figure 1). They can also use special tools to repair or remove tissue in the knee.

Minimally invasive surgery lets the doctor make smaller cuts in the skin. They insert long, thin tools through the cuts. One of the tools has a camera (called an "arthroscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the body. Then, they use the long tools to do the surgery.

Your doctor might suggest surgery if your knee problem is getting worse after trying therapy and medicines. People who have minimally invasive surgery often have less pain and are able to return to normal activities sooner than if they had open surgery.

How do I prepare for knee arthroscopy? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might send you to get additional imaging tests, such as a CT scan or MRI. Imaging tests create pictures of the inside of the body.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Eating and drinking before your procedure – In some cases, you might need to "fast" before surgery. This means not eating or drinking anything for a period of time. In other cases, you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure you are having.

●Lowering the risk of infection – In some cases, you might need to trim (not shave) your body hair before your procedure. You might also need to wash the area with a special soap.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during knee arthroscopy? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines. This is to make sure that you do not feel pain during the procedure. Types of anesthesia include:

•Local – This type of anesthesia uses medicine to numb a small part of your body so you don't feel pain.

•Regional – This type of anesthesia blocks pain in 1 area of your body, such as an arm, a leg, or the lower half of your body. If you get regional anesthesia, you might be awake. Or you might get medicines to make you relax and feel sleepy, called "sedatives."

•General – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure.

●You might get medicines to help control pain after the procedure.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●The doctor will make small cuts ("incisions") in the skin over your knee. They will put a scope with a tiny camera through 1 of the incisions to look at your joint. They will fill your joint with fluid to see inside it. They will put small surgical tools into the other incisions to find and, if possible, fix the problem inside your knee.

●The doctor will close your incisions and cover them with clean bandages. They might have you wear a cast or brace to protect the area and limit movement. This will help support your knee as it heals.

●The procedure usually takes 1 to 2 hours. More complicated surgeries can take longer.

What happens after knee arthroscopy? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off. Most people can go home on the same day of surgery.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●You might need to wear a brace after surgery to support your knee or limit movement. You might not be able to put all of your weight on the leg where you had surgery. Some people need to use crutches, a walker, or a wheelchair after surgery.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine if needed to help with pain. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

What are the risks of knee arthroscopy? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Infection

●Bleeding

●Damage to blood vessels, nerves, or other parts of your knee

●Blood clots

●Ongoing pain and stiffness

●The doctor can't fix the problem, or needs to do an open surgery

What else should I know? — Before you go home from the hospital, make sure that you know what problems to look out for and when you should call the doctor. Make sure that you understand your doctor's or nurse's instructions. Ask questions about anything you do not understand.

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