Knee Arthroscopy is commonly known as keyhole knee surgery.
The term literally means to “look within the joint” (from the two Greek words; Arthro = “joint” and Scope = “to look”).
In this procedure, a small camera is inserted into the knee and the images are relayed to a television screen. Delicate specialised instruments are then introduced into the knee joint through small incisions (< 1cm). Using these instruments, Mr Freedman can perform a number of procedures. These include repairing torn cartilage, washing out fluid or tissue debris, removing or reattaching loose bone or cartilage or reconstructing torn ligaments (such as the ACL).
Knee arthroscopy is normally carried out under a general anaesthetic. The procedure is usually quite quick (< 30 min) and patients are generally able to be discharged home same day. You may, however, feel a bit groggy after the anaesthetic and so will not be able to drive yourself home. You will usually be discharged home with 2 crutches but depending on the particular procedure performed will usually be able to discontinue crutches after a few days.
The small surgical portal incisions usually do not require sutures. If required, a single absorbable suture may be used so that you do not need to have sutures removed at a later date.
At your consultation Mr Freedman will take a thorough clinical history, perform a detailed examination and review the results of your scans to make an assessment as to whether you may benefit from arthroscopy. Plain-xrays are always a very useful baseline investigation for assessing our knee but soft tissue problems inside the knee and early cartilage loss may not be evident on plain X-ray alone and more sophisticated imaging as such an MRI scan may be required. Mr Freedman will asses you knee and advise on additional scans if required.
What conditions can be treated with knee arthroscopy?
Knee Arthroscopy is particularly useful for treating soft tissue problems inside the knee – such as cartilage tears or tears of the meniscus, which is a c-shaped shock absorbing disc that sits between the two main knee bones (femur and tibia). Knee arthroscopy is also very useful for repairing on reconstructing ligaments (such as the ACL) and can also be used to assist fracture repairs and to remove loose or damaged cartilage or bone from inside the knee
Are patients with knee arthritis candidates for knee arthroscopy?
This depends on an individual patient’s symptoms. At the present time, knee arthroscopy is not able restore large areas where cartilage is lost and so is not the preferred treatment for chronic pain associated with arthritis. Such patients would be better served by having a total knee replacement. However, patients with arthritis occasionally develop mechanical pain due to having a free-floating loose piece of cartilage floating in and occasionally getting stuck inside the joint. In this situation, removing the offending “loose body” can improve symptoms. Therefore, in the context of arthritis it is important to have a clear assessment as to the cause of symptoms and realistic expectations as to the purpose of the arthroscopy.
What are the risks of knee arthroscopy?
The complication rate from knee arthroscopy is extremely low. The procedure is quick, performed through very small incisions and is usually a procedure performed on relatively young patients with few medical problems. Knee arthroscopy is usually performed as “day surgery” with patients going home the same day and not requiring to stay overnight in hospital. Nevertheless, all surgical procedures carry some small risks. For knee arthroscopy this includes small risk of blood clot, infection, or cartilage damage. Multiple precautions are taken to minimise the risks and will be discussed with you.