Knee Arthroscopy
Knee Anatomy
The knee joint is one of the most complex joints of the body. The lower end of the thighbone (femur) meets the upper end of the shinbone (tibia) at the knee joint. A small bone called the patella (kneecap) rests on a groove on the front side of the femoral end. A bone of the lower leg (fibula) forms a joint with the shinbone.
To allow smooth and painless motion of the knee joint, the articular surfaces of these bones are covered with a shiny white slippery articular cartilage. Two C-shaped cartilaginous menisci are present in between the end of the femur and the top of the tibia.
Menisci act as shock absorbers providing additional cushioning to the joint. Menisci also play an important role in providing stability when load bearing through the knee joint.
Bands of tissue - the cruciate and collateral ligaments - together with the strong muscles keep the bones of the knee joint together and provide stability to the joint. The muscles are connected to the knee bones by tendons. The whole knee joint is covered by a ligamentous capsule, which further stabilises the joint. This ligamentous capsule is lined with a synovial membrane that secretes synovial fluid for lubrication.
What is Knee Arthroscopy?
Knee Arthroscopy is a common surgical procedure performed using an arthroscope - a viewing instrument / camera - which allows a surgeon to review the knee joint to diagnose and/or treat a knee problem. It is a relatively safe procedure and most patients are discharged from the hospital on the same day of surgery.
Indications for Knee Arthroscopy
The knee joint is vulnerable to a variety of injuries. The most common knee problems where knee arthroscopy may be recommended for diagnosis and treatment are:
- Torn meniscus
- Torn or damaged cruciate ligament
- Torn pieces of articular cartilage
- Inflamed synovial tissue
- Misalignment of patella
- Certain fractures of the knee bones
Knee Arthroscopy Procedure
Most knee arthroscopy is performed under general anaesthesia. Your anaesthesiologist will decide the best method for you depending on your age and health condition.
- The surgeon makes two or three small incisions around the knee.
- A sterile saline solution is pumped into the knee to push apart the various internal structures. This provides a clear view and more room for the surgeon to work.
- An arthroscope, a narrow tube with a tiny video camera on the end, is inserted through one of the incisions to view the knee joint. The structures inside the knee are visible to the surgeon on a video monitor in the operating room.
- The surgeon first examines the structures inside the knee joint to assess the cause of the problem.
- Once a diagnosis is made, surgical instruments such as scissors, motorised shavers, or lasers are inserted through another small incision, and the repair is performed based on the diagnosis.
The procedure may include any of the following:
- Removal or repair of a torn meniscus
- Reconstruction or repair of a torn cruciate ligament
- Removal of small torn pieces of articular cartilage
- Removal of loose fragments of bones
- Removal of inflamed synovial tissue
- Realignment of the patella
- Making small holes or microfractures near the damaged cartilage to stimulate cartilage growth
- The saline is then drained from the knee joint.
- Finally, the incisions are closed with sutures or steri-strips, and the knee is covered with a sterile dressing.
Postoperative Care Following Knee Arthroscopy
Most patients are discharged the same day after knee arthroscopy. Recovery after the surgery depends on the type of repair procedure performed. Recovery from simple procedures is often fast with no requirement for crutches but more complicated procedures may require braces and periods of restricted weight bearing on crutches.
Pain medicines are prescribed to manage pain. A rehabilitation program may also be advised for a successful recovery in order to restore motion and strengthen the muscles of the leg and knee.
Risks and Complications of Knee Arthroscopy
Knee arthroscopy is a safe procedure and complications are very rare. Complications specific to knee arthroscopy include bleeding into the knee joint, infection, knee stiffness, blood clots or continuing knee problems. These are detailed in the “procedure information booklets” which are to be found in the Patient Information tab.