What is a Knee Arthroscopy?
Knee arthroscopy is a minimally invasive, out-patient, procedure which allows the surgeon to visualize the inside of the knee joint and repair, reconstruct or resect damaged tissue. Three small incisions are made about the knee and a small fiberoptic camera is inserted into the knee joint. The joint is distended with sterile water to allow better navigation and visibility. Dr. Diaz will look at a television monitor as he performs the surgery, and in many cases the patient can look at the monitor as well.
What kinds of procedures can be performed with the arthroscope?
Arthroscopy allows the surgeon to view the inside of the knee joint and perform a variety of surgeries. These surgeries include:
- Complete evaluation of the joint (diagnostic arthroscopy)
- Removal of damaged or torn cartilage (partial meniscectomy)
- Repair of torn cartilage (meniscus repair)
- Smoothing of damage to the cartilage surface in arthritis (chondroplasty)
- Realignment of patella in patellar mal-tracking
- Removal of joint lining (synovectomy) or loose body
- Repair or reimplantation of loose osteochondritis dessicans lesion
- ACL reconstruction
How long does the surgical procedure take, and am I asleep?
The length of the procedure varies. For resection of a meniscal tear, for example, the surgical time is usually about 20 minutes. Most other procedures take a bit longer depending on the amount of work that needs to de done. A local anesthetic is administered into the knee before the procedure. This numbs the knee and allows the patient to remain conscious. A general anesthetic is almost never required, but the patient is given intravenous sedation.
What is the recovery time?
There is a high degree of variability in recovery times. Some patients are able to return to regular activities within two weeks, but most require roughly six weeks before they can resume full activities - including sports - comfortably. Reduction of pain and swelling and improvement in strength, motion, and coordination may continue for three to four months. The rate of recovery depends on the particular procedure performed, the general fitness of the patient, and the amount of underlying arthritis in the knee. A younger, fit patient with an isolated meniscus tear will often fully recover within 2 weeks, while a heavier patient with a tear and arthritis may take 2 months. For patients undergoing meniscal excision immediate weightbearing without crutches is started on the first day after surgery.
Will I have stitches and when do they come out?
Typically, you will have three simple sutures which are removed about a week after surgery by Dr. Diaz in the office.
When can I shower?
You can shower 48 hours after your surgery if there is no drainage from your incisions. Do not scrub directly over your incisions and gently pat the incisions dry after showering.
When can I drive?
You can drive as soon as you feel comfortable and have good control of your leg and quadriceps muscle. YOU CANNOT DRIVE IF YOU ARE TAKING NARCOTICS! If you drive a standard transmission vehicle and had surgery on your left knee, you should wait a few days before driving to avoid causing more pain/irritation from operating the clutch. If you need to drive long distances within two weeks after your surgery, you should take frequent breaks to stand up, stretch, and walk for 10 minutes per hour to decrease the risk of a blood clot forming.
When can I return to work?
This depends on your profession. Typically, if your work is primarily sedentary you may be able to return within a few days. If your work is extremely rigorous, you may require six to eight weeks before you return to full duty. Your physician will help you determine an appropriate return-to-work date, and will also provide any needed paperwork.
When can I travel?
You may travel as soon as you feel comfortable, but it is recommended that long trips be avoided for two weeks after surgery due to an increased risk of blood clots in the legs. If a long trip is unavoidable in the early post-operative period, we recommend that you get up to stretch or walk for at least 10 minutes per hour to decrease the risk of a blood clot.
What are some of the possible complications of surgery?
Generally, the complication rate for arthroscopic knee surgery is very low. The risk of infection is less than 0.1%. Rarely, a patient will develop a blood clot in the affected leg. Symptomatic clots requiring treatment occur in < 0.5% of Dr. Diaz's patients. Some patients can have residual pain in their knee after surgery. In most cases, this can be attributed to underlying arthritis. Dr. Diaz will discuss his intraoperative findings with you after surgery so you have a clear understanding of the overall health of your knee. It is important to understand that the rate and nature of complications varies from one to procedure to the next. The doctor will review the relevant risk with you prior to scheduling surgery.
What do I need to do to prepare for surgery?
Our staff will schedule the surgery and obtain insurance approval. If you are over the age of 50, or have significant health conditions you may require an EKG and/or chest x-ray. You may also need to see your internist or family doctor to obtain a Letter of Medical Clearance. The day before the surgery, a member of the hospital or surgery center staff will contact you about what time to arrive for surgery. You may not eat or drink anything after midnight before your surgery.