Everything about knee arthroscopy

Do you have knee pain? You may have experienced it while playing sports, walking, or even just standing. If your pain hasn't subsided despite taking medication and doing various things, your doctor may have recommended a small surgery to look inside your knee. That's what we call a knee arthroscopy in medical terms. Don't be scared when you hear this name. This is a very simple, very advanced surgical procedure that is performed through a small incision. Let's talk about it simply from the beginning.

What is this knee arthroscopy surgery?

Simply put, this is a special surgical procedure used to diagnose and treat problems in the knee. Instead of making a large incision in the knee like in the past, this surgery is performed through several small incisions the size of a keyhole . That's why it's also called "keyhole surgery."

Imagine, the doctor inserts a thin tube-like instrument into the knee through a small incision. At the end of this tube is a very small camera and a light. We call this an 'arthroscope'. This camera clearly magnifies everything inside the knee joint, including cartilage, ligaments, and bones, and shows it on a TV screen in the operating theater.

Now the doctor can see exactly what's wrong with the inside of the knee. If there's any damage, like a tear, he can make another small incision and insert very fine, special instruments through it to repair the damage.

Who needs this surgery and in what cases?

Usually, when you have knee pain, your doctor won't immediately recommend surgery. They will first advise you to rest, apply ice, use nonsteroidal anti-inflammatory drugs (NSAIDs), and do physical therapy (PT).

This surgery is often required for young athletes, especially those who play sports, due to injuries to their knees. However, for osteoarthritis, this surgery is not always a successful solution. Your doctor will explain this to you in detail.

Arthroscopic surgery is mainly performed for these three reasons:

What are the main conditions treated with arthroscopy?

This surgery can treat various knee problems.

• Soft tissue injuries: These include injuries to the ligaments that connect our bones and the tendons that connect muscles to bones. For example:
• Torn meniscus
• Anterior Cruciate Ligament (ACL) tear
• Medial Collateral Ligament (MCL) tear
• Bursitis (inflammation of the knee)
• Patellar tendonitis
• Fractures: Bone fragments inside the knee can break and become loose. Also, pieces of cartilage can become loose and become stuck inside the joint.
• Inflammation: Pain caused by swelling of the synovium, the lining of the knee joint. This condition is also called synovitis.

What do you need to know before surgery?

Before the surgery, your doctor will examine you and give you the necessary instructions.

• Tell your doctor about any medications you are taking: If you are taking any special medications, such as blood thinners, you should definitely tell your doctor about them. You may need to stop taking them a few days before the surgery.
• Food and drink:Your doctor will tell you when you should stop eating and drinking the night before your surgery. Follow those instructions exactly.
• Anesthesia: You will be given anesthesia to prevent you from feeling any pain during the surgery. Depending on your condition, your doctor will choose one of these methods:
• Local anesthetic: numbs only the area around the knee.
• Regional anesthetic: An injection is given in your back, numbing you from the waist down. You are conscious.
• General anesthetic: You will be put to sleep until the surgery is complete.

How is the surgery done?

After being taken to the operating theater, the surgery takes place like this.

1. First, your leg will be thoroughly cleaned and placed in a special device that will keep your knee in one place during the surgery.

2. Then, a small incision is made in the knee, and an instrument called an ``Arthroscope'' with a camera is inserted through it.

3. Now the doctor is looking at what's inside the knee on the TV screen. He's finding the exact location of the problem.

4. If treatment is necessary, one or two more small incisions are made and delicate surgical instruments are inserted through them.

5. Stitching up torn tissue, smoothing out damaged cartilage or bone fragments, or removing unwanted swollen tissue.

6. Finally, the small incision is closed with stitches or a special plaster, and a bandage is applied to the knee.

This entire process usually takes about an hour .

What to expect after surgery?

Most of the time, this is an outpatient procedure. That means you can go home the same day. However, since you cannot drive, you will need someone to drive you home.

Be careful of these things in the first few days after surgery.

• Do not put weight on the leg: Avoid putting weight on the operated leg for a few days. If you need to walk, you will need to use crutches.
• Elevate your leg: To reduce swelling and pain, keep your leg elevated as much as possible, like on a pillow. It's best to keep it above the level of your heart.
• Take painkillers: Take the painkillers prescribed by the doctor exactly on time.
• Keep the wound clean: Ask your doctor about when to remove the bandage and when you can shower. Keep the wound clean and dry.

After a few days of healing, your doctor will refer you to physical therapy (PT). This is essential to regain strength and flexibility in your knee.

What are the benefits and risks of this surgery?

Advantages

The biggest advantage of a "keyhole" surgery like this is that it allows for faster recovery than open surgery.

• The pain is less.
• The scars are very small.
• The risk of infection is low.
• You can return to normal activities quickly.

Risks/Complications

As with any surgery, there are some minor risks, but complications are very rare.

• Bleeding and infection.
• Blood clots in the legs.
• Difficulty bending the knee (knee stiffness).
• Swelling due to blood accumulation inside the joint (this occurs very rarely).

What symptoms should I see a doctor for after surgery?

If you experience any of these symptoms after going home after surgery, you should call your doctor immediately .

• The wound continues to bleed.
• Signs of an infection: fever, excessive swelling, redness, and pus around the wound.
• Severe pain that cannot be tolerated even after taking painkillers.

Arthroscopy is a very safe and effective surgical procedure. It can treat many knee problems without a large incision. The most important thing is to follow the doctor's instructions after surgery, especially the physical therapy exercises. Then you will recover quickly and be able to resume your work.