Your knee will be examined carefully while you are asleep under anaesthetic. A tourniquet is used for a short time during the procedure to prevent bleeding. Any hair around the knee is removed and the surgeon prepares your leg to reduce the risk of infection. Two small incisions are made on the front of your knee; each cut is approximately 1cm long. Occasionally, another cut is required and sometimes the incision may need to be extended. Fluid is then used to inflate the knee so that the whole of the inside can be examined by looking with the arthroscope and the planned treatment performed. The knee is then washed out and the cuts stitched. The surgeon will make a pictorial record of the state of your knee for future reference and photographs/videos will often be kept on record.
What will my knee be like afterwards?
When you wake up there may be some discomfort, but severe pain is uncommon. It is recommended that you take painkillers in the first week. There will be small plasters over the cuts and a larger bulky dressing over the knee. The bulky dressing can be removed and replaced with a tubigrip bandage within 24-48 hours. You will be seen by a physiotherapist and given advice about exercises, becoming mobile, and using ice packs. It is normal for the knee to be a bit bruised, swollen and stiff initially, but you should get in touch immediately about any concerns regarding infection, ongoing bleeding or increasing pain. Certain procedures require braces but this is not routine. Sutures are usually removed at 10-14 days post-operatively and your outpatient review will usually be 4-6 weeks post-operatively.
How soon can I …
Walk on the knee?
With most arthroscopic surgery, patients can walk on the knee immediately once they have recovered from the anaesthetic. It may be sore for a few days, but most patients will be fully weight bearing on the knee within a week. Sometimes there needs to be a temporary reduction of the force exerted on your knee so your doctor may advise a period of using crutches.
Go back to work?
This depends upon the physical demands of your job and the nature of the surgery performed. Your surgeon will guide you.
The simple answer is when it feels safe to perform an emergency stop. A sensible guide to help you answer this question is to ask: can you walk comfortably without any crutches? You can also try getting into the car and performing an emergency stop, but with the engine turned off.
The timing around returning to sport will vary greatly depending on the surgical procedure and sporting requirements. However, as a general guide, your knee should have regained sufficient strength and have reduced swelling enough within approximately two months in order to resume normal sporting activities.
Complications after routine arthroscopy are rare. The risk of infection is about 1 in 300. The symptoms to look out for are red, painful wounds, ongoing leakage of the wound, increasing pain and feeling unwell. If you think you have an infection you must be seen urgently. There is a small risk of blood clots (DVT) but usually only in people with other contributing medical risk factors. Occasionally, an arthritic knee can flare up after arthroscopy, but this usually settles. Some patients get small patches of numbness near the scars, which usually improve with time but may be permanent. Depending on the damage found you may have some persisting symptoms after surgery.