knee arthroscopy

So we're talking about you having your knee arthroscopy today, that's a keyhole procedure on your knee. What that means is that it's a minor procedure where we stick a camera inside the knee and have a look inside. We're expecting to find that it's probably a bit of wear and tear and that some of the cartilage has been worn and we'll first of all wash it all out, make sure it's nice and clean and also whatever we find that can be fixed we'll try and do that for you. It's a keyhole procedure so you have two very small cuts on the front of the knee, one just on the inside and one on the outside of the knee cap and they're about a centimetre and a half each. When we do the procedure, you'll most likely be completely knocked out asleep with an anaesthetic so you won't feel any of it and you definitely won't feel any pain. When we do the procedure, there's a big blood pressure cuff around the top of your leg and that's to control any bleeding so at the end of the procedure when you wake up, you might have a big red patch on your thigh but that will go down in a few hours' time. So when we do the procedure, we have a good look at the whole part of your knee, even the parts that we know probably are normal, just in case we find anything that we're not expecting to. Occasionally, the scans and the x-rays that you've had before, and what our plan is, can change once we've looked inside, because occasionally the scans lie or they don't show us anything. So what we do normally is do what's best for you and tell you exactly what we've done afterwards. 90% of the time, all we need to do is a little bit of shaving of the cartilage to tidy the loose ends up and a wash. Very occasionally, we find that the cartilage can actually have a stitch through it, but obviously we won't know until we've actually seen it. If we can put the stitch through, that's obviously better because it preserves your own tissues, but it does mean that we need to protect those stitches once you wake up from the operation. So what I mean by that is 90% of the time, You have the operation and you can start walking on it and you can walk home. In that 10% of the time, while we can repair it, we can put a stitch through, then we won't be able to let you walk on it for the next six weeks and you'll need to have a big brace on your knee to protect you and to remind you, but I'm afraid we'll only be able to know that once you're asleep and we've looked at the knee. So if you're happy with that, we will go ahead and do that because we think that'll be in your best interests until you're after. So when we do the operation, to make sure we can see inside the knee, we blow the knee up full of salty liquid. It's just salt water, there's no additional chemicals. But at the end of the procedure we can't suck it back out, so it's stuck in your knee. So you may feel that your knee is tighter, it's fatter, and your leg can be tighter and fatter for the next two weeks. That's completely normal and it will go down over the next two weeks, but just be aware that it will look slightly different. At the end of the procedure, we'll put a stitch through each of the holes that we've made and we usually ask your GP for you to make an appointment at your GP's practice for the nurse to take the stitches out in two weeks' time. Over the top of that will be a very small elastoplast kind of dressing and you can take that off when it falls off and right over the top of that is a couple of layers of wool and crepe bandage and again you can cut that off just with a normal pair of clean scissors in about three days' time. The physiotherapist will also come and see you before your operation and teach you how to use a pair of crutches. They give them to you even if you don't need them and most patients don't need them, but it's always good to have them at least for the first day or two just for confidence. Unless we tell you at the end, assume you can walk on your knee fully, you can put all the weight on and you don't need to hop on the other leg. It will only have to be non-weight bearing for the six weeks in that 10% that we've mentioned. This is a low risk procedure so we don't expect there to be many complications. Things that you do need to know before you sign the consent form is with any procedure there's a risk of bleeding, infection and damage to surrounding structures. For a knee arthroscopy procedure there's a chance that your knee can feel quite stiff for a while and it can take some time for it to limber up. We can cause some injury to blood vessels and the ligaments themselves when we put the camera in and we hope we don't do that and sometimes we find that there's too much wear and tear, too much arthritis, too much damage and that this knee arthroscopy procedure isn't enough. Again we're going to be able to know that once we're inside the knee and we'll have to tell you afterwards. At the end of procedure you go home today for sure but you need someone to pick you up and supervise you for 24 hours. We will then see you in our clinic and usually that's in six to eight weeks and check on your progress. Most people don't need to be seen it again after that, but very occasionally if you're having ongoing problems we can make plans to see you for longer.