Knee Arthroscopy

Many patients may have a problem within the knee that keeps it from moving and functioning normally.

Symptoms such as locking, catching, clicking, popping, and buckling or giving way are often caused by a loose body or torn cartilage within the joint. If the problem is not evident in a diagnostic image such as X-ray or MRI, the only way to know definitively what is causing the symptom is to look inside the knee joint to find and correct the problem.

Knee arthroscopy is a minimally invasive technique, typically performed on an outpatient basis, that involves looking within the knee joint using a fiber optic video camera (arthroscope) and small instruments.

Before arthroscopic surgery existed, orthopaedic surgeons had to make large incisions to open the knee joint and perform surgery, a procedure that disrupted the surrounding joint structures and tissues. Arthroscopy requires small incisions and is much less invasive than traditional surgical methods, resulting in less pain, decreased risk of infection, and shorter recovery period.

At Orthopaedics New England, we may recommend knee arthroscopy if your knee pain does not respond to conservative treatments such as rest, physical therapy, medication, or injections. By performing knee arthroscopy, we can diagnose and treat a number of common problems within the knee:

• Remove a loose piece of bone
• Trim or repair a torn area of articular cartilage
• Remove or repair a torn meniscus
• Remove excessive synovial lining or scar tissue
• Wash out an infection within the knee joint
• Smooth out roughened joint surfaces or cartilage
• Stimulate formation of scar tissue to fill in an osteochondral defect
• Reconstruct a torn anterior cruciate ligament (ACL)
• Determine the extent of arthritis and damage (this is particularly helpful for deciding whether a patient needs a partial or total knee replacement)

The Procedure

Most arthroscopic procedures are performed using a combination of local anesthetic injections and light sedation. While the length of the surgery will depend upon the diagnosis and treatment necessary, simple procedures, such as trimming a torn meniscus or removing a loose body, typically only take about 30 minutes or so.

1. The surgeon will make at least two small incisions, typically less than ¼-inch long, near your knee joint. The arthroscope is inserted through one incision while the other incision is for whatever instrument the surgeon will need to treat the problem. During the procedure, images from the camera are projected onto a monitor to guide the surgeon.Arthroscopy instruments can take photographs or record live video of the image displayed on the monitor. Many surgeons will keep these photos for later reference in case the patient has any future knee problems, such as arthritis.
2. A sterile saline (saltwater) solution is pumped into the joint through the arthroscope. This allows the surgeon to wash away any blood or material removed (such as meniscal trimmings or loose bodies). It also expands the space, which allows your surgeon a better view of your joint structures and ensures there is plenty of room to safely work with the small instruments.
3. Depending on the diagnosis, your surgeon may make additional small incisions for other surgical instruments needed to treat the problem.
4. When the procedure is complete, your surgeon may inject your joint with medication to reduce pain and inflammation, close each incision with a stitch or Steri-Strips, and cover your knee with a soft bandage.

After the procedure, you will be taken to the recovery room until you are fully awake and comfortable. Upon discharge, you will be given post-op instructions. You will need to elevate your leg and apply ice to your joint to help reduce pain and swelling. Some procedures may require limited weight bearing with crutches afterwards. Depending on the exact procedure performed, most patients can return to work within 1 to 3 weeks.

If you have knee pain that won’t go away, make an appointment with one of our knee surgeons, Dr. John Keggi or Dr. Robert Kennon, in Middlebury, New Milford, or Farmington, Connecticut. Call (203) 598-0700 today or you can request an appointment online.