Arthroscopy of the Knee



Partial Meniscectomy



Meniscus Repair (Arthroscopic Technique)



General Information

This is a minimally invasive surgical procedure in which a miniature telescope-like instrument is passed into the joint so that the surgeon can see the inside of the knee in great detail, and operate through just two small incisions.

An arthroscopy can be for diagnosis or treatment. Some conditions that may require this procedure include:

  1. Meniscal tears

    Tearing of the cartilage that cushions the knee joint can cause a number of symptoms, including pain and swelling. An arthroscopy may be performed to remove part of the damaged meniscus (cushining cartilage), or in some younger patients the meniscus can sometimes be repaired. This procedure may require a separate incision and take longer before full activities can be resumed.
  2. Cruciate ligament reconstruction
    The operation involves replacing the torn cruciate ligament with either the hamstring tendons or patella tendon from the same leg. Read more about Anterior Cruciate Ligament Reconstruction here.
  3. Arthritis
    Occasionally, arthritis can be helped by arthroscopy. Often it is performed as a “grease and oil change” for a knee that will eventually require a knee replacement. An arthroscopy cannot cure arthritis and sometimes results can be disappointing.
  4. Loose bodies
    Loose pieces of cartilage or bone can occur due to a variety of causes. They can be removed during arthroscopy.
  5. Diagnosis or assessment
    Arthroscopy is useful to assess the inside of the knee to determine the suitability for other surgical procedures.
  6. Knee cap pain
    A painful patella (knee cap) may be an indication for arthroscopy after treatment with physiotherapy. If there are loose fragments of carilage behind the kneecap these can be removed during an arthroscopy. Another treatment of patella pain is to perform a lateral release. This is a procedure where tight structures pulling the wrong way on your kneecap are released.
  7. Cartilage biopsy if you are a candidate for cartilage transplant
    A specimen may be taken at the time of your arthroscopy which may be used at a later time. This may avoid a repeat operation to take a sample of cartilage.

Patient Instructions

Before Your Surgery
Your surgeon will discuss the surgery with you in detail at your appointment. Please bring any x-rays, MRI scans or other investigations you have had done which may be relevant to your surgery, and a list of any medications that you are taking. Notify your surgeon if you have any abrasions or pimples around the knee.

Changes in your medications
Cease aspirin and anti-inflammatory medications (e.g. voltaren, feldene) ten days prior to surgery as they can cause bleeding.
Cease any naturopathic or herbal medications 10 days before surgery as these can also cause bleeding.
Continue with all other medications unless otherwise specified.

Smoking
You are advised to stop smoking for as long as possible prior to surgery.

Day of Surgery
You will be admitted to the hospital and asked a series of questions. An anaesthetist will discuss your past medical history and previous anaesthetics. The operation is usually performed under a general anaesthetic but the final decision rests with the anaesthetist.

Following surgery, you will wake up in recovery with your knee bandaged. Most patients will go home on the day of surgery, but some may require an overnight stay. You will require pain killers and may have crutches to go home with if required .You should make arrangements to get home, as you will not be able to drive.

You will be seen before you go home to explain the results of the operation. This will be further discussed at your follow up visit.

Post op Protocol

Most knee arthroscopies are performed as a day only procedure.
The following are guidelines to assist with your post-operative care until you see Dr Walker.
Bandage:
You will either have a bandage or tubigrip on your knee post-surgery. A tubigrip is an elasticated tubular
bandage that goes over your foot and around your knee. If you have a bandage, simply remove it the day after
surgery, as well as the soft fluffy white material (velband) underneath to expose the dressings, and put on the
tubigrip.

Dressings:
The dressings are covering up the wounds. Generally, they are clear plastic, called opsites. Leave these on unless
they are peeling off, which they do sometimes. These seem to stick to some people’s skin better than others. If they
are peeling off and you need to replace them, do so as cleanly as possible i.e. use some sort of antiseptic.
Under the dressing there are generally white strips called steri-strips. Try to keep these on. However, again, if they are peeling off you can replace them.
If the wound is actively bleeding, you should see your GP or go back to the hospital to change. This is rare.

Showering:
You may get the dressing wet in the shower. Do not swim or bath until your review with Dr Walker.

Crutches:
Not everyone needs crutches so this will be assessed on an individual basis. Unless Dr Walker specifically
advises otherwise you can fully weight bear.

Exercises:
Please do the exercises as shown below.
Physio is not always required and Dr Walker will discuss this with you at your post-operative visit.

Swelling and ice:
Swelling and some bruising is normal. ICING IS VERY IMPORTANT. Ice for roughly 15 minutes every 2 hours
until the swelling reduces. Icing varies from a bag of peas to fancy expensive ice machines. Do not ice directly
onto the skin as you can get an ice burn. The tubigrip or something of equivalent thickness is good.
When sitting place your leg on a stool and when lying place your leg on a pillow.

Pain:
Pain is to be expected. The anaesthetist will give you analgesics and/or anti-inflammatories. Take these as required.
Remember with opioid drugs, you cannot drive or operate machinery, so try and wean off these.

Concerns:
If your temperature rises over 38.5 degrees or if you are unwell (i.e. with rigors or shaking) contact Dr Walker or go to an emergency department.

If your wound becomes red please contact Dr Walker.

Follow-up:
Your check-up is usually 7-14 days after the surgery. Generally, this appointment will be emailed to you. If for some
reason you don’t hear from us please contact Dr Walker’s rooms.

Post-Surgery Knee Exercises

After your operation (knee arthroscopy) the following exercises are necessary to assist in your recovery.

Start these exercises the day after surgery.

To Improve Strength

Raise leg with your knee straight and hold for 6 seconds.
Repeat: 10 times every 2 hours.

Push both knees into the bed and hold for 6 seconds.
Repeat: 10 times every 2 hours.

To Improve Knee Movement

Place your unaffected leg under your affected leg. Gently lower and then raise.
Repeat: 1-2 sessions per day for 2-3 minutes per session.

To Maintain Calf Circulation

To maintain calf circulation, move your foot up and down for 5 minutes every waking hour.
Continue: for 2-3 days or until you are walking comfortably.

If you are experiencing any difficulties with these exercises please contact the clinic for advice.