Arthroscopic Knee Surgery
Arthroscopy is key-hole surgery of the joints where a thin (4 mm dia meter) telescope is introduced into the joint through a small cut, and the inside of the joint examined. Once the diagnosis is confirmed, the corrective surgery is done there and then by introducing micro-instruments through another small skin puncture (picture showing arthroscopy in progress).
Frequently Asked Questions
- Q 1. What is the benefit of arthroscopic surgery?
- Minimally cutting technique.
- Day-care surgery.
- Quick recovery.
- No plaster or bandaging.
- Better visibility even compared to open surgery.
- Q 2. What is the down side of arthroscopy?
- It is a technically demanding procedure, and needs a lot of experience and sophisticated equipment.
- Q 3. How is it done?
- It is done with the patient under spinal or general anaesthesia. The blood circulation to the leg is blocked with the help of a broad rubber band like thing (tourniquet) on the thigh. The knee is cleaned and draped as would be done for any other operation. A cut is made just below and outside the knee cap. Through this, the arthroscope ( a kind of telescope) is introduced, and a small video camera is attached to it. The arthroscope can be moved to different parts of the joint, and all the structures inside the joint are thoroughly examined. The second cut is made on the medial side of the patellar tendon through which other intruments such as probe, cutters etc can be introduced
- Q 4. In what cases is arthroscopy beneficial?
Arthroscopy may be done to make a diagnosis where it has not been possible to do so on clinical examination and investigations. Most often, today, arthroscopy is performed for curative purpose when the diagnosis is already made clinically or on MRI. The following are some of the common procedures which can be performed arthroscopically :
- Loose body removal
- Partial or complete menisectomy
- Chondroplasty (repair of degenerated cartilage)
- Excision of plicas
- Correction of patellar mal-tracking
- Synovial biopsy
- Release of a stiff knee (Arthrolysis)
- Ligament Reconstruction
- Fusion of the knee (Arthrodesis)
- Q 5. How much time does it take to recover?
- It depends upon the problem for which arthroscopy is done. In its simplest form, such as meniscus surgery, one is up and about the next morning, and fit to work within two-three days. In more complex arthroscopies such as ligament surgery, it may take 2-3 weeks to be able to walk.
- Q 6. What complications can happen?
Arthroscopy is a fairly safe operation. In rare cases there may occur some collection of blood (haemarthrosis). In most cases it is mild and absorbs by itself, but in some removal of the blood may be required with a needle aspiration, under local anaesthesia.
The only other, though uncommon, complication is infection, which is a complication which can happen after any operation, though much less common with arthroscopy. Prevention is the best approach, but if it does happen, a repeat arthroscopic cleaning may be required.
In some cases stiffness may set in after arthroscopy. Taking care of knee in the post op period can prevent this complication
- Q 7. What is the cost?
- In its simplest form, it costs approx seventy thousand in a single room with one night stay. In more complicated surgeries, the cost can go upto 2 lacs. Your doctor can give you a rough estimate of the cost involved in your case.
- Q 8. How long one does stay in the hospital?
- In most cases the stay is for one night, but some time it may be two
- Q 9.How painful is it going to be?
- Being key-hole surgery, pain is minimal, at most discomfort for a period of 2-3 days. One can be up and about the very next morning, and fit to move out of home in 2-3 days.