What is Knee Arthroscopy

Knee arthroscopy is a surgery to examine the inside of the knee joint and repair any damage to cartilage, surfaces, and other soft tissues around the joint.

You may have this surgery if non-surgical treatment has not relieved your symptoms. Knee arthroscopy may be used to:

• Repair a torn ligament or other torn tissues. Ligaments are tissues that connect bones to each other.
• Remove bone fragments.
• Remove a fluid-filled sac (cyst).
• Treat kneecap (patella)problems.
• Treat an advanced infection in the knee (septicknee).

Arthroscopic surgery is done using a thin tube that has a light and camera on the end of it (arthroscope). The arthroscope is placed through a small incision, and the camera sends images to a screen in the operating room. The images are used to help perform the surgery.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to blood vessels, nerves, or tissues in the knee.
• A blood clot that forms in the leg and travels to the lung (pulmonary embolism).
• Failure of the surgery to relieve symptoms.
• Knee stiffness.

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

Ask your health care provider about:

• Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
• Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines unless your health care provider tells you to take them.
• Taking over-the-counter medicines, vitamins, herbs, and supplements.

Testing

• Your knee may be examined. Your health care provider may move your knee or ask you to move it in specific ways to see how much motion you have.
• You may have blood tests.
• You may have imaging tests, such as an X-ray, MRI, or CT scan.
• You may have an electrocardiogram. This test records the electrical activity in the heart.

General instructions

• Do not drink alcohol unless your health care provider says that you can.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes, for one month or more before your surgery. If you need help quitting, ask your health care provider.
• Plan to have someone take you home from the hospital or clinic.
• Plan to have a responsible adult care for you for at least 24 hours after you leave the hospital or clinic. This is important.

What happens during the procedure?

• To lower your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Hair may be removed from the surgical area.
  • Your skin will be washed with soap.
• An IV will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to numb the knee area (local anesthetic).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into an area of your body to numb everything below the injection site (regional anesthetic). This may be injected into your groin or thigh.
• A cuff may be placed around your upper leg to slow blood flow to your lower leg during the procedure.
• Several small incisions will be made around your knee.
• Your knee joint will be rinsed (flushed) and filled with a germ-free solution (sterile saline). This expands the area to allow your surgeon to see the joint more clearly.
• An arthroscope will be passed through one of your incisions, into your knee joint.
• Other surgical instruments will be passed through the other incisions. Then, your surgeon will examine and repair your knee as needed.
• The sterile saline will be drained from your knee, and the cuff will be removed from your upper leg.
• Your incisions will be closed with adhesive strips or stitches (sutures) and covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You will be given pain medicine as needed.
• You may be given medicine to lower your risk of blood clots.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
• Your health care provider will give you instructions about how much body weight you can safely support on your leg (weight-bearing restrictions). You may be given crutches or other devices to help you move around (assistive devices).
• You may be shown how to do physical therapy exercises to help you recover.
• Do not drive until your health care provider approves.

Summary

• Knee arthroscopy is a surgery to examine or repair the inside of the knee joint.
• Before the procedure, follow instructions from your health care provider about eating and drinking.
• Plan to have someone take you home from the hospital or clinic.

Care After Knee Arthroscopy

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• Soreness.
• Swelling.
• Pain that can be relieved by taking pain medicine.

Follow these instructions at home:

Incision care

• Follow instructions from your health care provider about how to take care of your incisions. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), staples, skin glue, or adhesive strips in place. These skin closures may need to stay in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision areas every day for signs of infection. Check for:
  • Redness.
  • More swelling or pain.
  • Fluid or blood.
  • Warmth.
  • Pus or a bad smell.

Bathing

• Do not take baths, swim, or use a hot tub until your health care provider approves. Ask your health care provider if you may take showers. You may only be allowed to take sponge baths.

Activity

• Do not use your knee to support your body weight until your health care provider says that you can. Follow weight-bearing restrictions as told. Use crutches or other devices to help you move around (assistive devices) as directed.
• Ask your health care provider what activities are safe for you during recovery, and what activities you need to avoid.
• If physical therapy was prescribed, do exercises as directed. Doing exercises may help improve knee movement and flexibility (range of motion).
• Do not lift anything that is heavier than 10 lb (4.5 kg), or the limit that you are told, until your health care provider says that it is safe.

Driving

• Do not drive until your health care provider approves. You may be able to drive after 1–3 weeks.
• Do not drive or use heavy machinery while taking prescription pain medicine.

Managing pain, stiffness, and swelling

• If directed, put ice on the injured area:
  • Put ice in a plastic bag or use the icing device (cold therapy unit) that you were given. Follow instructions from your health care provider about how to use the icing device.
  • Place a towel between your skin and the bag or between your skin and the icing device.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Move your toes often to avoid stiffness and to lessen swelling.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

If you are taking blood thinners:

• Before you take any medicines that contain aspirin or NSAIDs, talk with your health care provider. These medicines increase your risk for dangerous bleeding.
• Take your medicine exactly as told, at the same time every day.
• Avoid activities that could cause injury or bruising, and follow instructions about how to prevent falls.
• Wear a medical alert bracelet or carry a card that lists what medicines you take.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you are taking prescription pain medicine, take actions to prevent or treat constipation. Your health care provider may recommend that you:
  • Drink enough fluid to keep your urine pale yellow.
  • Eat foods that are high in fiber, such as fresh fruits and vegetables, whole grains, and beans.
  • Limit foods that are high in fat and processed sugars, such as fried or sweet foods.
  • Take an over-the-counter or prescription medicines for constipation.
• Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. These can delay incision or bone healing. If you need help quitting, ask your health care provider.
• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

• Have a fever.
• Have severe pain.
• Have redness around an incision.
• Have more swelling.
• Have fluid or blood coming from an incision.
• Notice that an incision feels warm to the touch.
• Notice pus or a bad smell coming from an incision.
• Notice that an incision opens up.
• Develop a rash.

Get help right away if you:

• Have difficulty breathing.
• Have shortness of breath.
• Have chest pain.
• Develop pain in your lower leg or at the back of your knee.
• Have numbness or tingling in your lower leg or your foot.

Summary

• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.
• To help relieve pain and swelling, put ice on your leg for 20 minutes at a time, 2–3 times a day.
• If you were prescribed a blood thinner, avoid activities that could cause injury or bruising, and follow instructions about how to prevent falls.
• If physical therapy was prescribed, do exercises as directed. Doing exercises may help improve range of motion.