Knee Arthroscopy

Knee arthroscopy is a surgical procedure used for the diagnosis as well as treatment of problems pertaining to the knee joint. In this technique a small camera, called an arthroscope, is inserted in the knee joint through a small incision. This technique is minimally invasive and involves limited risks and therefore, suitable for most patients.

Know More About Surgery

A knee arthroscopy may be required in the presence of the following symptoms or conditions:

  • Torn floating cartilage (meniscus) or torn surface (articular) cartilage
  • Torn anterior or posterior cruciate ligaments  
  • Removal of baker’s cyst
  • Removal of loose torn cartilage in the joint
  • Patella-femoral disorders
  • Infection in the knees
  • Swollen synovium (lining of the joint)
  • Fractures in the knee bones

A knee arthroscopy is in itself a diagnostic technique. However, a pre-diagnosis might already have been made using some other diagnostic methods. The following tests and diagnostic methods are used in order to diagnose problems with the joints:

  • Physical exam- the doctor would conduct a physical exam to check for signs of joint swelling, stiffness or redness. The doctor would also feel the joint for presence of swelling, warmth and fluid. Range of motion is also be checked by moving the joint back and forth.
  • Blood tests- blood tests may also be performed to check for the level of inflammation or the presence of antibodies.
  • Joint aspiration- a small sample of fluid is drawn out of the joint for testing using a needle.
  • Imaging tests- the most frequently used tests for this purpose are X-rays which help in looking for structural changes, signs of joint erosion, cartilage loss or tissue tear, inflammation, amount of fluid present etc. 

The doctor would start by administering either a local or general anesthetic. A tourniquet is placed around the thigh to prevent bleeding. The surgeon will make a few cuts or incisions in the knee. The knee is prepared with the use of sterile salt water or saline. This expands the knee, thereby giving the surgeon a better view of the joint. The arthroscope (small camera device) is then put in through one of the incisions and the images can be seen on the monitor present in the surgery room. Once the problem is identified, small surgical instruments are inserted through anther incision and the problem is treated. After the treatment, the saline is drained out and the incision is closed with stitches.

The risks and complications related to a knee arthroscopy are extremely small and rare. However sometimes the damage maybe more that was initially expected which could delay the recovery process and increase the chances of post procedure complications. The risks involved with the surgery may be as follows:

  • Bleeding at the wound site
  • Deep vein thrombosis (blood clot in the leg)
  • Infection at the site of incision
  • Stiffness in the knee
  • Allergic reaction to anesthesia or any other medications administered during the procedure
  • Bleeding or infection inside the knee joint
  • Injury or damage to the blood vessels, cartilage, ligaments or nerves of the knee

 

The surgery is typically non-invasive and is only one to two hours long. The patient can go home the same day as the surgery. Swelling and pain may be present as a result of the surgery and the patient may be advised to use ice packs as a relief for the same. The incision wound would need to be covered in a dressing. Pain medications may also be prescribed. The doctor may give a few exercises to help in recovery and strengthen the muscles.

Knee Arthroscopy Cost in Mumbai

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Knee Arthroscopy

Knee arthroscopy is a surgical procedure used for the diagnosis as well as treatment of problems pertaining to the knee joint. In this technique a small camera, called an arthroscope, is inserted in the knee joint through a small incision. This technique is minimally invasive and involves limited risks and therefore, suitable for most patients.

Symptoms

A knee arthroscopy may be required in the presence of the following symptoms or conditions:

  • Torn floating cartilage (meniscus) or torn surface (articular) cartilage
  • Torn anterior or posterior cruciate ligaments  
  • Removal of baker’s cyst
  • Removal of loose torn cartilage in the joint
  • Patella-femoral disorders
  • Infection in the knees
  • Swollen synovium (lining of the joint)
  • Fractures in the knee bones

Diagnosis

A knee arthroscopy is in itself a diagnostic technique. However, a pre-diagnosis might already have been made using some other diagnostic methods. The following tests and diagnostic methods are used in order to diagnose problems with the joints:

  • Physical exam- the doctor would conduct a physical exam to check for signs of joint swelling, stiffness or redness. The doctor would also feel the joint for presence of swelling, warmth and fluid. Range of motion is also be checked by moving the joint back and forth.
  • Blood tests- blood tests may also be performed to check for the level of inflammation or the presence of antibodies.
  • Joint aspiration- a small sample of fluid is drawn out of the joint for testing using a needle.
  • Imaging tests- the most frequently used tests for this purpose are X-rays which help in looking for structural changes, signs of joint erosion, cartilage loss or tissue tear, inflammation, amount of fluid present etc. 

Treatment

The doctor would start by administering either a local or general anesthetic. A tourniquet is placed around the thigh to prevent bleeding. The surgeon will make a few cuts or incisions in the knee. The knee is prepared with the use of sterile salt water or saline. This expands the knee, thereby giving the surgeon a better view of the joint. The arthroscope (small camera device) is then put in through one of the incisions and the images can be seen on the monitor present in the surgery room. Once the problem is identified, small surgical instruments are inserted through anther incision and the problem is treated. After the treatment, the saline is drained out and the incision is closed with stitches.

Risks

The risks and complications related to a knee arthroscopy are extremely small and rare. However sometimes the damage maybe more that was initially expected which could delay the recovery process and increase the chances of post procedure complications. The risks involved with the surgery may be as follows:

  • Bleeding at the wound site
  • Deep vein thrombosis (blood clot in the leg)
  • Infection at the site of incision
  • Stiffness in the knee
  • Allergic reaction to anesthesia or any other medications administered during the procedure
  • Bleeding or infection inside the knee joint
  • Injury or damage to the blood vessels, cartilage, ligaments or nerves of the knee

 

After Procedure

The surgery is typically non-invasive and is only one to two hours long. The patient can go home the same day as the surgery. Swelling and pain may be present as a result of the surgery and the patient may be advised to use ice packs as a relief for the same. The incision wound would need to be covered in a dressing. Pain medications may also be prescribed. The doctor may give a few exercises to help in recovery and strengthen the muscles.

FAQ Section

1) What is knee arthroscopy?

Knee arthroscopy is a surgical procedure in which a very small incision is made in the knee and a small camera, which is called the arthroscope, is inserted. This allows the surgeon to diagnose the issues with the knee and also correct the condition, if possible, with instruments attached to the arthroscope. It is commonly used to repair torn ligaments, cartilage and other components of the knee joint.

2) What is a torn meniscus?

The meniscus is a piece of cartilage that acts like a cushion between the two bones which are joined at the knee – the femur (thigh bone) and the tibia (shin bone). If the meniscus gets damaged or torn due to physical activity that puts a strain on the knee joint or rotates the knee joint, it is not necessary that the strain or rotation should be of high magnitude, a simple act like getting up after sitting down for too long can also cause a torn meniscus.

3) How long does it take to recover from arthroscopic knee surgery?

The actual procedure takes 30-45 minutes. You will be kept at the hospital for a maximum of 48 hours. Recovery time can be very different for different people. You can use a cane or crutches for the first few days and further if walking is causing pain. Most people can limp after the first few days, but normal functioning can take up to 6 weeks. The drainage from the incisions should stop in 48 hours, and a normal bandage can be used to cover the incisions. The knee must be thoroughly rested, and no undue strain should be put on it. Sports-related activities and other physically intensive activities should be undertaken after three months of the surgery. Any symptom of complication should be reported to the doctor immediately. Generally, some amount of physiotherapy is recommended during this period to slowly heal the joint back to its normal function. You have to be very careful with your knee, and you should follow your doctor’s instructions religiously.

4) Is arthroscopic knee surgery painful?

Arthroscopic knee surgery is a minimally invasive process which combined with anaesthesia should not cause any pain to the patient.

5) Can you walk right after arthroscopic knee surgery?

You can walk with the help of a cane or crutches. The normal function of the knee takes about six weeks to return, so normal walking will not be possible. Some patients are able to limp right after the surgery which is allowed if there is no pain felt while walking.

6) Is arthroscopy a major surgery?

Arthroscopy is a minimally invasive procedure which completes well within an hour. Serious complications arising from the surgery are also uncommon. Hence, knee arthroscopy cannot be called a major surgery.

7) How long do I have to wait to walk after meniscus surgery?

You will have to wait for six weeks to return to normal walking. You might be able to limp during these days, but most patients require some kind of aid like a cane or crutches to move.

8) Is arthroscopic knee surgery effective?

Arthroscopic knee surgery is very effective in repairing torn menisci, ligaments etc. in the knee joint, conditions which are caused due to injury. The recovery period of such surgeries is reasonable, and long term complications are rare. Its effectiveness decreases as the knee issue becomes more to do with old age. Studies have shown that issues in older people like osteoarthritis cannot be solely dealt with arthroscopic knee surgery. These require some other treatments like physiotherapy etc. In fact, arthroscopy in such cases has been found to have more long term downsides than upsides.

9) What are the complications of arthroscopy?

Short term complications of arthroscopic knee surgery include-

  • Infection at the site of surgery
  • Clot formation in the veins (Thrombophlebitis)
  • Damage to the arteries
  • Excessive Bleeding (Haemorrhage)
  • Allergic reaction to the anaesthesia or other medications used during the surgery
  • Damage to the nerves
  • Feeling of numbness at the incision sites
  • These complications can be avoided if the surgery is done by a well-trained surgeon under proper conditions. You should follow the instructions of the doctor pertaining to medications, diet, strenuous activities, change of bandage etc. to avoid any of these complications. Make sure you provide the hospital with your relevant medical history and get all the check-ups done as prescribed by the surgeon.

Long term complication of arthroscopic knee surgery include-

  • Swelling in the joint
  • The stiffness of the knee joint. (It happens due to scar tissue formation at the site of surgery.)
  • Cartilage Damage Progression (Usually happens in the case of arthritis where arthritis progresses more rapidly after the surgery as compared to before the surgery.)
  • SONK or spontaneous osteonecrosis of the knee (It is a result of microscopic fracture of the bone around the knee joint which causes inflammation within the bone and subsequent pain. The pain is sometimes more than what patients experienced before the arthroscopy. This condition usually gets worse with time, and people end up getting a partial or full knee replacement.

10) What happens if you leave a torn meniscus untreated?

A torn meniscus, if left untreated can cause more damage to the knee joint and can hasten the onset of osteoarthritis. You can sit, stand etc. without pain but as time goes on and the torn meniscus moves, it will cause excruciating pain and eventually you won’t be able to walk because of the pain. The knee should be given complete rest after diagnosis, and it should be left to the doctor to decide on the best possible treatment after the various tests.

11) Can you walk with a torn ACL or MCL?

You can walk with a torn Anterior Cruciate Ligament (ACL) or Medial Collateral Ligament (MCL) but not without some difficulty and considerable pain. There will be instability in your knee, and the knee might swell. Eventually, the pain would become too excruciating to move the knee.

12) How much does knee arthroscopy cost?

Knee arthroscopy in India ranges from Rs. 1,00,000 to Rs. 1,80,000 depending upon the hospital. In the US, it costs $5000 or about Rs. 3,80,000.