Before surgery
If you have medical conditions then you may be invited to attend a pre-assessment clinic by one of our specialist nurses. Routine blood tests, tracing of the chest (ECG) and an MRSA swab will be performed to ensure you are safe to be admitted to hospital.
If you have any source of infection then you will need to contact us at your earliest convenience. For example any cuts or grazes near the knee or a dental / chest infection. Your surgery may well need to be postponed for your safety and to reduce the risk of infection.
Some medication for the heart / tablets to thin the blood / tablets to control rheumatoid arthritis will need to be stopped and can be discussed with our pre-assessment team.
Seeing a physiotherapist prior to surgery will improve your recovery after surgery.
Follow instructions to stop eating and drinking before surgery. Usually 6 hours before you should not eat or drink.
We perform pre-operative checks according to the World Health Organisation to ensure that we operate on the correct site.
During Surgery
You will have a light general anaesthetic administered to you.
Two small cuts are placed either side of your knee cap tendon to allow access to the knee from the front. Occasionally more small cuts are needed to gain access to difficult areas of the knee.
Sterile fluid is allowed into your knee to give a better view.
A special camera (arthroscope) is inserted through one of the cuts and specialised equipment can be inserted into your knee under direct vision to remove or repair the painful areas of your knee.
Once finished the fluid is removed, local anaesthetic inserted and the skin closed with adhesive dressings.
After surgery
You will need to recover from the anaesthetic given and that should not take more than a few hours.
The knee may feel some discomfort but should be easily managed with painkillers such as paracetamol or ibuprofen.
You will be seen by physiotherapy staff to ensure you understand any special instructions from surgery and issue you with a brace or crutches if needed. You will also get an information sheet with activities to perform to ensure a quicker recovery to function.
If you are deemed to be at high risk of DVT then you will go home with tablets that thin the blood for 2 weeks. These sadly can increase the risk of bleeding and swelling in and around the knee.
Risks of arthroscopic surgery
An arthroscopy is generally considered to be a low-risk procedure, but like all types of surgery it does carry some. Your individual circumstances will be discussed at the time if you decide to opt for surgery. It is normal to experience short-term problems such as swelling, bruising, stiffness and discomfort after an arthroscopy. It is common to feel discomfort at the ‘portal’ sites which can take a few months to fully settle. In some circumstances there may be a lot of non-reversible damage to your knee and thus the aim is to make your knee better, rather than normal. Thus you can have persisting discomfort despite adequate surgery.
More serious problems are much less common, occurring in less than 1 in 100 case and include:
A blood clot that develops in one of your legs – this is known as deep vein thrombosis (DVT) and it can cause pain and swelling in the affected limb. This can sometimes go to the lungs and cause a pulmonary embolus (PE) which in rare circumstances can cause death.
Infection inside the joint – this is known as septic arthritis and it can cause a high temperature (fever), pain and swelling in the joint
Bleeding inside the join – Will produce swelling and increased pain.
Accidental damage to the nerves that are near the joint – this can lead to numbness, sensitivity and some loss of sensation, which may be temporary or permanent.
Chronic regional pain syndrome – is a greater than normal reaction by the body to an injury or surgery. This can lead to chronic pain, swelling and skin changes.