Knee arthroscopy

An arthroscopy is an operation that enables an orthopaedic surgeon to examine the inside of a joint. This allows a diagnosis to be made and also any treatment to be carried out. Arthroscopy involves making very small incisions (cuts) around the knee area and inserting a narrow telescope.

• Do not eat anything, including sweets or chewing gum, for 6 hours before your appointment
• You can drink clear fluids up to 2 hours before your appointment

When you arrive at the hospital you must report to the location stated in your appointment letter. You will be visited by a member of your consultant’s team, an anaesthetist (who will give you anaesthetic) and the nurse who will be looking after you during your stay.

You will be asked to change into a hospital gown and to remove any dentures.

We advise patients not to wear any jewellery other than a wedding band which will be covered with tape before going to theatre.

Your personal items will be left on the ward/day unit during the operation.

You will be taken to the operating theatre on a bed, trolley or chair by a ward nurse and a theatre porter.

Recovery

After the surgery you will be taken to the recovery area where a nurse will monitor your progress. When the recovery nurse is happy with your condition you will be able to return to the ward/day unit. You will be given pain relief to make you more comfortable.

Dressings

After the operation you will find a large bandage around your knee. This will become loose over the following 48 to 72 hours. Remove the bandage but leave the steri-strips or plasters in place. If there is blue gauze over the wound, replace it with a plaster. Always wash your hands before and after checking your wounds.

Washing

When washing and bathing take care to keep the incision wounds clean and dry until healed. This will take about 7 to 10 days.

Pain relief

You may have some discomfort for several weeks after the surgery but taking regular pain relief for the first few days will make you feel more comfortable.

Going home

For 48 hours after the operation:

• Do not drive a car, ride a bicycle or operate machinery
• Do not drink alcohol
• Do not sign any legally binding documents
• Do not take sleeping tablets

Swelling

It is important to reduce the swelling as much as possible although you can expect some swelling to last for several weeks after the surgery. Using ice as described below and sitting with your leg raised will help reduce the swelling.

1. Use either a bag of frozen vegetables or a polythene bag containing ice which is tightly sealed and all the air expelled. Make sure that your wound and dressings remain dry.
2. Cover your knee with a damp tea towel or cloth. It is important that ice does not come into direct contact with the skin as it can lead to an ice burn.
3. Place the ice pack over your knee. Hold in place with a towel or bandage.
4. Leave in place for 20 minutes.
   • The skin will become red and cold. Make sure that you check the skin every 5 minutes and note the following advice.
   • If the skin becomes white, blue or blotchy, remove the ice pack straight away.
   • If the area becomes more painful, remove the ice pack.

Daily activity

• Try to walk as normally as possible
• Try to walk up the stairs. If this is too painful in the early days, do one step at the time. When going upstairs, step up with your good leg first and when going downstairs step down with the operated leg first

The success of your operation will often depend on the amount of effort you are prepared to put into your rehabilitation. The exercises might seem hard at first and a little sore. If you feel that the exercises are making your knee more painful or increasing any swelling, cut down on the number that you are doing for a few days.

If you have any concerns over the level of pain you have, please contact your local physiotherapy department.

Please complete the exercises regularly throughout the day. If you fit them into your daily routine you are more likely to do them.

The following exercises can be done from day 1 after the operation (see figures on page 4 within the PDF below).

1. Straighten your knee by tightening the muscles at the front of your thigh. Hold for 5 seconds and release. Repeat this regularly.
2. While sitting, bend your knee as far as is comfortable (as shown in the picture). Do not force it. If you have had your meniscus repaired do not bend your knee past a right angle. You will be advised if you have had this procedure.
3. Sit with your leg straight. Push your kneecap quite firmly in all directions. If you have had a lateral release operation, pay extra attention to pushing the kneecap towards the inside of your knee. Repeat this 10 times and perform regularly throughout the day.
4. When comfortable, practice standing on your operated leg. If you feel safe doing this then you can practice not holding on to anything. If you find this is easy, try and do it with your eyes closed.

The following exercises are to restore strength and control to the muscles around your knee. You may begin them as soon as you feel able to (see figures on page 5 within the PDF below).

1. Standing with your feet shoulder width apart, slowly squat keeping your heels on the floor.
2. Try and sit down slowly on a chair. This can be made more difficult by changing the height of the chair or moving your operated leg closer to the chair.
3. Stand with your affected leg on a step. Slowly lower yourself down until your other foot brushes the floor. Straighten your knee but do not let if fully lock. This is quite a hard exercise and you may not be able to do it for a couple of weeks after the operation.

You should be able to return to sport when you feel able to do so. It may take longer to return to sports that involve twisting and turning. If you have any questions please discuss with your doctor when you are seen in clinic or contact the ward physiotherapist.

An arthroscopy is a very safe operation with very few risks. Your knee may be sore and swollen for a few weeks but this is short term. There is a very small risk of developing a blood clot and a small percentage of patients will get an infection.

If after leaving hospital, you have any concerns please contact the ward or unit where you had your surgery. If you feel your concerns require more urgent attention please contact your GP or NHS 111.

NHS 111

Tel: 111

Alternatively, you can contact your nearest Physiotherapy Department:

Cheltenham General Hospital

Tel: 0300 422 3040

Gloucestershire Royal Hospital

Tel: 0300 422 8527

Cirencester Hospital

Tel: 01285 655711

Dilke Memorial Hospital

Tel: 0300 421 8640

Lydney Hospital

Tel: 0300 421 8722

North Cotswolds Hospital

Tel: 0300 421 8770

Stroud Hospital

Tel: 0300 421 8080

Tewkesbury Hospital

Tel: 0300 421 6133

The Physiotherapy Departments are open Monday to Friday, 8:30am to 4:30pm.

American Academy of Orthopaedic Surgeons (AAOS)

Website: www.aaos.org