Arthroscopy is a minimally invasive type of surgery, which is used as diagnostics and for treatment of injuries and illnesses of joints. It is a procedure, which is technically more demanding than comparable classical surgery, it demands higher level of expertise of the operator and special technological equipment but at the same time, it has many advantages.
With this procedure, the surgeon through a small incision that measures only few millimeters, introduces optics in the joints. It is a system of lenses, which usually measure 3-5mm in diameter, and are located in a metal tube in the dimension of a pencil, and allows transferring the light form the joint. An artificial light also flows towards the joint through this system. There is a special camera attached to this optics that can monitor the interior part of the joint and transfers an increased picture on the TV screen. In this way arthroscopy gives the surgeon a review of all joint structures, also of that ones that cannot easily be seen in classical surgeries or are even inaccessible to examine. In addition to the incision, which is necessary for introducing the optics, there is normally also needed one or more extra, also only few millimeters small incisions, through which we can insert different operative instruments into the joint. These different sensors, tongs, clips, miniature motorized, and electric instruments are used for the surgical procedure performed in the interior part of the joint.
The procedure of knee arthroscopy
Knee arthroscopy is performed depending on the type of the injury or illness with arthroscopic surgery under local, spinal or general anesthesia. After positioning the patient on the operating table before surgery we sterile the part where the operation will be performed. If necessary, we place a compression cuff on the thigh, which allows blood stasis in the leg during surgery. In most cases, there are only two tiny incisions required in a knee arthroscopy, one for the installation of optics and another one for introducing the instruments. During surgery, the knee joint is filled with sterile saline. It is a solution of NaCl, which rinses the joint, stretches it a little and in this way provides a good visibility inside the joint. In the procedure, depending on the type of injury or illness, we remove the defective area or because of the disease altered tissue, or reconstruct the damaged ligaments. Considering the extent and complexity of the procedure, the time of the operation varies and ranges from 20 minutes to two hours. After the procedure, the patient rests in recovery room for a short time, and in the same day, he is released to home care.
The advantages of arthroscopic procedures on the knee
Arthroscopic surgical techniques that allow minimally invasive treatment of injuries and illnesses of joints have compared to traditional surgery several advantages. In knee, arthroscopy allows much more detailed and comprehensive review of all inner joint structures. Many of those in traditional surgeries are not even reachable to evaluate.
An important advantage of the arthroscopic procedure is minimal traumatization of the surrounding healthy tissues, which is associated with significantly less pain in the postoperative period, and hospitalization is not even required. All of the above advantages improve the functional results of surgical treatment, risk of postoperative complications such as excessive bleeding, infections of the joint and wounds, and excessive scarring. Nevertheless, due to the small skin cuts the cosmetic effect of the operation is also significantly better.
Indications of knee arthroscopy
- Acute anddegenerative meniscal tears
• Intra-articular loose bodies
• Cruciate ligament injuries
• Initial degenerative changes in cartilage
• Cartilage injuries
• Problems associated with patella
• Chronic inflammation of the synovial membrane
Recovery from knee arthroscopy
Due to minimal invasiveness, the recovery from arthroscopic surgery is in many ways much faster than after classical surgery. After these types of operation there is less pain, in some cases, the joint function is rapidly regained. The actual recovery time depends on the type of the procedure; usually there is minimum recovery after partial removal of the damaged meniscus, and the longest in complex reconstructive operations on the knee ligaments. If degenerative changes are already present in the knee, this may contribute to a substantial extension of the recovery.
Immediately after the operation, it is necessary to cool the knee with ice several times per day, which reduces swelling and pain. Normally, immediately after surgery a full loading of the operated leg is allowed. At discharge, every patient gets individual instructions. On the first examination after surgery, an appropriate physical therapy program is prescribed; its execution time depends on the type of the procedure.