Knee arthroscopy: what to expect on the day

A knee arthroscopy is keyhole surgery. The surgeon looks inside the knee with a small camera through cuts a few millimetres long, and treats the problem with fine instruments. Most people go home a few hours later, on the same day. Here is what the day usually looks like, from the night before to your first evening at home.

Why it is done

An arthroscopy can find and treat the cause of knee pain, swelling, stiffness or locking. Common reasons include:

• trimming or repairing a torn meniscus
• removing loose pieces of cartilage or bone
• treating damaged cartilage
• reconstructing a torn ligament, such as the ACL
• washing out an infected joint

The days before

You will be told:

• when and where to arrive
• whether you need a health check or blood tests first
• when to stop eating and drinking on the day
• which of your usual medicines to stop or keep taking

Follow the eating and drinking instructions exactly. If they are not clear, ask. Tell the team if you might be pregnant, and about any blood thinners.

Arrange for an adult to take you home and stay with you the first evening. Plan time off work: how long depends on what is done in the knee and on your job.

The morning of surgery

• Shower or bathe that morning or the night before. Clean skin lowers the risk of infection.
• Wear loose trousers or shorts that will fit over a bandage.
• Bring your usual medicines, and leave jewellery at home.
• If you have them, bring crutches. If not, the team will advise you.

Before the operation

A nurse checks your details and health, and the surgeon marks the correct knee. You meet the anaesthetist, who talks through the options:

• General anaesthetic. You are asleep throughout.
• Spinal (regional) anaesthetic. You are numb from the waist down but awake. You can usually have medicine to help you relax.
• Local anaesthetic. Only the knee is numbed. This suits some small procedures.

Which one you have depends on what is planned, the joint and your general health.

During the arthroscopy

In the operating theatre the skin of the knee is cleaned and the leg is covered with sterile drapes. Then:

1. The surgeon makes two or more small cuts, called portals, each a few millimetres wide.
2. Sterile fluid is run into the knee to expand it and wash away cloudy fluid, so the view is clear.
3. The arthroscope, a thin camera with a light, goes in through one portal. It sends pictures to a screen.
4. The surgeon checks the whole joint first, to confirm the diagnosis.
5. If treatment is needed, fine instruments go in through another portal to trim, cut, repair or stitch.
6. The cuts are closed with a stitch or adhesive strips, and the knee is wrapped in a soft bandage. A brace may be fitted after a repair or reconstruction.

An arthroscopy can take from about 30 minutes to a few hours, depending on what is done. A simple knee procedure is at the shorter end.

Waking up and going home

You rest in a recovery room while the anaesthetic wears off. Nurses check your pain, your circulation and your ability to move. When you feel well enough, often within one or two hours, you can go home. Some people stay overnight.

Before you leave, you should know:

• how much weight you can put on the leg, and whether to use crutches
• which painkillers to take, and whether you need medicine to lower the risk of blood clots
• how to look after the dressing, and when you can shower
• which exercises to start
• when your follow-up visit is

You must not drive after a general anaesthetic. Someone needs to take you home and check on you that evening.

The first evening and first week

• Keep the leg raised when you sit, for the first few days.
• Use an ice pack wrapped in a cloth for 20 minutes every 2 to 3 hours.
• Keep the dressing clean and dry.
• Start the exercises you were given. They help restore movement and strength.
• Expect the knee to be sore and stiff at first. Painkillers help.

At your follow-up visit, the surgeon checks the wounds, explains what was found and plans the next steps. Recovery can take from about a week to several months, depending on what was done. After a minor procedure, many people drive in 1 to 3 weeks and return to most activities by 6 to 8 weeks, sometimes sooner. A meniscus repair or ligament reconstruction takes longer.

Read more about knee arthroscopy in Dubai and meniscus tear treatment.

When to see a doctor

Complications are rare, but contact the clinic or your surgeon straight away if you have:

• a high temperature, or feel hot, cold or shivery
• severe pain, or pain that keeps getting worse
• smelly fluid leaking from a cut
• spreading redness or severe swelling around the knee
• numbness or tingling around the knee
• pain, warmth or swelling in the calf

Sudden shortness of breath or chest pain can mean a blood clot in the lungs. Call 998 for an ambulance straight away.