1. Knee Arthroscopy University Orthopaedics & Sports Medicine
Presentation designed for patient education
Updated 2/11

2. University Orthopaedics & Sports Medicine
Offices
Clifton (Medical Arts Building)
Westchester

3. University Orthopaedics & Sports Medicine
Surgery
Holmes Hospital (Clifton)
Outpatient Surgery Center
Mercy Fairfield
Main
Westchester Medical Center
University Pointe Ambulatory Surgical Hospital (ASH)
University Hospital

4. What is Knee Arthroscopy?
Simply looking around the joint with a camera
A complete inventory of the knee can be performed
Many pathologic conditions can be addressed.

5. Indications (Reasons) for Knee Arthroscopy
Meniscus Tears
Articular cartilage injuries
Ligament repairs and reconstruction (i.e. ACL reconstrucion)
Removal of loose or foreign bodies
Lysis of adhesions (cutting scar tissue to improve motion)
Debridement
Irrigating out infection
Lateral Release (cutting tissue to improve patella pain)
Fixation of fractures or osteochondral defects (bone/cartilage defects)
Diagnostic ↑
Meniscus Tear
Debrided and Repaired Meniscus Tear

6. Arthroscopic Instruments
Camera
Probe
Shaver- “shaves and debrides” loose or torn tissue
Baskets- “nibble away” damaged tissue
Scissors
Cautery-coagualates small bleeding vessels

7. How is surgery done?
The surgery begins with an examination of your knee while you are asleep
This allows for testing of your knee ligaments to make sure they are stable without the resistance of your muscles
“Examination Under Anesthesia”

8. Arthroscopic Examination
A camera is inserted into your knee thru a tiny poke hole in the front of your knee called a portal
The doctor moves the camera around your joint while looking at a monitor
A complete inventory of your knee will be performed looking at all the structures inside your joint
A second portal is created for the insertion of working instruments
Usually only two portals are necessary, but occasionally additional portals are needed to get the job done effectively

9. Normal Arthroscopic Anatomy
Knee Cap ↓
Thigh Bone ↓
Meniscus ↓ ↑ ↑ ↑
Thigh Bone
Shin Bone
Anterior Cruciate Ligament (ACL)

10. Addressing Pathology
Instruments can be used to inspect the knee structures
Other instruments can be used to debride or repair structures
Probe used to evaluate torn meniscus
Shaver used to debride a bone tunnel for ACL reconstruction

11. Pathologic conditions
Meniscus Tear and Arthritis ↑ ↑ ↑
Loose Bodies ↑ ↑
Torn ACL
Scar tissue and adhesions

12. Various Pathology
An infinite number of problems can be treated with arthroscopy and we are continually expanding the array of diseases that can be effectively treated with the camera
Tibial spine fracture with pulled off ACL
Arthroscopically assisted fracture repair and restoration of ACL anatomy

13. Post Operative Rehabilitation
Usually you can go home the same day
Ice and elevate your leg as much as possible for the first 72 hours
You may or may not have a brace depending on what surgery was done
Your doctor will tell you how much weight you can put on your leg

14. Post Operative Rehab
You can usually take your dressings down on the third post op day and shower
Do not scrub or submerge your wound
No soaking, swimming or hot tubs
Do not apply any ointments to your wound—this includes polysporin or other antibiotic ointments
Other than bathing keep your wound clean and dry
After your shower you can leave your leg open to air if nothing is draining
If your knee is draining then apply a clean dry dressing and notify your doctor
You will be given pain medications and a pill for nausea
Please take an Aspirin 325 mg per day until your follow up appointment

15. Post op You will usually see your doctor 5-7 days post op
At that point you will get into physical therapy
You will work on range of motion
The thigh muscle (quadriceps) goes to sleep after many knee injuries and after surgery. Thus, much of your rehab will be aimed at quadriceps strengthening exercises

16. Physical Therapy
The amount of physical therapy that you will need depends on what was done in surgery
The rehab is quite different for different arthroscopic knee surgeries
Please make sure you understand the expected rehab goals
Physical therapy is very important in optimizing your outcome
It is critical to do exercises at home on your own as well
Your therapist will give you a home exercise program that should be done every day

17. Return To Work or Sport Desk job—3-5 days
Prolonged standing or heavy lifting—usually about a month
This is highly variable depending on surgery and rehab and most importantly what kind of work you do or what sport you play
This is also very much dependant on your rehab progress
It is best to anticipate the expected length of recovery before surgery
Sometimes the recovery is shorter or longer than expected but often can be estimated before surgery

18. When Can I Drive? Must be off all narcotics
Should be able to hold a straight leg raise for 10 seconds
Ask you doctor before you drive?
Practice in a parking lot first

19. Conclusions
Knee arthroscopy is a very useful tool of the orthopaedic surgeon
We are constantly getting better and better to expand the types of procedures that can be done
The recovery is variable, but you should be able to get a ballpark estimate based on the anticipated procedure
Your doctor or therapist can be a useful resource for any and all questions. Do not hesitate to ask questions at your appointment or call the office when questions arise

20. Thank You