Knee arthroscopy surgery is a type of procedure where your surgeon investigates and corrects issues using an arthroscope. It's not as invasive as conventional surgery, and surgeons use it for diagnosing and treating problems in your joints.
Knee arthroscopy has gained popularity because it typically requires a shorter recovery time. The surgery generally takes no more than an hour, and it's uncommon to experience serious complications.
Dr. Mufaddal Gombera, Board-Certified Orthopedic Surgeon and Specialist in Sports Medicine at Fondren Orthopedic Group, prides himself on performing knee arthroscopy surgery successfully.
How Do Knee Injuries Happen?
Knee injuries often occur due to recreational activities, sports, home projects and work tasks. They can happen to anyone. You can experience them due to acute injuries, overuse injuries or other conditions related to basic wear-and-tear.
1. Acute Injuries
Acute injuries, which are sudden injuries, are a common reason for knee issues. Things like a blow to your knee, bending, twisting or falling on your knee causes knee problems. You can experience symptoms ranging from numbness or tingling to bruising, pain and weakness. These types of injuries include:
- Meniscus tear
- Sprains, strains or other tendon and ligament injuries
- Fractures of your kneecap, upper fibula or tibia or lower femur caused by an abnormal force like twisting, falling, direct contact or bending
- Ligament tears like to your anterior cruciate ligament (ACL) or medial collateral ligament (MCL), which is the most common type of injured ligament
- Dislocated kneecap
- Dislocated knee joint, a rare type of injury caused by a large amount of force, which requires immediate medical attention
2. Overuse Injuries
These develop after repeated pressure on your knee or repeated activities. Activities like riding a bike, climbing stairs, jumping or jogging can add stress on your joints and cause these injuries, which include:
- Tendinosis or tendinitis: Tendon inflammation or small tears in your tendons.
- Bursitis: Inflammation of the small fluid sacs called bursae that lubricate your knee.
- Iliotibial band syndrome: Inflammation and irritation of your iliotibial band, a fibrous tissue running down your outer part of your thigh.
- Patellofemoral pain syndrome: Pain in your front knee following injury, overuse, problems in your kneecap or excess weight.
- Plica syndrome: Folding or thickening of your knee ligaments.
3. Knee Conditions
Sometimes, knee issues can happen without any association with specific overuse or an injury. Often, specific knee conditions cause them, such as:
- Osgood-Schlatter disease: Causes swelling, pain and tenderness under your kneecap at the front of your knee.
- Osteoarthritis: A type of degenerative joint disease that usually develops following a previous injury. Other arthritis types can cause knee problems as well.
- Outside issues: Problems in other areas of your body like hip issues and pinched nerves can cause knee pain.
- Infections: Infections in the joint (infectious arthritis), skin (cellulitis), bursa (septic bursitis) and bone (osteomyelitis) can cause issues with knee movement and pain.
- Popliteal cyst: Also referred to as Baker's cyst, this causes swelling in the back of your knee.
- Osteochondritis dissecans: A reduced movement and pain after cartilage, bone or both inside your knee joint loses its supply of blood and dies.
What Are the Symptoms of Knee Injuries?
The signs and symptoms of knee injury depend on the part of your knee injured and the type of injury. The primary knee injury symptoms are:
- Pain in knee
- Difficulty bending your knee
- Popping or clicking sounds
- Problems weight bearing
- Feeling of instability
- Locking of your knee
If your injury is acute, the primary symptoms you'll experience will likely be knee swelling and pain. If your injury is from overuse or is chronic, your symptoms of popping, clicking, and intermittent pain will be more intense.
How Do You Know If You Need Surgery For a Knee Injury?
Both the cause of your knee injury and how long it’s been since your injury can affect your ability to move. The good news is that you can usually treat it with weight loss, physical therapy and other techniques. In some cases, when it's more serious, your doctor might recommend surgery.
But how will you know when surgery is your best option? This is something you'll need to talk to your doctor about. Surgery can't repair all knee problems, and not everybody is an ideal candidate.
The Telltale Signs
You might be a knee arthroscopy candidate if you're experiencing:
- Chronic loss of motion to the point you can't fully extend or bend your knee
- Problems bearing your weight on your knee or you can't squat
- Difficulties twisting or turning
- Hearing a popping noise or another type of noise
If you're only experiencing one of these four signs, begin with the basics — physical therapy, rest and some low-stress, consistent exercise. You may even want to try some anti-inflammatory medication. This might be all that's required.
However, if you're experiencing two or more signs, while a conservative approach may do, it might not be enough. If you're experiencing all of these signs, surgery may be your best approach.
Of course, your injury's nature will be what determines the treatment you require.
What Is the Goal of the Arthroscopy?
Dr. Gombera uses knee arthroscopy to conduct a broad range of surgical procedures on the knee joint. These procedures can include:
- Confirming a diagnosis
- Fixing fractures of the joint surface
- Removing loose bodies
- Removing or repairing a torn meniscus
- Repairing articular cartilage
- Reconstructing torn ligaments
Our goal is to perform a suitable surgical procedure to repair or improve your knee problems. An arthroscope enhances our ability to perform these procedures. You can expect different results from a knee arthroscopy procedure depending on what is wrong with your knee, what we can do inside your knee to improve the problem and your effort at rehabilitation after the surgery.
How Much Does Knee Arthroscopy Surgery Cost?
If you don't have insurance, and you're trying to decide if you should have knee arthroscopy surgery performed, make sure you let your doctor know you'll have to pay for the procedure out of pocket. Often, doctors will work with you by offering a payment plan or a non-insurance option. Even so, the amount you'll pay for knee arthroscopy depends on what you and the doctor decide. Therefore, you'll want to sit down and discuss fees up front.
What to Expect Before, During & After Knee Arthroscopic Surgery?
Below is what you should expect with your knee arthroscopy.
1. Before the Procedure
Always let your doctor know if you're taking any medications, even herbs or supplements bought over-the-counter.
During your two weeks before your procedure:
- Dr. Gombera might tell you to stop taking any medications that could make your blood harder to clot like ibuprofen, aspirin, naproxen or other blood thinners.
- If you smoke, he’ll likely suggest you stop. He can offer you ways to help. Smoking can slow bone and wound healing, and can also lead to higher surgical complication rates.
- Let Dr. Gombera know if you've been consuming a lot of alcohol.
- Ask him which medications you should continue taking on your surgery day.
- Let Dr. Gombera know if you have any fever, herpes breakout, flu or other illness before your procedure.
2. During the Procedure
On your surgery day:
- Dr. Gombera might ask you not to eat or drink anything for at least six to 12 hours before your surgery.
- Dr. Gombera will let you know when to come to the hospital.
- You'll take any medications you've been told to take, but only with a tiny sip of water.
Before surgery, we will place you under either general anesthesia. We’ll prep your skin around the knee with a sterile solution. We’ll place sterile drapes to create a sterile environment for the surgeon to work. There is a great deal of equipment that surrounds the operating table, including the TV screens, cameras, light sources and surgical instruments.
We begin the operation by making two small openings into the knee, called portals. These portals are where we place the arthroscope and surgical instruments inside the knee. We take care to protect the nearby nerves and blood vessels. We then insert the arthroscope into the knee joint and fill the joint with sterile fluid.
We then take a “tour” (diagnostic arthroscopy) to look at all aspects of the knee joint. We then address any areas of damage or injury with specialized arthroscopic instruments.
Over the years since the invention of the arthroscope, many very specialized instruments have been developed to perform different types of surgery using the arthroscope to see what is going on while we use the instruments. Today, many surgical procedures that once required large incisions for the surgeon to see and fix the problem can be done with much smaller incisions. For example, simple removal of a torn meniscus or loose body can be done using two small 1/4 inch incisions.
After the surgery, we will close the arthroscopic portals and surgical incisions with absorbable sutures (no sutures need to be removed). A large bandage will be applied with a compressive wrap to reduce swelling and prevent blood clots in the leg. Once the bandage has been placed, we will take you to the recovery room.
What Are the Risks Involved With Knee Arthroscopy?
As with any surgery, there are risks involved, although they're rare. All operations come with the following risks:
- Infection at the surgery site
- Excessive bleeding during your surgery
- Allergic reactions to medications administered during the procedure, like the anesthesia
- Breathing problems due to the anesthesia
There are also risks involved specifically with knee arthroscopy surgery like:
- Blood clot formation in your leg
- Bleeding inside your knee joint
- Stiffness in your knee
- Infection inside your joint
- Damage or injury to your ligaments, cartilage, blood vessels, meniscus or nerves of your knee
How Long Is Knee Arthroscopy Recovery?
Knee arthroscopy isn't very invasive. For many individuals, this surgery takes no more than an hour, but the total time depends on the specific procedure. You'll likely be able to go home for recovery on the same day of your procedure. You should use dressing and an ice pack on your knee. The ice helps minimize swelling and pain.
At home, you will want to have a family member or friend look after you, at least on your first day. Elevate your leg as much as possible and put ice on it for a couple of days. Make sure you change your dressing as directed. Be certain you go to your follow-up appointment with your knee arthroscopy surgeon, which will likely be several days after your surgery.
Your doctor will likely prescribe you an exercise regimen you can perform at home that will help with your knee recovery, or they may suggest a physical therapist help you regain normal knee function. The exercises prescribed are necessary for helping to strengthen your muscles and restore full range of motion. With the proper care, your outcome after you've had the surgery performed is excellent.
How to Prevent Further Knee Injuries
Follow these tips to prevent future knee injuries:
1. Maintain a Healthy Weight
If you're overweight, it places extra stress on your joints, particularly those of your lower back, hips, ankles, knees and feet. Additional stress on your joints can increase your osteoarthritis risk. Also, being overweight can cause you to have weaker quadriceps muscles, which you need to support your knee.
2. Wear Stable, Supportive, Well-Fitted Shoes
Along with increasing pressure on the knees, when you wear high heels, it can shorten and tighten your calf muscles. This is a condition that could cause overpronation, which is when your foot is pulled inward too far. When feet excessively pronate, the arch of your foot may collapse and cause your lower leg to roll inward, which then stresses your knee and ankle. Shoes ideal for knee protection are:
- Shoes with an inch or shorter heels
- Flat shoes
- Shoes with cushioned soles
- Shoes that fit well, keeping your feet from sliding front to back and left to right
Shoes with a non-slip, rubber sole can help keep you from sliding on slippery surfaces that can also cause knee injury. If you run, walk or exercise regularly, be sure you change your workout shoes every three months or more frequently to ensure you have enough cushion for protecting your knees and your ankles, feet, back and hips.
3. Keep Hip, Butt, Leg and Core Muscles Strong
When you have strong muscles overall, it protects all your joints, even your knees. When your core muscles are strong, it helps with healthy skeletal alignment and good posture, both of which you need for distributing pressure on joints equally and prevents your knees from sustaining excessive pressure. Strong leg, butt, hip and core muscles are particularly good for keeping pressure off your knees.
4. Regularly and Gently Stretch Your Muscles Supporting Your Knees
Stretching your quadriceps, calf, hip flexors, hamstrings and butt muscles helps to promote joint mobility and flexibility. Staying flexible overall helps maintain healthy joints as you get older.
5. Don't Kneel on Hard Surfaces Without a Cushion or Knee Pads
Repetitive kneeling or kneeling on hard surfaces can damage and compress the bursae that cushions and protect your tendons and ligaments.
Contact Dr. Gombera to Schedule Your Knee Arthroscopy Consultation
Dr. Gombera is a fellowship-trained and board-certified orthopedic surgeon specializing in arthroscopy, sports medicine and the treatment of hip, shoulder and knee injuries. His goal is to use the most cutting-edge and innovative therapies to relieve painful symptoms so you can get back to your optimal functioning and attain overall functionality and health. He focuses on minimally invasive procedures and never rushes surgical interventions so his patients can get back to their regular activities quickly.
Contact Dr. Gombera to schedule your knee arthroscopy appointment today.