Arthroscopy

Arthroscopy is a modern minimally invasive method of articular cavity examination which takes place in the operating room. It is, in fact, a rapid surgical procedure imposing only minimum strain on the body. The aim of arthroscopy is to establish a precise diagnosis of articular injury or disease.

The arthroscopy principle consists in using optical instruments, which makes performing diagnostics and subsequent therapy possible. An endoscopic probe (arthroscope) is inserted inside the knee joint, which does not require direct opening but only two small incisions. An arthroscope is a thin metal tube with a camera with non-burning light at one end. At the other end, there is a monitor where the physician and the patient can observe articular structures. After examination, treatment with miniature surgical instruments inserted through the endoscope may be performed immediately.

The meniscus may be injured, for example, by violent movement. Although firm and flexible, menisci may not withstand such a considerable strain and may become overstrained or torn. Other conditions requiring arthroscopy include knee cruciate ligament injury, various degrees of damage to the articular cartilage, injuries to lateral knee ligaments, a loosened part of a bone or cartilage entering the joint area, or knee-cap instability. If the injury is of a more serious nature, a standard knee operation may be necessary, or the joint may be replaced with an implant.

The procedure may be planned without any restrictions and is intended for all those who suffer from pain, swelling, instability, and reduced mobility.

The procedure is executed under sterile conditions in the operating room and usually takes between half an hour and one hour, always depending on the procedure complexity. It is done either under general or local anaesthesia.

Arthroscopy is performed as an outpatient procedure (without hospitalisation), or with hospitalisation lasting between one and two days. The surgery is done on a disinfected knee area where a small, 1cm long incision is made. An arthroscope is inserted through the incision while saline is irrigating the joint and allowing for better imaging. The surgical wounds are so small that they require no sutures and are only covered with sterile dressing.

If the procedure is conducted without the need for hospitalisation, the patient leaves on the day of the procedure. The procedure under anaesthesia necessitates a one-to-two-day hospitalisation.

Post-arthroscopy treatment of the knee is individual and depends on the type of injury and procedure itself. In case of a simple arthroscopy, the operated leg must be spared for one or two weeks by walking with crutches with burden indicated by the operating surgeon. Following more serious procedures and if knee instability is of concern, it is necessary to wear a knee orthosis. It is, e.g., in the case of sutured meniscus. Orthosis must be worn also during night’s rest and may be removed only for exercising. Rehabilitation facilitates fast healing.

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