Arthroscopic Meniscal Surgery

What is an arthroscopic meniscal surgery?

An arthroscopic meniscal surgery is a procedure in which a surgeon uses an arthroscope and other tools to remove all or part of a damaged meniscus in the knee or, if possible, to repair a meniscus. A meniscus is a piece of rubbery tissue (fibrocartilage) between the bones of the knee joint. An arthroscope is a tube with a light at the end that projects an image of the inside of your knee onto a TV monitor. The arthroscope is about the diameter of a pencil.

When is it used?

The procedure is used when you have damaged cartilage in your knee.

Examples of alternatives are:

• limiting your activity
• taking medicine to reduce the swelling
• having physical therapy
• having open knee surgery
• choosing not to have treatment, while recognizing the risks of your condition

You should ask your healthcare provider about these choices.

How do I prepare for this procedure?

Plan for your care and recovery after the operation, especially if you are to have general anesthesia. Allow for time to rest and try to find other people to help you with your day-to-day duties.

Follow instructions provided by your healthcare provider. Do not eat or drink anything after midnight or the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

The surgery is done with general, regional, or local anesthetic. All three types of anesthesia should keep you from feeling pain during the operation. During surgery the arthroscope and one or two tools are put into the knee joint through small cuts. The surgeon repairs any torn cartilage or shaves down the cartilage in the knee and removes the loose pieces. The surgeon will then remove the arthroscope and the tools and close the small openings with stitches.

What happens after the procedure?

You will go home the same day. You should keep your leg elevated. Take it easy for at least the next 2 to 3 days. Do not take part in strenuous activities until your healthcare provider feels you are ready.

After surgery:

• Use crutches for several days or until you can walk nearly normally. If the cartilage is repaired and not trimmed, your provider may want you to use crutches longer and to not put weight on your leg.
• Raise your leg on a pillow when you sit or lie down.
• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on the area every 3 to 4 hours, for up to 20 minutes at a time.
• Take an anti-inflammatory medicine such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
• Start bending your knee as soon as possible.
• Change your bandage after 4 days and cover the cuts with band-aids or gauze.
• If you have a brace or splint, consult your healthcare provider.

Ask your healthcare provider what other steps you should take and when you should come back for a checkup.

What are the risks and benefits?

• There are some risks when you have general anesthesia. Discuss these risks with your healthcare provider.
• Local anesthesia may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Local anesthesia is considered safer than general anesthesia in older people and in people with certain medical conditions.
• There is a risk of deep vein thrombosis, a condition in which a blood clot forms within a deep-lying vein.
• There is a risk of infection and bleeding.

You should ask your healthcare provider how these risks apply to you.

The recovery for arthroscopy is faster than if a full open incision were made to correct or diagnose the problem. Most people do very well after arthroscopy and have a rapid recovery.

When should I call my healthcare provider?

Call IMMEDIATELY if:

• There is excessive drainage from the puncture sites.
• There is unusual pain.
• Your knee locks.
• You develop a fever.
• You have numbness or weakness of your leg.
• You develop swelling in your calf or thigh that is not relieved by elevating your leg.
• You develop signs of infection.

Call during office hours if:

• You have questions about the procedure or its result.
• You want to make an appointment for a follow-up visit.