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Arthroscopy

Minimal invasive surgery

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Arthroscopy

Arthroscopy means "looking into the joint". This is usually the knee, schoulder or ankle but may also be
done in hip, elbow, foot or wrist. The knee joint is the articulation between the upper leg (femur) and lower leg (tibia). The articulating surfaces are covered by cartilage. Cartilage is essential in adequate shock absorption in the knee together with the menisci. The menisci are two semilunar discs between the femur and tibia. Stability of the knee is provided by various collateral and cruciate ligaments. Arthroscopy: view on meniscus, upper and lower leg cartilage
An arthroscopy is an operation to assess a knee disorder. Various knee disorders may be treated arthroscopically such as meniscal lesionscruciate ligament reconstructions, cartilage disorders and removal of loose bodies. The great advantage of an arthroscopy is the minimal surgical trauma to the knee. The recovery is quick. The arthroscopy is mostly done in day care. Patients can return to their homes on the same day.

Which method of anaesthesia is used?
An arthroscopy may be done by regional or general anaesthesia. Regional anaesthesia allows the patient to follow the surgery on a screen (optional). A regional anaesthesia may be combined with sleep medication so that a patient has no notion of the surgical procedure. You may discuss your wishes on the type of anaesthesia before the surgery. 

Arthroscopy: the surgery
Three small incisions (1 cm) are made around the knee. An arthroscope (small camera) and instruments are used through these 3 incisions to perform the surgery. The knee joint is continually flushed with sterile saline water to allow better view at surgery. The surgical time depends on the procedure. In general, a mensicectomy takes 20 minutes. More extensile procedures may take 2 hours. The incisions are closed by sutures. These sutures dissolve in 2-3 weeks time.

Arthroscopy: 3 small skin incisions

After the surgery
Analgesic medication is prescribed. You may use the pain medication if necessary. You may move the knee joint freely. Walking is allowed but some periods of rest are generally recommended in the first two weeks. Bicycling is allowed as soon as the knee bends sufficiently to cycle. This is an excellent method to restore knee motion. Crutches are only necessary if prescribed. Showering is allowed after the bandage is removed (3 days after surgery). Swimming and bathing should be postponed till 2 weeks after surgery. This in order to prevent infection of the knee. If necessary, an appointment is made at the Orthopaedic Center Máxima. Physiotherapy will be prescribed if knee motion is insufficient.

Return to work and sports
The return to work period is dependent on the type of surgery and type of work. In general, I recommend return to work in 1-2 weeks if you have an office job, 2-3 weeks in case of physical work. Driving a car might be difficult in the first week after surgery. Return to contact or running sports is advised after 6 weeks depending on the type of surgery. Bicycling is allowed (hometrainer) as soon as the knee bends sufficiently. Swelling of the knee is a sign that activities should be more restricted. Arthroscopy by RPA Janssen M.D.

Complications
Complications may occur after any type of surgery. Complications after arthroscopy are rare (incidence < 1%). Complications that may occur are: hematoma of the leg or knee, infection, venous thrombosis or neurovascular disorders.

Contact our office in case:

This document has been approved by the Dutch Orthopaedic Society.


RPA Janssen, MD PhD 
Orthopaedic Surgeon
Orthopaedic Associates Eindhoven Greater Area
Orthopedic Center Máxima
Máxima Medical Center (MMC)

Visiting adress MMC Eindhoven:
Ds. Th. Fliednerstraat 1
Ingang Zuid
5631 BM  Eindhoven
The Netherlands 
(outpatient clinic and surgery)

Visiting adress MMC Veldhoven:
De Run 4600
5504 DB  Veldhoven
The Netherlands
(Outpatient clinic)

Mail adress:
Postbus 90052
5600 PD  Eindhoven
The Netherlands

Tel. 0031 (0)40 88 88 600
(Call center Orthopedie)

Fax: 0031 (0)40 88 85 938
www.rpajanssen.com 

Links:
Orthopaedic Associates Eindhoven Greater Area
Máxima Medical Center
Orthopaedic Center Máxima
 

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