Artroskopisk center: Knee arthroscopy

Information regarding knee arthroscopy.

Arthroscopic knee surgery

In this pamphlet you can read the relevant information regarding your surgery.

A short overview

  • The operation of your knee is done as a day surgery procedure.
  • You will be fasting prior to the planned time of your surgery.
  • At the time of your discharge you will have to be accompanied home by an adult who can stay with you until the next day.
  • The surgeon will talk to you prior to the start of your operation.
  • After your operation the surgeon will talk to you and inform you of the procedure and the further plan for your rehabilitation.

You can read the rest of this pamphlet if you require more thorough information.

Introduction

When you have been referred to Arthroscopic Center Hvidovre you will be examined by an orthopaedic surgeon. If the treatment diagnosis of your knee requires arthroscopic surgery, this will be planned for.
During arthroscopic surgery the surgeon will examine the menisci, cartilage, cruciate ligaments, mucosal lining and joint capsule. If there are signs of injury or disease this will be operated on right away and further surgery will not be required.

Preparation

Prior to your surgery the doctor will write up your chart and your blood pressure will be measured. You will also be seen by an anaesthesiologist either at the preparation or on the day of surgery. If you have concurrent medical diseases, these may have to be examined or treated prior to the knee surgery.

The surgeon will give you a date for the surgery and you will be informed of the expected course of the treatment. You will also receive a letter regarding the date, time and place for the surgery.

If there are more than 3 months between the time of your examination and the date of your surgery you will have to come back for the preparation on a date closer to the time of the surgery.

Learning how to use crutches

Every week the physiotherapists offer a course, regarding the use of crutches and the basic training program which you will have to follow after the surgery. You will also receive a pair of crutches adapted to your height. You will have to bring the crutches with you at the time of the operation.

The day of surgery

The operation is done as same-day-surgery which means that you will be going home in the afternoon after the surgery.

You will meet at the planned time in the sameday-surgery clinic (Dagkirurgi 141). You will be fasting.

You will change into hospital clothing and will be prepared for surgery. The surgeon will come to see you and will assure that surgery is still necessary. He will also mark the knee which is to be operated on and will assure that there are no wounds or signs of infection on the skin of the leg.

2 hours before the planned meeting time you should take some painkillers as instructed on the preparation day.

Fasting rules

You are not allowed to eat after 12 p.m. If your scheduled time is 2 p.m. or later, you can eat until 8 a.m. in the morning. You are allowed to drink water, juice without pulp and coffee/tea without milk until 2 hours before the scheduled time. Children under 18 years are allowed to drink until 1 hour before the scheduled time.

The operation

In the operating room you will be met by the operating room nurse and the anaesthetist nurse who will identify you once again. The anaesthesiologist and the anaesthetist nurse will prepare you for the anaesthetic and the operating room nurses will get their instruments ready. Your leg will be prepared by disinfecting the skin.

For arthroscopic surgery 2-3 small incisions are done on the front of the knee.

Through these incisions the surgical instruments can be guided into the knee joint. The surgeon can then examine the whole knee joint including the menisci, cartilage, cruciate ligaments, mucosal lining and joint capsule. If there are signs of injury or disease this can be treated.

If there are only small injuries in the knee joint, these will be repaired and no further treatment/ training will be necessary afterwards.

Meniscus injury

The damaged part of the meniscus can either be removed or sewn back on. If it is removed there will be no restrictions for you, and you can start using your knee normally right away after the surgery.
If it can be sewn back on and there is a fair chance of it healing, this will be done. Then you will have to wear a brace on your leg for 6 weeks. Also during the night. It will be limited how much support you can put on your leg and how much you will be allowed to bend the knee.

Cruciate ligament injury

A ruptured cruciate ligament can not be repaired right away. In that case only the damaged parts of the ligament can be removed.

Cartilage damage

Large cartilage damage which is not caused by arthritis can require that the surgeon will drill holes into the bone and thereby stimulate the stem cells in the bone marrow to produce some cartilage like scar tissue which will then fill up the damaged areas of the cartilage. This tissue is weaker than normal cartilage and weight bearing is not permitted for 6 weeks. During this time you will have to follow a training program of at least 500 unloaded knee bends daily.

Risks

There is always a risk of complications after surgery but fortunately this is rare.

The anesthesia

There is always a small risk of complications. This risk increases for patients who suffer from diseases of the heart or lungs, have high blood pressure or are overweight.

Infection

There is always a small risk of infection (less than 1%). If a superficial infection develops, this can be treated by daily cleaning and antibiotics. An infection inside the knee joint usually requires further surgery to ”clean up” inside the knee joint and long term treatment with antibiotics. The cartilage may be permanently damaged and cause pain and decreased range of motion.

Thrombosis

A ”blood clot” is blockage of a vein that leads the blood away from the leg. Such a blood clot will require treatment with blood thinners for a period of 3-6 months. In very rare occasions a blood clot can travel to the lungs and this can be a life threatening condition.

After the operation

After the operation you will be offered a light meal and drinks. When you are fully awake the surgeon will inform you of the result of the operation and the plan for your post-operative period and training.

A prescription for painkillers will be sent to your pharmacy. Make sure you have some ”over the counter” pain killers at home to take after the first few days if necessary. For example: Pamol, Pinex or Panodil.

An adult person will have to take you home following the surgery and be with you until the next day. This is a security measure requested by the anesthesiologists.

If you have not been able to arrange for an adult person to pick you up from the Dagkirurgi department following surgery your operation will be cancelled. Most often the knee will be swollen for the first week or two, this will then decrease over the next few weeks.

Normally you can support fully on your leg, but it is recommended that you take it easy for the first few days.

Already the day after your surgery you will have to start the training of your thigh muscles, and do pumping exercises of your lower leg by bending the ankle and tightening of the calf muscles.

Back to work

Following uncomplicated surgery the normal ”sick time” is 1 week, but you can go to work when you feel it is ok. If the type of work you do include heavy kneeloading, you may want to wait longer until you are ready to go back. For certain types of operations there can be restrictions which will require that you stay off work for longer periods of time.

Driving

You are allowed to drive again when you are in full control of the car. There is no set time for this as it varies from person to person and for the different types of operations. You cannot drive a car safely if you are wearing a brace on your leg or if you are not allowed to put full support on the leg.

Removal of sutures

The sutures can be removed after approx. 10 days, either at the hospital or with your GP if you live far away from the hospital. In that case you will have to make the appointment yourself.

Follow up

The surgeon will decide whether a post operative control is needed. If an appointment is necessary, a letter will be sent to your E-boks.

Physiotherapy

Some patients will be referred to physiotherapy. This could take place in your ”kommune” or at the hospital.

Cancellation

Your operation may be cancelled if you have open sores or scratch marks on your legs, since this could increase the risk of infection in your knee joint. If you are suffering from the flu or any other infections at the time of your surgery, this will have to be postponed. If you are not able to meet for the planned surgery, please contact the department as soon as possible. We can then arrange for another appointment for you and the time that was scheduled for you can be utilized by another patient.

More information

The Dagkirurgi department 141 is located in Center 1, se picture. The Physiotherapi department is in Center 2, depts 234 / 236.

The illustration shows Department 141 in Center 1 and Department 234 and 236 in Center 2.
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