Arthroscopy

Arthroscopy is a common orthopedic procedure. It is used to diagnose knee problems and to fix some knee problems and some types of knee pain.

The Arthroscopy Procedure

Arthroscopy lets orthopedic surgeons see inside the knee without making a large cut (incision) in the knee. The surgeon operates through a few small incisions—each about the size of a buttonhole.

A tiny camera inserted through one incision shows the inside of the knee on a high-definition video monitor. The orthopedic surgeon looks at the inside of the knee and does the procedure using tiny instruments inserted into the other incisions.

Uses of Arthroscopy for Treatment

Orthopedic surgeons use arthroscopy to treat many knee problems.

Arthroscopy for ACL injuries

For ACL injuries, orthopedic surgeons use arthroscopy to:

  • Confirm an ACL tear and look for and treat other injuries
  • Do part or all of an ACL reconstruction

Arthroscopy is also used to repair a torn meniscus, which often happens along with an ACL tear.

Arthroscopy for arthritis and other knee pain

Orthopedic surgeons also use arthroscopy to treat knee pain from arthritis and other painful knee problems, including:

  • Loose bone fragments or cartilage in the knee.
  • Damaged or torn knee cartilage.
  • Inflamed lining (synovial fluid) of the knee.
  • Other torn knee ligaments.
  • Scarring within the knee.
  • Kneecap problems.
  • Knee infection.

Anesthesia for knee arthroscopy

Shelbourne Knee Center uses general anesthesia for arthroscopy. General anesthesia puts you to sleep and prevents you from feeling pain during surgery. It’s usually a combination of drugs given through a vein (intravenous drugs) and inhaled gasses (anesthetics).

After knee arthroscopy

After knee arthroscopy, you’ll spend a few hours in a recovery room. Then you can go home. We’ll give you instructions about what to do and not do for the first few days, including medicines you can take to stay comfortable.

Most people can go back to desk work and light activity in a few days.

Physical therapy after knee arthroscopy

You’ll also get instructions for physical therapy. The goals of your therapy are to:

  • Control swelling.
  • Regain full straightening of your knee (extension).
  • Regain full bending of your knee (flexion).
  • Return to full knee strength.

Your own personal physical therapist or athletic trainer will guides you in doing the therapy. You’ll do most of the physical therapy at home, with periodic visits to Shelbourne Knee Center.

After ACL reconstruction, you’ll do physical therapy until you get back to your normal level of activity. For most patients at Shelbourne Knee Center, this takes about four to six months.

You’ll do most of your physical therapy at home, with guidance from your physical therapist or athletic trainer. But you’ll start physical therapy while you’re in the hospital.

Physical Therapy in The Hospital

During your hospital stay, you’ll begin knee exercises.

ACL-reconstructed knee:

  • Extension (straightening):
    • Heel props (perform quad sets at the same time).
    • Prop up opposite leg to make sure extension is equal.
    • Towel stretches for full hyperextension (equal to graft leg).
  • Flexion (bending):
    • Use the CPM machine to help with flexion.
    • Pull ankle toward the buttocks (using hands) as far as possible.
    • Measure flexion by using yardstick (centimeters).

Graft knee:

  • Flexion (bending):
    • Heel slides.
    • Measure flexion using yardstick (centimeters).
  • Strengthening:
    • Use the shuttle press.

Physical Therapy at Home

After you leave the hospital, you’ll do most of your knee exercises at home. You’ll come back to Shelbourne Knee Center for some physical therapy visits.

Days 1-7 after surgery

  • Stay in bed with the ACL-reconstructed leg elevated above the heart.
  • Keep the ACL-reconstructed leg in the CPM machine.
  • Maintain full extension on the ACL-reconstructed leg.
  • Maintain at least 120° of flexion on the ACL-reconstructed leg.
  • Maintain full flexion on the graft leg.
  • Use the shuttle press to work on increasing strength on the graft leg.

Follow-up appointment

Your first follow-up appointment will be 1 week after surgery.

Days 7-14 after surgery

You’ll continue your knee exercises and will probably be able to start resuming normal daily activities. We’ll determine your activity level based on how well your knees are doing.

ACL-reconstructed knee:

  • Use Cryo-Cuff® as needed to decrease swelling.
  • Maintain extension:
    • Lock knee straight while standing.
    • Heel props.
    • Prone hangs.
    • Towel stretches.
  • Flexion should be at least 135°
    • Heel slides.
    • Wall slides.
    • Flexion hangs.

Graft knee:

  • Maintain full extension and full flexion.
  • Increase strength.
  • Step-down exercise.

Follow-up appointment

Your second follow-up appointment will be 2 weeks after surgery.

Follow-up appointment

2 to 4 weeks after surgery

You’ll continue your knee exercises. On the ACL knee, you’ll continue working on range of motion:

  • Leg press.
  • Knee extension (replaces shuttle).

On the graft knee, you’ll focus on strengthening.

Your physical therapist or athletic trainer will design a customized rehabilitation program for you based on your needs and goals.

Follow-up appointment

Your third follow-up appointments will be 4 weeks after surgery.

2 to 12 months after surgery

You’ll continue physical therapy as you return to your preoperative, fully competitive level of activity.

At each visit, your physical therapist or athletic trainer will evaluate your strength, range of motion, and swelling. He or she will advance your therapy and sporting activities based on your strength, comfort, and confidence.

Follow-up appointments

During this time, your follow-up appointments will be about every 1-3 months. How often you come in depends on how you’re doing.