Common Operations in Knee Surgery

Plymouth Orthopaedic and Sports Injury Clinic

Arthroscopy

This literally means to look into the joint. Two small stab incisions are made in the front of the knee. A small “telescope” is introduced through one, and small instruments through the other. The generated image is magnified and displayed on a television screen. The surgeon is able to perform quite complex surgery including removal or repair of meniscal tears, retrieval of loose bodie, microfracture and cruciate ligament reconstruction.

Arthroscopy is usually performed as a day case procedure under light general or spinal anaesthetic. Recovery depends on findings and treatment, but most patients even after simple arthroscopy should modify activity for up to six weeks.

It is a very safe procedure, and the risks of anything going seriously wrong are extremely low, but not zero percent. Major complications can be deep infection within the knee or blood clots developing in the leg.

ACL Reconstruction

The surgery on the inside of the knee is performed through an arthroscopic technique and a small incision is required to harvest an appropriate graft, usually two of the four ham-string tendons. This incision is also used to make a small tunnel in the tibia bone to introduce the graft. ACL reconstruction may be performed as a day case procedure. For patients wishing to return to sport, a long period of rehab is required under physiotherapy supervision. This continues for nine months, although the majority of patients will be back to normal daily activity by six weeks. This is a relatively safe and dependable procedure with good outcomes. The risks are as for arthroscopy.

Knee Replacement

Knee Replacement is a major operation and should never be undertaken lightly. All patients should have tried simpler methods of managing their arthritic knee pain prior to undergoing this surgery. Patients undergoing total knee replacement are usually in hospital for five days. The average patient is able to return to driving by eight weeks, and most patients are back to normal activity by twelve weeks. However it may take a year for a knee replacement to completely settle down. Everything possible is done to minimise the risks associated with this surgery but there is no such thing as zero risk. Infection, blood clots, and nerve/blood vessel damage are recognised and potentially catastrophic complications. Sadly, even when surgery appears to have gone well, some patients remain dissatisfied with their result. Many experienced knee surgeons quote this risk at 10%, a figure that seems to be borne out my a number of international studies.