Knee Arthoscopy
Indications
| Diagnosis and treatment of meniscus and articular cartilage problems |
| Removal of loose bodies |
| Washout of septic arthritis |
| Synovial biopsy |
| Ligament reconstruction |
Diagnosis and investigations
| Diagnosis usually clinical |
| Investigations - Radiographs |
| - MRI |
Preoperative
| Consent and place mark on limb to be operated |
| Safe surgery check list |
Anaesthesia
| General Anaesthesia or Regional anaesthesia |
Examination under Anaesthesia
| Important step prior to every arthroscopy |
| Assess range of movements |
| Ligament stability- collateral ligaments, Lachman test, Pivot shift |
| Patella tracking |
Set-up
| Patient supine |
| Leg holder or side support to help control joint position |
| Bottom end of table removed if using leg holder |
| Soft support underneath opposite thigh to flex the hip |
| Tourniquet applied high up in the thigh |
Portals
Standard portals - |
| Anterolateral and Anteromedial |
Accessory portals - |
| Superolateral portal as drainage portal |
| Lateral portal to remove loose body from gutter |
| Posteromedial portal to visualise back of knee |
| Accessory anterior portal for bucket handle tears menisci |
Diagnostic Arthroscopy
Sequence of examination of joint |
| Start with camera in anterolateral portal |
| Visualise patellofemoral joint and then in to medial compartment |
| Make anteromedial portal |
| Go back into patella femoral joint and probe via anteromedial portal |
| Examine suprapatellar pouch and lateral and medial gutters |
| Medial compartment- meniscus and cartilage |
| Then examine notch and transfer scope in to the lateral compartment |
| Assess ACL and PCL |
| Lateral compartment- meniscus and cartilage |
Wound Closure
| Steristrips or simple suture |
| Bulky bandage |
Local anaesthetic
| Infiltration to joint and/or around portals |
Postoperative
| Mobilise weight bearing as comfort allows |
| Remove bulky bandage at 24-48 hours |
| Simple adhesive dressing |
| Increase range of movements |
| Physiotherapy |
Possible Complications
| Residual pain |
| Stiffness |
| Swelling |
| Bleeding |
| Painful portals |
| Infection - rare (<0.1%) |
| Thrombosis - (<0.1%) |
| Nerve injury - 0.01% |
| Complex regional pain syndrome |
Please Contact my Secretary
Ms Christine Kirkham on
07784476138
 
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All the content are provided for information only and though of high quality do NOT constitute professional medical advice.
Please consult a specialist for advice on your condition.
Please consult a specialist for advice on your condition.