Keyhole surgery, or arthroscopy, is a minimally invasive surgical procedure that enables the surgeon to examine inside of the knee. It is usually performed through two very small puncture holes either side of the knee-cap tendon. One of the puncture holes is used to pass the surgical instruments into the knee and the other is for the arthroscope, a thin flexible tube with a light and camera; an image is projected onto a television monitor so that the surgeon can see a clear image of the inside of the joint.
Keyhole surgery is a very safe and straightforward procedure that is usually carried out under a general anaesthetic. In most cases, it can be performed as a day case procedure. It can be used for a number of procedures, including:
- Examination of the knee under anaesthetic
If the knee has been badly injured, it may be too painful for a thorough examination. Having a general anaesthetic enables Adrian to examine the knee in detail and discover any abnormalities that are restricting movement, or discover tears that may be difficult to diagnose when you are awake and in pain
- Manipulation of the knee under anaesthetic (MUA)
Following an injury or surgery, scar tissue may build up inside the knee, making it difficult to bend or fully straighten the knee. This can affect your ability to walk. If non-surgical treatment, such as targeted physiotherapy, doesn’t work and the knee is still stiff, Adrian may be able to manipulate the knee under an anaesthetic. This involves gently bending and straightening the knee while you are asleep in order to improve the range of movement of the knee
Keyhole surgery is straightforward and low risk. The operation is usually carried out under general anaesthetic. Afterwards, you’ll be taken to the recovery ward and then back to your room. Most patients can return home the same day.
A bandage is applied in theatre that can be removed the day after the procedure. In most cases, you won’t need crutches after surgery and you should be able to walk without help. You won’t need to have a knee brace and you’ll be encouraged to move your knee fully as soon as possible afterwards. The small wounds are closed with paper strips or a single stitch that’s removed about 10 days later.
You’ll be offered a follow-up appointment around two weeks after surgery when there’ll be an opportunity to discuss the results of any tests in detail, using pictures or video taken during the procedure.
You’ll be advised to rest your knee for around 48 hours after surgery and then you should be able to gradually get back to normal, including walking and driving. Most patients feel comfortable enough to return to work after about a week although there may be some slight discomfort for 4-6 weeks after surgery, depending on the reason for the procedure.
All surgery carries some risk but keyhole surgery is considered very safe, with the chance of a major complication being less than 1%. You’ll have an opportunity to discuss any concerns you may have with Adrian before your procedure.