This video was prepared to educate and inform patients on what they need to know before having Anterior Cruciate Ligament (ACL) Reconstruction surgery.
Knee Arthroscopy Video Transcription
The purpose of this video presentation is to inform you about arthroscopy and arthroscopic surgery, its benefits, its risks, and potential complications. You will now see a video that contains information you need to know for your knee arthroscopy.
This is an arthroscope. It is an instrument that allows us to look directly into your knee joint.
The main advantage of arthroscopy is that quick and accurate information can be obtained. Many problems can be corrected at the same time using arthroscopic surgery. Only small incisions are required. The procedure is usually performed on an outpatient basis. Complications are very infrequent.
We must remember that not all conditions can be helped using arthroscopic surgery. This is especially true if the knee has arthritis or other degenerative changes.
As with any surgical procedure, there can be complications with arthroscopy. However, the incidence is fairly low. The incidence of clinically significant phlebitis, or blood clots in the veins of the leg, is in the same range. The risk of infection is less than 1%. Other problems such as instrument breakage, anesthesia complications, or artery and nerve injury are rare, but can occur. There are other possible complications that are even more infrequent. Precautions are taken to prevent all complications, but we must remember that they can occur despite all safeguards. We must weigh the risks against the potential benefits and alternatives in making a decision about having arthroscopy.
There are several other diagnostic methods, such as MRI, that may be ordered prior to your arthroscopy as needed.
Arthroscopy can be performed under local, spinal or general anesthesia. General anesthesia, in which you are put to sleep, is most common, because it allows the joint to be relaxed so that there is adequate room to work safely.
You may need to have some lab work done before surgery, such as a blood count, and maybe a cardiogram. If the arthroscopy is to be done at a future time, you can have the tests done at your local hospital or doctor’s office and have the results sent to us at least 3 business days before the procedure.
Some insurers require a additional information prior to approving elective surgery. You should check with your insurance company and be sure you have approval. You should also check to see if you need a referral from your primary care physician.
Prior to the procedure, you should start washing the area several times per day with soap and water. The skin has to be very clean. You do not have to shave the area. We will do that for you when you arrive. Please remember that the skin has to be perfect. You can’t have any scratches, pimples, sunburn, or poison ivy. Please check with Dr. Gill’s office the day before surgery for final instructions. It is most important for you to remember not to eat or drink after midnight on the night before surgery. If you are having a procedure under local anesthesia, this is not as important. You might want to put a reminder on your bathroom mirror so you don’t forget to avoid drinking water in the morning.
The operation will be done either at Newton-Wellesley Hospital (200 Washington Street, Newton, MA), the New England Baptist Outpatient Care Center (40 Allied Drive, Dedham, MA), or at Boston Outpatient Surgical Suites (840 Winter Street, Waltham, MA). Please confirm the location with Dr. Gill’s office.
Now let’s look at what you will do on the day of your arthroscopy.
In the pre-operative area, an anesthesiologist will take your medical history. The anesthesiologist will explain to you the benefits as well as the risks and potential complications of the different types of anesthesia.
You will then be taken into the operating room. During the procedure, the arthroscope is put into the joint through a small incision. A television camera is connected to the arthroscope and a view of the inside of the joint is projected onto a television monitor. Dr. Gill moves the arthroscope throughout the joint, and makes a diagnosis of the problem. If the problem can be corrected, Dr. Gill will make another small incision and introduce operating instruments into the joint. Sometimes several openings are needed. Dr. Gill watches the television screen so he can see what he is doing inside the joint.
When you wake up in the recovery room, you will be drowsy, and should not have much pain. However, the novocaine should wear off several hours later, and the knee will be painful.
If you have had general anesthesia or sedation, someone will have to pick you up from the hospital. You can unwrap the dressing when you get home, and apply ice to the joint. Change the band-aids whenever you like. You can walk on the leg, but this will be painful in the first few days. You can wash or shower 2 days after the procedure.
Unless otherwise instructed by Dr. Gill, or unless you are allergic to aspirin, take 1 or 2 aspirin tablets per day for 1 week, as this helps prevent phlebitis, or blood clots.
Call Dr. Gill’s office to make a follow up visit 10-14 days after arthroscopy.
Call Dr. Gill’s office if you experience problems after arthroscopy, especially if you have excess pain or swelling, fever, or redness of the operative area. Call if you have other problems, or signs of complications.
Following the arthroscopy, you should do isometric exercises. These are quadriceps setting exercises in which you tighten the thigh muscle and perform straight leg raising exercises. Tighten the muscles, and lift the leg up. You should try to do 20 or 30 every hour. You can bend the knee, but avoid sitting for prolonged periods of time for the first few days.
If you have any questions at all, we would be happy to answer them.
Remember, you should have nothing to eat or drink before surgery, and be sure the skin is clean.
Please re-read the written instructions that you were provided, and which are available at www.bostonsportsmedicine.com. If you have any questions, please call Dr. Gill’s office at 781-251-3535.