This information has been designed to give you and your family a basic understanding of what an arthroscopy is and what you can expect to happen before and after the operation. This information is intended as a guideline, you may have many more questions, which the doctors, nurses and physiotherapists will be only too happy to answer.

Why is the procedure necessary?

Many conditions affecting joints do not show up on x-rays and may be difficult to diagnose accurately by symptoms alone. By examining the bones, ligaments and cartilage from within the joint, you consultant is often able to detect the problem that may have been causing your pain.

An arthroscopy is one of the most frequently performed procedures in orthopaedic surgery. It is the process of viewing the internal aspects of a joint using a thin ‘telescope’ – an arthroscope. Using this arthroscope it is possible to inspect the surfaces of the bones coming into contact within the joint and also ligaments and cartilage.

This procedure is normally performed as a day case, however, sometimes if there is a medical problem you may have to stay in overnight. On your admission the nursing staff will meet you and show you around the ward. They will ask you a number of questions, so that they can cater for any special needs you may have.

The ward doctor will see you and arrange for your preoperation tests. These are usually an examination, an xray and blood tests.

The surgeon and anaesthetist will see you and arrange for your pre-operation tests. These are usually an examination, an x-ray and blood tests.

The surgeon and anaesthetist will see you before your operation to examine you and answer any questions you may have. The surgeon will discuss with you the nature of the surgery, outline the associated risks and obtain your informed consent. The anaesthetist will discuss the type of anaesthetic best suited to you; usually the procedure is performed under general anaesthetic. Remember that staff are here to help you and answer any questions you may have.

You will not be able to eat and drink for a period of time before your operation, the nursing staff will advise you. You will be helped into a gown and the nurses will complete a checklist in order to ensure you are safely transferred to theatre. A member of the nursing staff will escort you to theatre either on a trolley or bed. Once in theatre your care will be transferred to a member of the theatre staff who will check your personal details again and who will look after you until it is time for your anaesthetic.

Once in the anaesthetic room you will be given an injection in your hand to put you to sleep if you are having a general anaesthetic. Once asleep, 2 or 3 needles are pushed down through the skin into the knee joint. The needles have hollow centres down which the arthroscope is placed. At the end of the arthroscope is a camera that transmits the pictures from inside the joint onto a large screen in the operating theatre. In a few cases it may be possible to treat the problem immediately by removing cartilage or ligaments or to shave protrusions from the surface of the bone. Once the procedure has been completed these needles are then removed and a small dressing applied over the puncture sites and a wool and crepe bandage applied over the knee.

After a short stay in the theatre recovery area you will return to the ward.

As soon as you are awake and comfortable you will be seen by a physiotherapist, if appropriate, who will check that the muscles in your leg are strong enough to mobilise. The physiotherapist will give you a walking aid, if this is necessary, and check whether you are able to manage the stairs. If the physiotherapist is happy with your progress, arrangements will be made for you to be discharged home with an escort.

What problems can occur?

No operation is without the risk of complications. Your surgeon and therapist will explain any particular risks/complications of your operation before surgery.

Swelling is common after surgery and might be treated by elevation.

Is the operation always successful?

The surgeon’s expectations of your operation will be discussed before surgery (usually when initially seen in Outpatients) so that you understand the likely result, and the risks/benefits of the proposed operation. This information must be taken into account when you make the decision to undergo surgery.

Your discharge

You are usually admitted as a day case but occasionally an overnight stay will be necessary. It is important that you have someone to stay with you for the first 24 hours following your anaesthetic.

It is advisable that you arrange your transport home prior to your admission. If you have any problems arranging transport please notify the ward staff.

When you are discharged your named nurse will give you some things to take home. These will include:

• A letter for your GP (in some instances this will be posted) This should be handed in to your GP by either a relative or friend on the next working day following your discharge.
• Medication Any medication you have brought into hospital will be returned to you. You will also be given a 7-day supply of any new medications. The nurse will advise you on how and when to take these.
• Outpatient Clinic Appointment You will be given an appointment to be reviewed in clinic. If transport is required then this can be arranged by contacting your GP, providing a week’s notice where possible. If for any reason you are unable to attend your appointment please contact the Outpatient Department to rearrange the appointment.
• Discharge Record This provides details about your stay and is for your own information.
• Mobility Aids It is important that you have your walking aids, wheelchair and any other equipment that you require.
• Patient information Please take home any written information given to you during your stay and please do not hesitate to use the contact numbers if you require any further advice.
• Valuables Please ensure you have all your valuables with you.

General advice after discharge

You should anticipate a short period of convalescence at home before you are able to resume your normal activities.

• Mobility You may walk about and bend your knee as far as you are able, but do not overdo it. If your knee becomes too painful this is a warning to ‘ease off’. You will need to be able to straight leg raise before you are able to mobilise.
• Pain It is likely that you will experience some discomfort following this operation. If necessary take your usual painkillers – Do not exceed the stated dose. If these
• do not control your pain you should contact your GP.
• Wound Care When you are discharged from hospital, you will have a crepe bandage on your knee. You may remove this 48 hours after your operation unless instructed otherwise. You will find you have a small Elastoplast dressing on either side of your knee. These are to cover the incision holes and should be left in  place for 5 days. If they do come off you should replace them. Stitches are not always used. If you have stitches these will be removed when you come back to the Outpatients Department. Your wound should be kept clean and dry.
• Hygiene You may have a bath, but keep your knee out of the water so that your stitches do not get wet.
• Occupation/Strenuous Exercise Your surgeon will advise you when you can resume these, when you attend for your Outpatient appointment.

Follow Up

You will be followed up as an outpatient after your discharge from hospital. Please use this opportunity to ask questions and discuss any concerns you may have.
You are also welcome to call the ward for advice, following your discharge from hospital.

Return of equipment

Please return all walking aids to the Physiotherapy Department at the hospital in which you stayed, when they are no longer required. All other equipment should be returned to the loan equipment store it came from, ring them and they will collect it.