Name of the Procedure:

Arthroscopy, knee, diagnostic, with or without synovial biopsy
Common names: Diagnostic Knee Arthroscopy, Knee Scope, Synovial Biopsy

Summary

Diagnostic knee arthroscopy is a minimally invasive surgical procedure used to examine the inside of the knee joint. It sometimes includes a synovial biopsy, where a small tissue sample is taken from the synovial membrane for further examination.

Purpose

Diagnostic knee arthroscopy helps diagnose knee problems such as torn ligaments, damaged meniscus, cartilage injuries, and joint inflammation. The main goal is to identify the cause of knee pain or other symptoms and to obtain tissue samples if necessary for more detailed analysis.

Indications

• Persistent knee pain unresponsive to conservative treatments
• Swelling or fluid buildup in the knee joint
• Suspected tears in ligaments or meniscus
• Signs of inflammatory conditions like rheumatoid arthritis
• Unclear results from non-invasive imaging tests like MRI

Preparation

• Fasting for 6-8 hours before the procedure
• Adjusting or stopping certain medications as advised by your doctor
• Undergoing pre-procedure tests like blood work or imaging studies

Procedure Description

• The patient is given anesthesia (local, regional, or general depending on the case).
• Small incisions are made around the knee to insert the arthroscope (a small camera) and surgical instruments.
• The surgeon examines the knee joint and may take samples of synovial tissue if needed.
• The incisions are closed with sutures or surgical tape.

Duration

The procedure typically lasts 30 minutes to an hour.

Setting

Diagnostic knee arthroscopy is usually performed in an outpatient surgical center or hospital operating room.

Personnel

• Orthopedic surgeon
• Surgical nurse
• Anesthesiologist or nurse anesthetist

Risks and Complications

• Infection at the incision site
• Blood clots
• Knee stiffness or swelling
• Nerve or blood vessel damage
• Adverse reactions to anesthesia

Benefits

• Accurate diagnosis of knee problems
• Minimally invasive with smaller incisions
• Quick recovery compared to open surgery
• Immediate visual confirmation of knee pathology
• Obtaining tissue samples for more detailed analysis

Recovery

• Rest and elevate the knee for the first few days
• Apply ice to reduce swelling
• Follow prescribed pain management plan
• Begin physical therapy as recommended
• Full recovery typically takes several weeks, with light activities resuming in 1-2 weeks

Alternatives

• Non-invasive imaging tests (e.g., MRI, CT scan)
• Conservative treatments like physical therapy and medication
• Open knee surgery for severe cases Each alternative has its own pros and cons, with imaging tests being less invasive but potentially less definitive, and open surgery being more invasive with longer recovery.

Patient Experience

During the procedure, the patient is usually under anesthesia and experiences no pain. Post-procedure, mild to moderate pain and swelling can occur, which are managed with pain medication and ice packs. Physical therapy helps in regaining knee function and strength, and overall discomfort typically decreases within a week or two.