Name of the Procedure:

Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture

Summary

This surgical procedure involves using a small camera called an arthroscope to view the inside of the knee joint. Based on what the surgeon sees, they may perform abrasion arthroplasty, where the damaged cartilage is scraped away; chondroplasty, where the cartilage is trimmed or smoothed; multiple drilling; or microfracture, which stimulates new cartilage growth.

Purpose

The procedure addresses knee problems caused by damaged cartilage. The goals include relieving pain, improving knee function, and promoting the growth of new, healthy cartilage to replace the damaged tissue.

Indications

Indications for this procedure include knee pain, swelling, or stiffness that doesn't respond to non-surgical treatments. It is particularly suitable for patients with cartilage damage due to injury, osteoarthritis, or other degenerative conditions.

Preparation

Patients are typically instructed to fast for several hours before the procedure and may need to stop certain medications. Pre-operative tests could include blood work, imaging studies like X-rays or MRI, and a pre-surgical assessment by the healthcare team.

Procedure Description

1. The patient is given anesthesia (either general or spinal).
2. The surgeon makes small incisions around the knee.
3. An arthroscope is inserted into the knee joint to visualize the area.
4. Based on the findings, the surgeon may perform:
   • Abrasion arthroplasty: removing damaged cartilage to stimulate healing
   • Chondroplasty: smoothing or trimming the cartilage
   • Multiple drilling: creating holes in the bone to encourage new cartilage growth
   • Microfracture: making small fractures in the bone to release marrow elements that form new cartilage
5. The instruments are removed, and the incisions are closed.

Duration

The procedure typically takes between 1 to 2 hours.

Setting

It is usually performed in a hospital or an outpatient surgical center.

Personnel

The procedure involves an orthopedic surgeon, anesthesiologist, surgical nurses, and possibly an assistant surgeon.

Risks and Complications

Common risks include infection, bleeding, blood clots, and reactions to anesthesia. Rare complications might include nerve or blood vessel damage, persistent pain, or stiffness.

Benefits

The primary benefits include pain relief, improved knee function, and potentially delaying the need for more extensive surgeries. Improvement is often noticed within a few months post-surgery.

Recovery

Post-procedure care includes keeping the knee elevated, applying ice, and taking prescribed medications for pain and inflammation. Physical therapy is typically recommended. Full recovery may take several weeks to months, and follow-up appointments are necessary to monitor progress.

Alternatives

Alternative treatments include non-surgical options like physical therapy, anti-inflammatory medications, and injections (corticosteroids or hyaluronic acid). Pros of these alternatives include being less invasive; cons might be less long-term relief or improvement compared to surgery.

Patient Experience

During the procedure, patients won't feel pain due to anesthesia. Post-operatively, they may experience pain and discomfort, which can be managed with medications. Some swelling and stiffness are normal, but symptoms should improve with time and physical therapy.