Name of the Procedure:

Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed.

Summary

Arthroscopy of the knee with meniscectomy involves the use of a small camera to look inside the knee joint and perform surgical removal or shaving of damaged meniscal tissue on both the medial (inner) and lateral (outer) sides. It also includes cleaning and smoothing of the damaged cartilage surfaces (chondroplasty).

Purpose

This procedure is used to address knee pain and limitations caused by damaged or torn menisci and cartilage. The goal is to relieve pain, improve knee function, and prevent further joint damage.

Indications

• Persistent knee pain and swelling
• Meniscal tears not responding to conservative treatment
• Mechanical symptoms like clicking or locking of the knee
• Cartilage damage causing joint pain and dysfunction
• Patients typically include those who have not improved with physical therapy or other non-surgical treatments

Preparation

• Patients may need to fast for several hours before the procedure.
• Adjustments to medications, particularly blood thinners, might be necessary.
• Pre-operative tests could include knee X-rays or MRI scans.
• A pre-surgical evaluation might be conducted to ensure the patient is fit for surgery.

Procedure Description

1. Anesthesia: General or spinal anesthesia is administered.
2. Small incisions are made around the knee joint.
3. An arthroscope (a small camera) is inserted to visualize the inside of the knee.
4. Small surgical instruments are introduced via other incisions.
5. Damaged portions of the menisci are removed or shaved.
6. Damaged cartilage areas undergo chondroplasty, where the surface is smoothened.
7. The instruments are removed, and the incisions are closed with sutures or adhesive strips.

Duration

Approximately 1 to 2 hours.

Setting

Typically performed in a hospital or an outpatient surgical center.

Personnel

• Orthopedic surgeon
• Surgical nurses
• Anesthesiologist
• Surgical technician

Risks and Complications

• Infection
• Blood clots
• Damage to surrounding structures
• Persistent pain or stiffness
• Swelling and bruising
• Need for additional surgeries

Benefits

• Relief from knee pain
• Improved mobility and knee function
• Prevents further joint degeneration
• Often realized within a few weeks to a few months post-surgery

Recovery

• Initial rest and elevation of the leg
• Pain management with prescribed medications
• Physical therapy for rehabilitation
• Gradual return to normal activities over a few weeks to months
• Follow-up appointments to monitor progress

Alternatives

• Physical therapy
• Medications (NSAIDs, corticosteroids)
• Injections (corticosteroids, hyaluronic acid)
• Other surgical methods (partial meniscectomy, meniscus repair)
• Pros: Non-invasive options may involve less risk, quicker initial recovery
• Cons: May not be as effective for severe cases requiring mechanical correction

Patient Experience

• Some discomfort during the first few days with pain managed through medication
• Use of crutches or a knee brace initially
• Gradual improvement in knee function with physical therapy
• Potential for swelling and bruising which typically resolves over time