Name of the Procedure:

Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee (G0289).

Summary

Arthroscopy of the knee is a minimally invasive surgical procedure used to remove loose bodies or foreign objects and to perform debridement or shaving of damaged cartilage. This is done in a different compartment of the knee than where another arthroscopic surgery may be occurring.

Purpose

It addresses issues such as loose bodies or foreign objects in the knee joint, damaged cartilage, and other related conditions. The goal is to relieve symptoms like pain and swelling, improve joint function, and prevent further damage.

Indications

• Persistent knee pain or swelling
• Mechanical symptoms such as locking or catching
• Damage from joint injuries or conditions like osteoarthritis
• Presence of loose bodies or foreign objects within the knee

Preparation

• Patients may need to fast for at least 8 hours before the procedure.
• Adjustments to current medications, especially blood thinners, as advised by the physician.
• Pre-operative diagnostic tests may include MRI or X-rays.

Procedure Description

1. The patient is administered anesthesia (general or regional).
2. Small incisions are made around the knee.
3. An arthroscope (a small camera) is inserted to visualize the knee joint.
4. Specialized instruments are used to remove loose bodies, foreign objects, and perform debridement or shaving of the damaged articular cartilage.
5. The procedure is done in a different compartment from the primary arthroscopic surgery.
6. The incisions are closed with sutures or adhesive strips, and a bandage is applied.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity.

Setting

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

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Operating room technician

Risks and Complications

Common risks:

• Infection
• Bleeding
• Swelling

Rare risks:

• Blood clots
• Damage to surrounding tissues or nerves

Possible complications include prolonged pain or stiffness and the need for further surgery.

Benefits

• Reduction in pain and swelling
• Improved knee function and mobility
• Removal of obstructions like loose bodies
• Prevention of further joint damage

Benefits may be realized within several weeks after the procedure as the knee heals.

Recovery

• Initial recovery involves rest, ice, compression, and elevation (RICE).
• Pain management may include medications.
• Physical therapy may be recommended to regain strength and flexibility.
• Full recovery can take a few weeks to a few months, with follow-up appointments to monitor progress.

Alternatives

• Conservative treatments such as physical therapy and medications
• Injections (e.g., corticosteroids)
• Open knee surgery for more extensive damage

Each alternative has its own risks and benefits; for instance, conservative treatments may provide relief without surgery but may not be sufficient for severe cases.

Patient Experience

During the procedure, patients will be under anesthesia and should not feel any pain. Post-procedure, there could be some discomfort or pain, managed with prescribed pain relief. Physical therapy and rest will be key components of the recovery, and patients should follow post-operative instructions carefully for optimal healing.