Your knee has two crescent-shaped pieces of cartilage that cushion the thighbone (femur [FEE-muhr]) and shin bones (tibia [TIHB-ee-ah] and fibula [FIB-yoo-lah]). Each of these pieces of cartilage are called a meniscus.
A torn meniscus is a common knee injury. It happens most often in athletes who twist the knee with a planted foot, such is in basketball, football, or soccer, but it can happen to anyone.
Treatments for a torn meniscus vary. For mild tears, your doctor may recommend at-home treatments like rest, ice, and medicine. For more severe tears, your doctor may recommend surgery.
Arthroscopic [ahr-thruh-SKOP-ik] knee surgery is surgery used to diagnose and repair problems with your knee. During surgery, the surgeon inserts an arthroscope (a tiny camera) into your knee, and projects a large picture of your knee on a screen, giving a close look at the problems. The surgeon can then make small incisions (cuts) and insert tools to repair or remove damaged tissue. With arthroscopic surgery, your incisions are small and your recovery is relatively fast. Most patients can go home the day of surgery.
Most of the time, arthroscopic surgery is only considered after you have tried all other options, like medicine, knee braces, changes in activity, and/or physical therapy.
Common risks of arthroscopic surgery include:
- Bleeding or infection. With any surgery, there is a small risk of bleeding or developing a wound infection. Antibiotics and careful sterile techniques are used to reduce this risk.
- Failure to relieve symptoms. Your surgeon will do everything possible to give you the best results. Even so, surgery may not relieve all your symptoms.
- A blood clot in a deep vein (DVT). These problems are rare and treatable.
The benefits of arthroscopic surgery include:
- Accurate diagnosis. The arthroscope helps your doctor get a better picture of what's wrong with your knee.
- Faster recovery. Recovery is usually faster than with surgery involving larger incisions.
- Less scarring.The incisions result in very small scars that don’t interfere with movement.
Be sure to talk to your doctor about what you can expect from your surgery.
There are a few things you can also do to prepare that will help your surgery go better, and may also help you recover faster.
- Ask for a ride. After your surgery, you may not be able to drive. You should arrange to have a responsible adult give you a ride home from the hospital and stay with you for the first 24 hours after surgery.
- Ask for time off work. Ask your doctor how long you may need to be off work, and arrange this with your boss or employer.
- Follow all instruction about eating a drinking the day before your surgery. You may be asked to stop eating a drinking for a few hours before. This is to prevent problems with anesthesia [ann-ess-TEE-see-uh]. If you don't follow these instructions, your surgery may have to be postponed.
- Wear comfortable clothing. Wear clothes that are loose and easy to get on and off. You may have a cast or thick dressing on your knee after the surgery.
- Bring assistive devices. If you have a walker, knee brace, or crutches, your doctor will advise you on using them to go home after the surgery.
- Bring a list of your current medicines. This includes all prescriptions, over-the-counter medicines, patches, inhalers, herbal supplements, and vitamins. You may be asked to bring inhalers or other medicines with
- Tell your doctor if you’re allergic to any medicines, have a rash or infection near your knee, or if you have ever had any negative reactions to anesthesia.
You’ll be given anesthesia so you don’t feel pain during surgery. A doctor who specializes in pain control (an anesthesiologist [ANN-ess-tee-see-OHL-oh-gist]) will explain the type of anesthesia you will be given. You may be given:
- General anesthesia. Medicine is delivered through an IV or mask to keeps you asleep and pain-free.
- Regional anesthesia. Medicine is delivered to the nerves in your spine that blocks sensation in your legs. You’ll be awake, but will be given a sedative to make you sleepy and relaxed.
- Local anesthesia. Medicine is injected into the knee and right around it to block all sensation. . You’ll be awake, but will be given a sedative to make you sleepy and relaxed.
Your knee will be marked to make sure that the correct knee is repaired.
The surgery usually lasts between 30 minutes and 1½ hours.
The anesthesiologist will give you anesthesia. If you have general anesthesia, you may have an IV line attached to your hand or forearm.
After making 1 or 2 tiny incisions (cuts) in your skin, the surgeon will flush your knee with sterile fluid. This will reduce any bleeding and expand your knee so the images can be clearer.
The surgeon will insert the arthroscope, so the interior of your knee shows on a video monitor. The surgeon will use the arthroscope to look at various areas of your knee and diagnose the problem.
The surgeon may make more incisions to insert small instruments. These will be used to repair damaged tissues or remove loose fragments of bone and cartilage.
At the end of the surgery, the surgeon will drain the sterile fluid from your knee and close the incisions with stitches or surgical tape. A bandage may be placed over the incisions.
After surgery, you can expect the following:
- Recovery room. Nurses will keep an eye your vital signs (temperature, pulse, breathing rate, and blood pressure) for 1 or 2 hours in a recovery room. You’ll be able to go home as soon as your vital signs are good, you are fully awake, and you can move to a chair or stand and walk.
- Home instructions. The nurses or medical team will discuss the outcome of your surgery, and instructions for caring for yourself at home. It’s a lot of information to remember. Ask a friend or family member to take notes and be sure to ask any questions you may have before you go home.
Take your pain medicine as prescribed by your doctor. When your pain is controlled well, your body can focus more on healing. Take your pain medicine exactly as ordered by your doctor.
Don’t take any pain medicine that your doctor has not recommended, and don’t drink alcohol while taking pain medicine.
Follow all instructions from your doctor concerning ices and elevation after your surgery.
Take over-the-counter stool softeners or laxatives if needed, to avoid constipation. This is a common side effect of pain medicine. Drink at least 8 glasses of water each day.
Wear your compression stockings (T.E.D. hose) to help prevent blood clots.
Keep your bandages clean and dry. Don’t take a bath or shower until your doctor says it’s okay.
Watch for bleeding and signs of infection at the incision site (increased redness or swelling, pus, or fever over 101°F). Report them to your doctor.
Take it easy. You should rest on the day of surgery and for one to 2 days after, other than getting up for the bathroom or to get meals or medicine.
Follow your doctor’s instructions about walking or putting weight on your leg. Don’t put any weight on your knee or try to walk until your doctor tells you it is okay. If your doctor tells you to use crutches, be sure to use them every time you walk.
Do range-of-motion exercises as ordered. These will help you regain strength, balance, and range-of-motion in your legs and knees. They also help prevent blood clots. Unless told otherwise, start these exercises on the day of surgery, and do them as often as every hour you’re awake.
Begin other activities and go back to work when your doctor says it is okay. The recovery period after arthroscopic surgery is different for each patient. Many patients can return to office work within a week—sometimes even the next day.
Your doctor may recommend physical therapy. A physical therapist can create and supervise a program of specific exercises to increase your flexibility, strength, and balance. Physical therapy also includes a variety of treatments to reduce scar tissue, promote healing, and help prevent future injuries.
Watch for problems, and call your doctor if you have:
- Persistent bleeding at the knee (small spots might show on the bandages, but they shouldn’t spread).
- Pain that you cannot control.
- Pus or foul-smelling liquid drains from your knee.
- Chills or a fever over 101°F.
- Nausea and vomiting that does not stop.
- Continued swelling or numbness at the knee and elevating your leg or loosening your bandage doesn’t help.
- Symptoms of a blood clot in a deep vein (DVT), including chest pain or shortness of breath. If these are severe, call 911 or your local emergency services.