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What is a Knee Arthroscopy?

An knee arthroscopy is a common orthopaedic operation which involves looking into the knee joint with a fine telescope. It allows the surgeon to see inside the knee and treat several conditions. It is performed under a general anaesthetic, which means that you will be asleep throughout the procedure.


Preparing for Your Appointment
• Please see your day surgery appointment and guide booklet for further instructions. It is important that you read and follow these instructions fully.
• Please wear loose fitting trousers, e.g. track suit bottoms as you will have a bulky bandage on your knee after your surgery.
• Do not shave your knee.

Pain

• You can expect some discomfort around the wound area. The painkiller tablets given to you before going home should help. We will advise you how to take these. Within the first 24-48 hours, if you have severe pain in your knee not relieved by the painkillers or if your knee becomes very swollen, you should seek advice. See here for details.
• Do not take alcohol while taking pain killers.
• You can help to reduce pain and swelling by raising your leg several times a day and using ice over the knee for 10-15 minutes. (It is important to wrap the ice in a damp towel to protect from ice burn)

Wound Information

Wound Healing
• The wounds will take approximately 1 week to heal.

Stitches
• Normally there are no skin stitches.
• Small sticky tapes have been applied.
• Please make an appointment with your GP 10 days following your surgery to have your stitches removed (if applicable)

Wound Dressing
• You may have a padded bandage on top of the dressing. Please remove the padded bandage 24 – 48 hours after your operation.
• You will have a dressing covering your wound. Remove the dressing after 24- 48 hours. 
• Some surgeons like you to replace the bandage with a tubigrip to proved knee support.
• The tubigrip should be worn over the knee from 3-4 inches above to 3-4 inches below the knee.
• Continue to wear the tubigrip until the swelling goes down. It should be worn all day but removed at bedtime.

Wound Care
• Do not shower or bathe for at least 24 hours after your operation.
• Bathe in plain water only, do not use perfumed products or talcum powder.
• Make sure you dry your wound gently and thoroughly.

Activity

• Once home, rest as much as possible for the remainder of the day.
• For the initial few days after surgery the leg should be rested and raised several times a day. It is however vital that you perform your physiotherapy exercises
• You should limit your amount of walking for the first few days and gradually build this up.

Physiotherapy
• You should not need any walking aids following your surgery; you should get up and try to walk as normally as possible.
• If you are finding stairs difficult, it may be easier, for the first few days if you take one step at a time, going up with your unoperated leg first and down with your operated leg first.

Return to Work
• You can usually return to work after 24 hours but this will depend on your occupation.

Driving
• Do not drive a vehicle or ride a bicycle for a minimum of 24 hours.
• Only return to driving when able to comfortably and safely change gear and carry out an emergency stop.
• Contact your insurance company for further details; all policies vary.

Exercises

 You can start doing these exercise immediately after your surgery although some people prefer to wait until the next day.

1. Knee Flexion / Extension
Repeat 2-3 sets of 10 reps of this exercise. Continue to perform this 2-3 times daily until the movement of your operated leg is equal to the other side.

2. Passive Knee Extension Stretch
Sitting on a chair, supporting your operated leg on a chair as shown. Let your leg straighten in this position. Remain in this position for 15 minutes to allow the knee to stretch. Slowly bend the knee to take it off the chair. This exercise will assist you to regain full straightening of the knee. Discontinue when you have regained full straightening.
Repeat 1-2 times daily.

3. Static Quadriceps Strengthening
Sit with your leg straight. Pull your toes back and push your knee straight by tightening the muscles on the front of your
thigh.
Hold for 5 seconds – relax.
Repeat 2-3 sets of 10 reps of this exercise 2-3 times daily.

4. Quadriceps strengthening
Sit with a rolled up towel (or pillow) under the knee. Pulling toes up, press the back of the knee into the roll and lift the heel up by tensing the front of the thigh.
Hold for 5 seconds – relax.

Repeat 2-3 sets of 10 reps of this exercise 2-3 times daily.

5. Straight leg lift (knee strengthening)
Sit with your operated leg straight. Exercise your straight leg by pulling the toes up, keeping the knee straight and lifting the leg off the bed.
Hold approx. 5 secs – slowly lower.
Repeat 2-3 sets of 10 reps of this exercise 2-3 times daily.

Progress onto this exercise when you are able to do it pain free after surgery. This may take up to 6 weeks.

6. Step up:
Stand in front of a step. Lead with the operated leg and step fully up onto it.  Use your operated leg to lower yourself back down and start again.
Repeat 10-30 times as able, repeat on the other side.
Aim to do the same on each side. Do this 2-3 times daily

Follow up and other information

Follow Up Clinic
• For most patients there is no need for you to return to the Orthopaedic clinic after your surgery
• However, if 6-8 weeks following you operation you have any concerns regarding your knee, see contact details

Passing Urine
• It is important that you pass urine as normal after day surgery.
• Sometimes there may be a delay because you have been fasting. If you have not passed urine before leaving day surgery then you should continue to drink plenty of fluids.
• After several hours at home if you still do not pass urine, or have an urge but are unable to do so, seek advice.
See contact details 

First Aid
• Slight oozing of blood from the wound is not unusual in the first 24 hours.
• If the wound bleeds heavily, lie down, raise the leg on a pillow and apply pressure with your hand for 10 minutes.

Seek advice immediately, using the contact details, if you develop:
• Persistent bleeding
• Severe bruising or swelling
• A high temperature
• A hot red wound
• A foul smell from the wound
GP Letter
• You will be given a letter for your GP. Please hand this into your GP surgery as soon as possible to inform them of your hospital attendance.

Contact Details

In an emergency
• In an emergency go immediately to your nearest Accident and Emergency (Take your GP letter, procedure information sheet and any tablets issued by Day Surgery).

If you have any further queries regarding your operation please contact the Day Surgery Unit where you had your operation.

New Victoria ACH (Day Surgery Unit)

0141 347 8242 8.30am – 8.00pm Monday to Friday.
• Out with these hours, if further help or advice is required, contact Ward 3, The New Victoria Hospital (0141 347 8453)
Contact NHS 24 Telephone No: (111)

Gartnavel General Hospital (Ward 2A)

0141 211 3172 8.00am – 7.00pm Monday to Friday
• Out with these hours, if further help or advice is required, contact NHS 24 Telephone No: (111)

Queen Elizabeth University Hospital (Ward 10A/10B)

0141 452 2700/452 2730 8.00am – 7.00pm Monday to Friday• Out with these hours, if further help or advice is required, contact NHS 24 Telephone No: (111)

For most patients there is no need for you to return to the Orthopaedic clinic after your surgery and most patients do not need follow up physiotherapy.  

However, if 6-8 weeks following you operation you have any concerns regarding your knee, please contact the  physiotherapy team at the QEUH on 0141 452 3713 or 0141 452 3710.