PLANNING FOR ARTHROSCOPIC SURGERY
Although arthroscopic surgery is a relatively minor procedure, it is still invasive, with potential risks and complications. It also requires a period of rest from normal activity.
Planning for the Procedure
The arthroscopic surgery is done as an outpatient. In most cases the procedure takes somewhere between 30 and 45 minutes. The patient can have either a general anesthetic (which means being put to sleep) versus a spinal anesthetic (where an injection is put into the lumbar area of the back in order to anesthetize the leg). Although either works from a surgical standpoint, the high majority of people choose to have a general anesthetic.
It is important that the patient does not eat or drink anything after midnight on the day prior to their procedure. Any medications that thin your blood such as aspirin, Plavix, or Coumadin should be stopped five to seven days prior to the procedure.
Risks of Arthroscopic Surgery
The two most common risks of arthroscopic surgery of the knee are infection and a blood clot in the leg. The risk of infection after arthroscopic surgery is about 1 in 500, or .2%. Usually, such an occurrence will not come to the forefront until about ten to fourteen days after the procedure. The occasional infection that has been encountered has been quite successfully treated with antibiotics and a washout of the knee.
The second most common complication is a deep vein thrombosis, or blood clot in the leg. The risk of a DVT after arthroscopic knee surgery is somewhere between .2% and .4%. DVTs are extremely uncommon in patients under forty years old. I am now prescribing one aspirin per day in the first seven to fourteen days after surgery to reduce the incidence of a deep vein thrombosis.
The patient needs to be relatively quiet for the first 72 hours after surgery. There should be a lot of elevation of the extremity higher than the heart. Most patients will use crutches for one to two days, but usually will be walking quite well after seven to ten days. I try to have patients riding a stationary bike, swimming, or using an elliptical machine by the time they're two weeks postop. It usually takes six to eight weeks to get back to running sports. Eighty to ninety percent of the recovery will occur by six to eight weeks, although the final ten percent of the recovery might take several months after that. Most patients can go back to a sedentary job such as office work after half a week. A profession that requires constant standing in an eight-hour day might require four to six weeks off of work. Any job that's somewhere in between will obviously require an intermediate amount of time off of work.
Patients can usually play golf on a cart within three weeks of surgery.
I usually would recommend against doing a long car ride or plane ride for the first fourteen days after arthroscopic surgery, to reduce the tendency for DVT, in the face of prolonged travel and immobility of the extremity.
Article by Frank P. Mannarino, M.D.