Prima Medical Group

Raymond Bonneau, M.D. Orthopedic Surgeon

165 Rowland Way, Suite 100
Novato, CA 94945
(415) 898-4211
www.primamedgroup.com

Knee Arthroscopy Information

Introduction

You have been scheduled for a knee arthroscopy. This is the most common type of knee surgery and can now be used for a variety of problems within the knee joint.

Pre-Operative Instructions

You should not take Motrin, Advil, Naprosyn, or any other nonsteroidal anti-inflammatories for ten days prior to surgery. You should not take aspirin for ten days prior to surgery unless you have had any type of cardiac surgery including angioplasty, stent placement or bypass then you will need to continue taking aspirin, unless otherwise instructed by your cardiologist. You may eat or drink anything you’d like the night before the surgery, but you should have no solid food after midnight the day of your surgery. You may have clear liquids up until 4 hours before your surgery but limited to 4 ounces. Clear liquids are fluids that light can shine through, such as apple juice, coffee, tea and water. This does not include orange juice or milk. The best thing to have is a glass of apple juice or cranberry juice approximately 6 hours before the surgery to give you some glucose and fluids to get by until the time of surgery. Please make sure you drink nothing, not even water, beginning 4 hours before surgery.

Going to the Hospital

You should report to North Bay Regional Surgery Center or Novato Community Hospital 1 to 1 ½ hours prior to the scheduled time of your surgery. If your surgery is in the afternoon, it is often a good idea to call Same Day Surgery 4 hours before your surgery to determine whether or not the surgical schedule is running on time. The number at North Bay Regional Surgery Center is 415-209-2500. The number at Novato Community Hospital is 415-209-1558.

What to Wear

Loose clothing is best. You can wear underwear in surgery if you wish. You may want to have a pair of loose fitting sweat pants to wear home.

Anesthesia

You will get to speak to your anesthesiologist prior to the surgery. You may have a general anesthetic, or you may also have a spinal, where you’re numb from the waist down. This would usually be your choice. Some patients simply prefer to be asleep during the procedure.

Modern day general anesthetics are quite safe and post-operative nausea, which used to be quite common, is now very rare. However, some patients wish to be awake and in this case, you may certainly have a spinal, and you can even watch the procedure on the TV screen and we can explain to you what we’re doing. After either type of anesthetic, we will put a long-acting local in your knee, so that when your anesthesia wears off, you’re knee will be numb. This local will usually keep your knee numb for 6 to 12 hours following the surgery.

Surgery

The procedure itself takes approximately one hour, and it is performed through two ¼ inch puncture wounds that are placed just below the kneecap. Through one of these portals, an arthroscope is placed. The arthroscope is smaller than a pencil and is connected to a television camera and is used to inspect the knee. The instruments come in through the other portal. Dr. Bonneau makes a video tape of your surgery with narration for you to watch afterwards. Most patients find this quite helpful in understanding what was done in their knee. The video tape shows the inside of your knee only, the same image that Dr. Bonneau is seeing, and you certainly should plan to watch this tape in the first few days after your surgery.

Post-Surgery

After the surgery, you will wake up in the recovery room with an ace bandage on your knee and your knee will be numb. You’ll usually stay in the recovery room for 30 to 60 minutes, following which you’ll return to Surgical Day Care for an hour or so, until you feel well and can get up and use you crutches.

At home

The first day after the surgery, you may have more soreness than the day of the surgery itself. As the local anesthetic wears off, please do not hesitate to take the pain medication as we certainly want you to be as comfortable as possible. You may see some bloody drainage on the bandage, which is arthroscopic fluid, mixed with blood leaking out. This is normal and you should not be concerned. If the bandage becomes quite soaked, however, you can certainly come to the office and we can change the dressing for your comfort. Each day after the first day, you will start to feel considerably better. It is important to maintain elevation of your leg for the first three days, as this helps to keep the swelling down. You can get up and use your crutches to go to the bathroom, and eat your meals. You can put whatever amount of weight on the knee that you find comfortable. The knee itself is not delicate, but it is very helpful to maintain elevation as much as possible in the first three days to decrease swelling. Ice is somewhat helpful, and certainly in the first 48 hours you can use an ice pack on the knee on an as needed basis.

We would normally see you back in the office 2 to 4 days following your surgery. At that point you’ll begin a very gentle exercise program where you lay on your back three times a day and do 10 straight-leg raises, followed by 10 gentle stretches to regain flexion in your knee. I’ll review this with you at your postoperative office visit. At this first postoperative visit, we’ll remove your bandages and the tape strips that hold the wounds closed. Band-aids will then be placed on the wounds. Following this, you may remove the band-aids and take a shower. Gently dry the wounds and place new band-aids over the wounds. We would suggest you not put any ointments, such as Neosporin on the wounds, and do not immerse the knee in water, such as a bathtub or hot tub, for 10 days following the surgery. After 10 days, the band-aids will be discontinued and you can immerse your leg in water.

You can progressively put weight on the knee, and gradually wean yourself off the crutches as your comfort allows. Most people use crutches for 3 to 10 days.

You’ll return again to the office at 2 weeks post-operatively, at which time you’ll most likely be off the crutches and can progress with a more vigorous exercise program. By 3-4 weeks, most people are ambulating fairly well on a day to day basis. By 6-8 weeks, you’ll be walking normally and returning to light sports. It does require 3-4 months for full recovery, and up to 6 months to regain all of your knee strength.