Knee Arthroscopy Treatment Cost in India

In knee arthroscopy, the inside of the knee joint is examined with the help of a telescopic instrument with a minute but a strong camera called an arthroscope. With the help of a fiber optic cable, the image is produced on a monitor for the surgeon to keep a tab of exactly what is the situation inside the joint. This aids the surgeon to do most of the repair and removal of the parts in the affected knee joint without conducting an open surgery thus enabling a faster recovery period.

Even the incisions used are very small but the major amount of the surgery can be easily performed inside the knee joint. This is usually done on an outpatient basis.

A patient who may require an arthroscopic surgery may have the following problems:

• Torn meniscus
• Anterior or posterior cruciate ligaments found torn
• Out of position patella
• Baker’s cyst removal
• Torn cartilage pieces found loose in the knee joint
• The lining of the joint, synovium is swollen
• Fractured bones in the knee

Some of the symptoms of an injury are:

• Extreme pain in the knee
• Redness and swollen  knee joint
• Tenderness
• Too much difficulty in flexing the knee

The patient is placed in a supine(lying face upwards) position and much prior to the surgery, the choices of anesthetics will be discussed with the patient. Usually, general anesthesia is used and in some cases local anesthesia where the lower part of the body will be made to feel numb.

After the anesthetic is administered, the knee will be examined thoroughly by the knee arthroscopic surgeon. A tourniquet will be placed on the upper part of the thigh and with the help of a padded limb holder, the thigh is kept secured on the table to allow no movement.

The lower leg along with the knee will be sterilized properly and draped to proceed with the diagnostic arthroscopy. The instrument will be about 5 mm in diameter and will be inserted in the knee via 3 or 4 incisions of 1 cm length each made around the knee.

One of these incisions is made for making a channel for saline inflow that keeps the vision unobstructed in the knee joint. When the meniscus tear is identified in the screen, the size, pattern, and location along with the stability and quality of the tissues around will be assessed. Thereafter the decision whether to repair or remove the damaged tissue totally will be taken.

A motorized shaver or a small rasp is used for enhancing the quality of healing for the opposing edges of the torn meniscus. If the tear has a severe blood supply problem, then many other techniques can be employed for improving the healing process. One such way can be to place a blood clot in between the torn two parts. This creates small channels for vascular access in the peripheral rim of the meniscus. The other way can be to make the joint lining bleed.

With the help of various devices like absorbable tack or suture, or a meniscal repair device the meniscus is again secured back in place. Sutures, however, require additional small incisions to tie it down.

Arthroscopic knee surgery complications are some of the aspects which both patients and surgeons must keep in mind. Though they are quite rare but should be kept in mind:

• Infection at the site of the surgery
• Excessive flow of blood during the surgery
• Anesthesia affecting breathing patterns or allergic reactions to anesthesia
• Bleeding caused inside the knee joint
• Blood clot formation in the leg
• Joint infection found
• Knee experiencing stiffness later
• During the surgery injury caused to tissues, meniscus, nerves surrounding the region, cartilage or blood vessels

Before the knee arthroscopic surgery, the patient will be checked for overall fitness. It is highly advisable for patients to reveal any medical condition or drugs which they have taken recently to a doctor before the surgeon.

Just prior to the surgery the patient is advised to quit smoking and alcohol to get better results and shorter recovery time. Knee arthroscopy is usually performed on an outpatient basis and as a result, one should prepare to bring a friend or family member to help them leave the hospital safely.

In some cases, patients may be asked to follow a certain physical regime to get better outcomes of the surgery a few weeks before the actual procedure.

During the rehabilitation and recovery management time three goals are focussed upon:

• Decrease swelling in the knee gradually
• Get the knee out straight totally
• And gradually get the quadriceps control.

During the first few days after the surgery, patients are advised to do straight leg raises in the brace. For about the next 6 weeks the patient is advised to walk with the brace with the knee in extension. Soon after surgery range of motion is started from 0 to 90 degrees, however, it eliminates the weight-bearing motion.

When good control of quadriceps is exhibited by the patient by the end of 6 weeks then the brace is unlocked and weaned off.  Motion is gradually advised to increase but deep squats are still avoided till the 12th-week post after the surgery.

Patients are however advised to do low impact activities like exercise machines and swimming after 12 weeks. And by the time the patient is 16 weeks old post the surgery they are advised to do the cutting and pivoting sports. During this whole arthroscopic knee surgery recovery time, a physical therapist guides the patient and helps them with recovery.

Apart from the above, the patient is, of course, said to take care of early signs of bleeding or high fever and keep the incision clean for the first few days post the surgery and report any anomaly to their healthcare provider.

Knee arthroscopy is required if the patient does not respond well to physical therapy. In the case of degenerative tissues, it was found that above 30% of patients who have undergone a knee arthroscopic surgery will require a knee replacement surgery at the end of three years. Which means depending upon the age of the patient and severity, one should definitely consider the alternatives for knee arthroscopy surgery since it may really not be worth it after a certain age.