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The type of anesthesia will depend on the joint your doctor is looking at. You may receive one of the following:

• General anesthesia —you will be asleep
• Local anesthesia—the area will be numbed
• Spinal anesthetic —your lower body will be numbed by putting a numbing medicine in your back

Description of the Procedure

The doctor will make tiny incisions in the skin along the joint. Special tools will be inserted through the incisions. The tools include the arthroscope. The picture from the arthroscope will show up on a screen so that the doctor can see the inside of your joint. The doctor may use the images to move around other tools that can cut and repair tissue in your joint.

For example:

• Some meniscal tears in the knee will be repaired by cutting out some of the cartilage.
• Carpal tunnel syndrome in the wrist may be treated by loosening the ligament that puts pressure on the nerves.
  Once the examination or surgery is done, the tools will be removed. The skin may be closed with stitches or clips. The incisions will be covered with a dressing. The fluid or tissue that was removed may be sent to a lab for examination. The procedure generally lasts less than one hour, but may be longer depending on the severity of the injury.

A meniscectomy is done when the cartilage is damaged. Damaged cartilage can cause pain, or give you problems with knee motion.

Description of the Procedure

There are two methods for meniscectomy. The more common procedure is called arthroscopy. Arthrotomy, an open technique, is rarely used. This may also be referred to as an open meniscectomy.

Arthroscopy

Small incisions are made around the knee. Special tools are inserted into the knee joint. A tiny camera will provide a view of the inside of the knee. The damaged meniscus is either repaired or removed. The doctor will remove as little cartilage as possible. A drain may be inserted to drain away fluid. The incisions are closed with stitches. The stitches are usually removed in the doctor’s office one week later.

Arthrotomy

A larger incision is made over the knee joint. The meniscus is then either repaired or removed. The incision is closed with stitches. It usually results in a longer recovery period. This process is usually done when there are problems with the knee that make the arthroscopic procedure difficult.The procedure usually takes less than one hour.

Procedure: Total Knee

Once you are under general anesthesia (meaning you are temporarily put to sleep) or spinal/epidural anesthesia (numb below the waist), an 8- to 12-inch cut is made in the front of the knee. The damaged part of the joint is removed from the surface of the bones, and the surfaces are then shaped to hold a metal or plastic artificial joint. The artificial joint is attached to the thigh bone, shin and knee cap either with cement or a special material. When fit together, the attached artificial parts form the joint, relying on the surrounding muscles and ligaments for support and function.

The average ASC stay after knee joint replacement is usually three to five hours. The vast majority of people who undergo knee joint replacement surgery have dramatic improvement. This improvement is most notable one month or more after surgery. The pain caused by the damaged joint is relieved when the new gliding surface is constructed during surgery.

After knee joint replacement, people are standing and moving the joint the day of surgery. At first, you may walk with the help of parallel bars, and then a walking device — such as crutches, walker, or cane — will be used until your knee is able to support your full body weight. After about six weeks, most people are walking comfortably with minimal assistance. Once muscle strength is restored with physical therapy, people who have had knee joint replacement surgery can enjoy most activities except running and jumping.