Arthroscopy – cartilage repair operation


DATE: 19 November 2012
Operation: Right knee arthroscopy and partial medial menisectomy

Pre-op

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I arrived at the hospital, to be greeted and taken to a lovely single room, with en suite toilet and shower, nothing at all like the wards of the NHS hospitals.

Loads of forms., a sign on the door saying rm 17 is my room, then we wait for a couple of hours. In that time a physio came to show me the exercises (hmm you have clearly done this before she said) the surgeon came to talk to me and explain all the things he will do (yes, my foot issues may in fact be linked to the knee ones, and it would make sense to have the orthotics remade).

He intends to repair the meniscus if he can, if not he will remove a small portion of It. He assured me it was rare to have to remove it all. I asked about long term prognosis. Due to all the trauma to that knee (this is operation number 3 on that knee alone!) it is likely I will get arthritis. This operation will not affect that in any way. It is also very likely that in the very long term I will need a knee replacement. For now, this is the only option, as the symptoms have not improved, the pain is still there and has not got any better.

The anaesthetist then came in to talk to me (and gave me a business card!). She explained that there was in fact another option to the general anaesthetic. I was more worried about the anaesthetic than about anything else, having had an awful experience with it, being sick for a week despite the anti sickness drugs following the ACL operation 13 years ago. She said I could have a spinal anaesthetic. This would be a needle into the spine. No, it is not like an epidural she said. She also told me it meant less danger of a DVT as well as less likely to be sick. I decided to go for that option.

The operation

I walked walked with the nurse to the pre op area at 11:30am. I had a canular into my hand (I forget what she said it was!) then I was asked to sit up. After having my back covered with iodine, she put the needle into my spine. The first think I felt was the usual needle scratch, a sharp pain, then my right foot started to twitch. When I told her, she did something from behind me and it stopped. I felt a dull ache in my lower back. Again, she did something then it went away again.

I was laid back down, sides up then went into theatre. I have never been in a theatre while wide awake before. Despite asking to be sedated, I was aware after some chit chat, I could no longer feel my legs, they felt cold, then they felt nothing. The leg was pulled to an angle, it was then that I noticed the screen and camera. I asked was that my knee, and had he already started? Although I could not see the surgeon, I could hear him behind the screen, and he was talking to me and explaining what I was seeing on the screen. The nurses looked a little concerned and said its ok, you don’t have to watch.

Now that I was aware he was already underway, I still couldn’t feel anything, I knew my leg was being moved, a few pushing sensations, but if I hadn’t noticed he had started then I mustn’t be able to feel anything, so I decided to watch and talk to him, it would be cool to see what was happening and have it explained to me!

He showed me the ACL graft, which was in a relaxed state, looking like a fluffy rubber band. He explained that it was still intact and functioning well. He moved the camera around to show me the front of the knee, and the medial meniscus there looked like a tidy white pillow between my bones. When he moved the camera round to the back the meniscus looked more like a freyed piece of material, with a few nicks out of it. He said that it wasn’t a tear, as such, it was degenerative damage. I could also see his surgical tool in the picture. I watched as he worked away shaving the freyed edges off and making it as smooth as he could. He explained that the damaged section had been protruding outside the knee joint, which was likely to be the source of the pain.

And really, that was it. My leg was put back, the camera went off while he dressed it, and I was wheeled into recovery. There they seemed surprised that I was so awake and chatty. It seems a spinal anaesthetic is not necessarily the norm. I had been in theatre 45 minutes, tops. What did amuse me was each set of nurses that I was passed to throughout the procedure were given a message from the last ones: “her blood pressure and pulse are both low, but don’t worry, she’s a triathlete”.

Post op recovery

I was so so cold, I could not control the shivering, so they gave me a groovy Blow up blanket that they connected to a machine and blew warm air around. I stayed there for a while, the two nurses chatted about sport, fitness, what is a triathlon, before taking off the oxygen mask and sending me back to the room. I was back at the room within 85 minutes of leaving it, having not been asleep at all.

It took quite some time for the feeling to return to my legs. A nurse came in at around 2pm and walked me the 4-5 short steps to the toilet. My legs didn’t feel like they belonged to me at all. Hmm. You need a bit more time she said. I could only partially feel my feet and couldn’t feel anything at waist level, but could elevate and slightly bend the knee already.

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At around 4pm a nurse arrived to change the dressings and remove the canulars. To my surprise, there were steri strips, not stitches, and I was told I was allowed to have a shower and everything. I asked her when they would be taking out the needle from my spine. She said ‘oh they did that before you left theatre’. I never noticed, and I was awake! No backache, nothing, way better than my previous experience of an epidural.

By around 5pm I could feel most things. By 6pm I was discharged. Now I could feel everything, it was a little more sore to walk, but I walked out of the hospital, without crutches.

9 Comments on “Arthroscopy – cartilage repair operation

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