Arthroscopic surgery on the knee involves inserting a small camera, less than 1/4 inch in diameter, into the knee joint through a small incision. The camera is attached to a video monitor, which the surgeon uses to see inside the knee. In some facilities, the patient can choose to watch the surgery on the monitor as well. For a simple surgical procedure, a local or regional anesthetic is administered, which numbs the affected area. The patient remains awake and able to respond. For more extensive surgery, general anesthesia may be used. In this case the patient is unconscious and pain-free. After the camera is inserted, saline is pumped in under pressure to expand the joint and to help control bleeding. Some surgeons also use a tourniquet to prevent bleeding. After looking around the entire knee for problem areas, the surgeon will usually make 1-4 additional small incisions to insert other instruments. Commonly used instruments include a blunt hook to pull on various tissues, a shaver to remove damaged or unwanted soft tissues, and a burr to remove bone. A heat probe may also be used to remove inflammation (synovitis) in the joint. At the completion of the surgery, the saline is drained from the knee, the incisions closed, and a dressing applied. Many surgeons take pictures of the procedure from the video monitor to allow the patient to see what was done.
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