Office operative arthroscopy of the knee: technical considerations and a preliminary analysis of the first 100 patients.

Abstract

Office operative arthroscopy of the knee under local anesthesia with light intravenous sedation was performed on 106 knees in 100 patients between 1989 and 1992. There were 169 procedures performed in these 106 knees. Facility design and necessary equipment and supplies are presented. Patient flow in the office, from check in to check out after surgery, is discussed in detail. Anesthesia techniques, monitoring techniques, and emergency precautions are presented. Patients were asked to complete a questionnaire assessing their comfort level during and satisfaction with office arthroscopy during and following the procedure. Twenty-four patients had undergone previous arthroscopy under general anesthesia in a hospital or ambulatory surgery center setting. These patients were asked to compare their previous procedure with the office procedure as to discomfort and the overall experience. Only 1 of these 24 patients preferred the hospital setting to the office setting. The discomfort experienced during the procedure was almost universally rated as minimal. There were four minor complications, which are discussed in detail. The cost-effectiveness of office operative arthroscopy under local anesthesia with light intravenous sedation is demonstrated and discussed. This preliminary report demonstrates that office operative arthroscopy of the knee is feasible, cost-effective, safe, and preferred by the patient.