DAY-CASE ARTHROSCOPY UNDER LOCAL-ANESTHESIA

A prospective study of the effectiveness of local anaesthesia in arthr oscopy of the knee was performed in 212 consecutive patients. Arthrosc opic surgery was undertaken successfully in 121 cases (57%), including meniscectomy and drilling of osteochondral defects. Dynamic evaluatio n of the patellofemoral joint articulation was possible and demonstrat ion of pathological abnormalities was felt to be beneficial by some pa tients. The method described is safe, reliable, confers good postopera tive analgesia and enables physiotherapy to begin immediately. Convers ion to general anaesthesia was necessary in one case due to pain local ised to a stiff and osteoarthritic hip. Intra-articular haemorrhage wa s found to be a problem in one case with synovitis. Only ten patients complained of moderate pain, none had severe pain. Local anaesthesia i s contraindicated in cases with ipsilateral osteoarthritis of the hip or with significant synovitis of the knee. This technique is particula rly suited to day case surgery.