ARTHROSCOPIC SURGERY OF THE KNEE IN LOCAL-ANESTHESIA - AN ANALYSIS OFAGE-RELATED PATHOLOGY

Arthroscopy of the knee joint was performed in 356 consecutive outpati ents in local anaesthesia and without premedication. A continuous pres sure-irrigation system was used with 0.2% lidocaine chloride solution in the irrigation fluid, following administration of 5-7 ml prilocaine with epinephrine in each portal. All patients had clinical symptoms o f internal derangement of the knee, such as meniscal, cruciate ligamen t injury or osteoarthritis. Associated intra-articular pathology was r egistered. Intra-articular surgery was performed in 228 cases. This in cluded partial or subtotal meniscectomy in 207 cases and meniscus sutu re in 3 cases. In 18 of 228 cases (8%) the operative procedure had to be terminated due to patient discomfort. Of the meniscal injuries 84% were medial and 16% lateral. The age distribution of the medial menisc us tears was as follows: bucket handles 33 +/- 9 years; flap tears 42 +/- 10 years and degenerative tears 53 +/- 10 years. For the lateral m eniscus the age distribution was: bucket handles 34 +/- 9 years, cleav age and radiating tears 37.5 +/- 12 years, flap tears 29 +/- 7 years, peripheral tears 32 +/- 9 years and degenerative tears 48 +/- 11 years . Osteoarthritis was observed in 52% of all medial degenerative tears, whereas a low frequency was found in the remaining tears. The majorit y of patients tolerated the procedure well. In summary, 64% of the con secutive arthroscopies were operative, including 3 meniscal sutures. O nly 8% of these procedures had to be abandoned due to patient discomfo rt. Thus, arthroscopic surgery in local anaesthesia with no premedicat ion is an efficient and well-tolerated method in outpatient practice.