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Knee Arthroscopy with the Use of Local Anesthesia—An Increased Risk for Repeat Arthroscopy?

A Prospective, Randomized Study with a Six-Month Follow-up

Eva Jacobson, MD^*,, Magnus Forssblad, MD^*, Lars Weidenhielm, MD, PhD and Per Renström, MD, PhD

^* Artro Clinic, St. Göran’s Hospital
Department of Orthopaedics, Karolinska Hospital, Stockholm, Sweden

Address correspondence and reprint requests to Eva Jacobson, MD, Artro Clinic/Tipskliniken, St Göran’s Hospital, S-112 81 Stockholm, Sweden

Although there have been many reports of good results when local anesthesia is used with knee arthroscopy, it is not used as a standard anesthetic. Concerns about local anesthesia include the fear of prolonged surgery, which could result in inadequate anesthesia, thus causing the patient unnecessary discomfort. The purpose of this study was to evaluate the risk of repeat arthroscopy and the patient satisfaction rate up to 6 months after knee arthroscopy under local anesthesia. In this prospective, randomized study, 400 patients scheduled for elective knee arthroscopy were allocated to one of three groups: local anesthesia (200 patients), spinal anesthesia (100 patients), or general anesthesia (100 patients). All enrolled patients were asked to complete a questionnaire 6 months after surgery and all of their medical records were reviewed. No repeat arthros copies occurred in the spinal and general anesthesia groups and only three occurred in the local anesthesia group, a nonsignificant difference. In only one of these three cases was the clinical course altered by the repeat arthroscopy. There was no difference in the satisfaction rate between the three anesthesia groups. We conclude that the choice of anesthesia does not influence the frequency of repeat arthroscopy, satisfaction with the procedure, or recovery at 6 months after knee arthroscopy.