Arthroscopic Knee Surgery

Understanding Arthroscopic Knee Surgery

Arthroscopic knee surgery is a medical procedure that uses a small camera, called an arthroscope, inserted through tiny incisions in the knee. The physician operates the camera to view the joint on a video screen and guide small surgical tools to treat issues inside your knee. 

The main purpose of this surgery is to diagnose and address knee problems, such as torn cartilage, meniscus injuries, ligament damage, or swelling inside the joint. Specialists such as orthopedic surgeons are trained to perform arthroscopic knee procedures. This procedure is sometimes called “knee scope” or “keyhole surgery.”

The technique is less invasive than traditional open knee surgery, which usually means less disruption to healthy tissues. Knee arthroscopy allows for a more precise approach to repairing or removing damaged tissue, potentially improving outcomes and reducing recovery times.

Benefits Of Knee Arthroscopy

Arthroscopic surgery offers certain benefits compared to open knee surgery:

• Minimally invasive approach using small incisions: Arthroscopic surgery uses incisions about the size of a pencil tip. This smaller opening limits injury to healthy skin, muscle, and other tissues, reducing the trauma your body experiences during surgery. It may also reduce the risk of infection.[1]
• Typically results in less scarring than open surgery: The smaller incisions lead to less scar tissue on both the skin and inside the joint. This helps preserve normal movement and reduces the risk of stiffness.
• May support improved joint function in some cases: Knee arthroscopy can be used to remove loose fragments, repair tears, or address damaged cartilage. These interventions can help restore joint surfaces and allow the knee to move more smoothly, directly impacting function and mobility.
• Can allow quicker return to daily activities compared to traditional surgery: Because arthroscopy is less disruptive compared to open surgery, it often leads to reduced swelling and pain after the procedure. This may help you start gentle movement and physical therapy sooner, which can speed up your return to work, sports, or your daily routine.

Research suggests that arthroscopic knee surgery generally results in smaller incisions, less blood loss, shorter hospital stays, and lower pain medication needs compared to open surgery.[2] Arthroscopy is also associated with less pain, quicker recovery, higher patient satisfaction, and a low complication rate of less than 2%.[3] 

How Arthroscopic Knee Surgery Manages Knee Pain

Arthroscopic knee surgery is used to identify and treat specific problems within the knee joint that may contribute to discomfort or limited movement.

Using a camera and special tools, the surgeon can identify and treat problems such as torn cartilage, loose tissue, or irritated joint surfaces. By removing, repairing, or addressing damaged areas, this procedure reduces irritation and helps improve the knee’s overall movement. 

The minimally invasive technique also limits trauma to surrounding tissue, supporting faster healing and helping to reduce ongoing pain after the procedure compared to open surgery.

What To Expect Before, During, And After Procedure

Before your procedure, you may need to stop certain medications and arrange for someone to drive you home. You should bring a list of your medications and wear comfortable, loose clothing. Some swelling, soreness, or stiffness is common after the surgery, and your care team may recommend recovery instructions, such as using ice, elevating your leg, and taking prescribed pain relief.

Preparing For The Procedure

Being prepared for arthroscopic knee surgery helps improve the procedure’s safety and effectiveness. Your care team will evaluate your health history, review any chronic conditions, and discuss steps to reduce risks during surgery. 

Common steps include:

• Patients are often asked to review their current health conditions with their provider.
• You may be advised to share a list of medications you’re taking.
• Specific instructions may be provided ahead of time to help you prepare.

What Happens During The Procedure

Arthroscopic knee surgery is most often completed within one to two hours. You will be monitored by medical staff throughout, and anesthesia will be used to keep you comfortable. Most patients can go home the same day, and the surgeon will provide you with precise instructions for post-procedure recovery.

Typically, you can expect:

• The leg is cleaned, and the knee is positioned in a stabilizing device.
• A small incision is made for an arthroscope (a tiny camera) to allow the surgeon to see inside the joint.
• Images are shown on a screen to help guide the procedure.
• Additional small incisions may be made if surgical tools are needed.
• Torn tissue may be repaired, damaged cartilage smoothed, or inflamed tissue removed.
• At the end, the incisions are closed with stitches or bandages, and the knee is covered with a larger dressing.

Post-Procedure Expectations

Your care team will structure a recovery routine to promote healing and reduce complications. You can expect to manage common symptoms such as swelling, discomfort, or limited movement, especially in the first few days. Your care team will guide you on pain management, activity restrictions, and wound care. 

Some key aspects include:

• Patients usually arrange for transportation home on the day of surgery.
• Some pain or discomfort is common and can be managed with medications as directed by the doctor.
• For the first few days, it’s recommended to avoid weight-bearing, using crutches or a walker as needed.
• Elevating the knee can help reduce swelling.
• Bandages generally need to be kept clean and dry.
• Physical therapy may be suggested to help regain strength and mobility over time.

Conditions That Knee Arthroscopy May Address

Knee arthroscopy can help manage a wide range of problems inside the knee joint. Since it provides access to the inner aspect of the knee for diagnostic and treatment purposes, this approach can be used to address injuries, damage from wear and tear, and certain types of inflammation that do not improve with other treatments.

• SONK: SONK (Spontaneous Osteonecrosis of the Knee) is a condition in which reduced blood flow affects bone tissue in the knee, which may contribute to joint discomfort or stiffness. Read more about SONK.
• PCL Tear: PCL tear is an injury to the ligament at the back of the knee, which may occur due to direct impact or overextension. Read more about PCL Tear.
• ACL Tear: A tear in the anterior cruciate ligament, often caused by sudden stops or changes in direction, leading to knee instability.
• Torn Meniscus: A rupture in the cartilage between the thigh and shin bones, commonly resulting from twisting motions.
• Synovitis: Inflammation of the synovial membrane in the knee joint, causing pain, swelling, and reduced mobility.
• Patella Misalignment: A condition where the kneecap shifts out of its normal position, often leading to pain or difficulty with movement.
• Baker's Cyst: A fluid-filled swelling behind the knee, usually due to underlying joint problems like arthritis or a meniscus tear.
• Knee Fractures: Breaks in the bones of the knee joint, typically from trauma or high-impact injury.

Potential Risks And Complications To Consider

While complications in arthroscopic knee surgery are rare, every surgical procedure comes with some risks. Understanding these risks can help you make informed decisions and recognize the warning signs of a complication during recovery.

• Internal bleeding within the knee joint: Blood may collect in the joint after surgery, leading to pain and swelling that can delay healing or require drainage.
• Development of a blood clot in the leg: Reduced movement after surgery can slow blood flow, increasing the chance of a clot formation. This can be a serious concern if not treated.
• Joint infection: Bacteria can enter the knee during or after surgery through the incision site. While arthroscopic surgery carries a lower risk of infection, it is essential to recognize the signs of an active infection, including redness, warmth, swelling, and pain. Infection often requires antibiotics or additional treatment to prevent serious complications.
• Reduced flexibility or stiffness in the knee: Scar tissue or swelling can limit movement, making it harder to bend or straighten the joint fully as you recover.
• Injury to cartilage, ligaments, meniscus, blood vessels, or nerves: Surgical tools can rarely damage structures inside or around the knee, such as nerves, ligaments, or muscles. This may lead to new symptoms or longer recovery times. 

Recovery Timeline After Knee Arthroscopy

Most people begin to see improvements within a few days after knee arthroscopy, but full recovery often takes several weeks. While you may be able to return to light daily activities within one to three weeks, healing time varies depending on your situation. Factors that may affect your recovery include:

• Your overall health
• The reason for the procedure
• The extent of knee damage treated
• How closely post-surgery instructions are followed
• Your response to physical therapy