Knee Arthroscopy

Knee arthroscopy is a common minimally invasive procedure used to examine, diagnose, and treat problems inside the knee joint. It is performed using a small camera called an arthroscope, which is inserted through tiny incisions around the knee. Because the incisions are smaller than in traditional open surgery, knee arthroscopy may reduce tissue disruption and can allow for a faster recovery in appropriate cases.

What is knee arthroscopy?

Knee arthroscopy is often referred to as keyhole surgery. During the procedure, an arthroscope is inserted into the knee joint so the surgeon can view the internal structures on a monitor in real time. Small surgical instruments can then be introduced through additional incisions to diagnose the cause of symptoms and, where appropriate, perform treatment during the same operation. Arthroscopy is commonly used for meniscal tears, loose bodies, cartilage damage, synovial problems, ligament assessment, and selected other knee conditions.

When is knee arthroscopy considered?

Knee arthroscopy may be recommended when knee pain, swelling, locking, catching, giving way, or reduced movement is caused by a problem within the joint that is unlikely to improve with non-surgical treatment alone. It may also be used when imaging and examination suggest a meniscal tear, cartilage injury, loose fragment, inflamed synovium, ligament problem, or another mechanical source of symptoms. The exact indication depends on the patient’s symptoms, examination findings, imaging results, and response to conservative treatment.

Conditions that may be treated arthroscopically

Knee arthroscopy can be used to assess and treat a range of knee problems. In some patients it is primarily diagnostic, while in others it allows the surgeon to perform specific procedures through the same keyhole incisions.

• Meniscal trimming or partial meniscectomy.
• Meniscal repair in suitable tears.
• Removal of loose cartilage or bone fragments.
• Treatment of cartilage damage, including chondroplasty or selected cartilage procedures.
• Synovectomy or removal of inflamed joint lining.
• Assessment or treatment of ligament injury, including procedures related to ACL or PCL reconstruction.
• Washout of the joint in selected cases.

How the procedure is performed

Knee arthroscopy is usually performed under general anaesthesia, although other anaesthetic options may be used depending on the patient and procedure. Small incisions, called portals, are made around the front of the knee. Sterile fluid is introduced into the joint to expand the space and improve visibility. The arthroscope is then inserted and the inside of the knee is examined in detail. If treatment is required, miniature instruments are passed through one or more additional portals to carry out the planned procedure.

A typical knee arthroscopy may include:

• Anaesthesia and positioning of the leg.
• Examination of the knee under anaesthesia where needed.
• Creation of small arthroscopy portals at the front of the knee.
• Insertion of sterile fluid to open the joint space and improve visibility.
• Insertion of the arthroscope and inspection of the menisci, cartilage surfaces, ligaments, and joint lining.
• Treatment of the identified problem using fine arthroscopic instruments.
• Removal of instruments, drainage of fluid as required, and closure of the small incisions.

Advantages of knee arthroscopy

Knee arthroscopy is less invasive than many open procedures and usually involves smaller incisions, less soft tissue trauma, and direct visualisation of the inside of the joint. In appropriate patients, this may mean less postoperative pain, smaller scars, and a quicker early recovery. It also allows diagnosis and treatment to occur during the same operation in many cases.

Risks and complications

Knee arthroscopy is generally considered a safe procedure, but all surgery carries risks. Possible complications include infection, bleeding, blood clots, persistent swelling, stiffness, damage to nerves or blood vessels, ongoing pain, anaesthetic risks, and the possibility that symptoms may not fully resolve. In some cases, further treatment or additional surgery may still be required depending on the underlying condition.

Recovery after knee arthroscopy

Recovery depends on the exact procedure performed. Patients who undergo a simple arthroscopic assessment or minor trimming procedure often recover more quickly than those who require meniscal repair, ligament reconstruction, or cartilage restoration work. Many patients are able to bear weight soon after surgery, although specific instructions vary depending on what was done inside the knee.

A general recovery pathway may include:

• Rest, ice, elevation, and swelling control in the early postoperative period.
• Pain relief and wound care.
• Gradual return to walking and daily activities as advised by your surgeon.
• Physiotherapy to restore movement, strength, and knee function.
• A longer rehabilitation period for procedures such as meniscal repair or ligament reconstruction.

Rehabilitation and return to activity

Physiotherapy is often an important part of recovery after knee arthroscopy. Rehabilitation focuses on reducing swelling, regaining full movement, restoring muscle control, and returning the knee to safe function. The timeline for return to sport, work, or physically demanding activity depends on the original knee problem and the procedure performed. Some patients return to normal activity within a few weeks, while others require a more structured and prolonged rehabilitation program.

Is knee arthroscopy right for you?

If you have persistent knee pain, swelling, locking, or mechanical symptoms that are not improving with conservative treatment, knee arthroscopy may be considered as part of your management. A detailed assessment, clinical examination, and imaging review can help determine whether arthroscopy is appropriate and what treatment is most likely to provide benefit. The goal is to diagnose the cause of symptoms accurately and improve knee function while using the least invasive approach suitable for your condition.