Knee Arthroscopy

Knee Arthroscopy: Procedure, Benefits, and Risks

Knee pain, swelling, and limited range of motion can often be addressed with non-invasive orthopaedic treatments such as physiotherapy and medication. However, when conservative treatments prove ineffective, doctors may recommend knee arthroscopy. This procedure allows for both diagnosis and treatment of various knee conditions, such as ligament tears and cartilage damage.

What Is Knee Arthroscopy?

Knee arthroscopy is a minimally invasive procedure that uses a small, fibre-optic camera called an arthroscope to examine and treat structural problems in the knee joint. This technique involves creating small incisions around the knee through which the arthroscope and specialised instruments are inserted. The arthroscope then transmits real-time images onto a monitor, allowing the knee surgeon to view the internal structures, such as cartilage and ligaments, and perform necessary repairs.

Knee arthroscopy is a relatively safe procedure typically done on an outpatient basis, meaning most patients are discharged on the same day as their surgery.

When Is Knee Arthroscopy Recommended?

A doctor may consider knee arthroscopy if conservative treatments, such as resting, ice application, anti-inflammatory medications, and physiotherapy, fail to alleviate knee discomfort.

Certain signs that warrant knee arthroscopy include:

• Persistent knee pain
• Chronic loss of knee mobility (flexion and extension)
• Inability to bear body weight on the knees
• Difficulties with turning or pivoting using the knee
• Hearing a popping sensation in the knee area

Furthermore, knee arthroscopy serves as a valuable diagnostic tool. It provides surgeons with a direct view of the cartilage, bones, and soft tissues within the knee joint, enabling accurate identification of injuries such as ligament tears and cartilage damage.

What Conditions Does Knee Arthroscopy Treat and Diagnose?

The knee joint is a complex structure susceptible to many types of injury. Some common knee conditions that require knee arthroscopy for diagnosis and treatment include:

• Meniscus Tears The meniscus is a cartilage disc that cushions impact in the knee joint. When this cartilage tears, it can result in knee pain, inflammation, and stiffness. With an arthroscopy, doctors can trim or repair damaged tissue and relieve symptoms.
• Articular Cartilage Injuries The articular cartilage covers the ends of bones in a joint and is often vulnerable to damage from trauma or wear and tear, especially in active individuals. Knee arthroscopic procedures allow doctors to address cartilage defects by smoothing rough surfaces or repairing the cartilage to restore proper joint function.
• Torn Anterior or Posterior Cruciate Ligament The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) provide stability to the knee. When these ligaments sustain partial or complete tears, individuals may experience knee instability and difficulties with walking. Arthroscopic knee surgery is a viable option to repair or reconstruct these ligaments.
• Synovitis When the synovial membrane—the tissue lining the inside of the knee joint—becomes inflamed, it can cause pain, irritation, and stiffness. To alleviate symptoms, knee arthroscopy may be performed to remove the inflamed tissue.
• Loose Bodies Fragments of bone, cartilage, or tissue can break off and become loose within the knee joint, leading to pain, swelling, or a feeling of the knee locking up. A doctor may opt for knee arthroscopy to surgically extract loose fragments from the knee joint.
• Baker’s Cyst Also known as a popliteal cyst, this condition refers to fluid-filled sacs that develop at the back of the knee. They are often caused by damage to the knee joint or surrounding tissues. When the cyst becomes enlarged or swollen, arthroscopic surgery may be necessary to repair the cartilage and remove fluid from the cyst.
• Patellofemoral Pain Syndrome (PFPS) Commonly known as “runner’s knee,” PFPS occurs when the patella does not track properly within the knee groove. When non-surgical treatments prove ineffective, arthroscopic surgery may be considered to improve patella tracking.

Details of the Procedure

How to Prepare for Knee Arthroscopy

Before the knee arthroscopy procedure, a comprehensive evaluation is conducted. This includes a thorough review of the patient's medical history and a physical examination. Lab tests or imaging studies, such as X-rays or MRI scans, are also ordered to assess the knee's condition and determine the patient's suitability for the procedure.

Patients will receive preoperative instructions, such as fasting for 6–12 hours before knee arthroscopy surgery. Patients should also inform their doctor about any current medications or supplements they are taking, as certain medications like ibuprofen or blood thinners may need to be temporarily discontinued for a few days or weeks before surgery.

What Happens During the Procedure?

To ensure the patient’s comfort, the procedure begins with anaesthesia. The surgeon will then clean the knee area and secure it with a stabilising device to keep it steady.

Next, the surgeon makes two or three tiny incisions around the knee joint. A sterile saline solution is gently introduced to expand the joint, providing a clearer view of the internal structures. An arthroscope is inserted through one of the incisions, allowing the surgeon to see detailed images of the knee on a monitor.

If treatment or repairs are needed, specialised miniature surgical tools are inserted through another incision to address the issue.

Once the procedure is complete, the surgeon carefully examines the knee joint for any signs of bleeding or potential damage. If everything is good, the incisions are then closed, and a sterile dressing is applied to protect the area and reduce the risk of infection.

Recovery and After-care

Depending on the findings and the treatment, knee arthroscopy procedures usually take less than an hour to complete. After surgery, patients may experience some pain and swelling in the knee area. The surgeon will prescribe pain medication and provide instructions on managing discomfort effectively. Additionally, patients may be advised to use mobility aids such as crutches or a supportive knee brace for several weeks.

A follow-up appointment will be arranged within a week or two to check the healing progress, discuss any surgical findings, and recommend a rehabilitation programme to help restore range of motion and strengthen leg and knee muscles. Most patients can resume regular activities approximately 6–8 weeks after the procedure.

FAQs About Knee Arthroscopy

Does Knee Arthroscopy Have Any Potential Risks or Complications? 

Knee arthroscopy carries some potential risks and complications, but they are generally rare. These may include:

• Infection around the knee
• Temporary or chronic knee stiffness
• Bleeding or blood clot formation in the knee joints
• Adverse reaction to anaesthesia
• Inadvertent damage to nerves or surrounding tissue

Rest assured that these risks are minimised in the hands of an experienced surgeon.

Can you immediately walk after undergoing knee arthroscopy?

You can walk on the operated knee immediately after surgery, depending on your comfort level. While it is important to maintain a normal gait, you should limit your walking during the first 24 hours.

If the knee is extremely painful, consider using crutches or a walker to minimise the weight placed on the affected leg. Your doctor will provide personalised instructions based on your recovery progress.

What are the different types of anaesthesia used in knee arthroscopy?

Before your knee arthroscopy, your doctor will administer anaesthesia. The type of anaesthesia used will depend on factors such as the extent of the procedure and your overall health. Options include:

• Local anaesthesia, which numbs the knee area only
• Regional anaesthesia, which numbs the area below your waist
• General anaesthesia, which will put you to sleep during the entire procedure.