Knee Arthroscopy

What is knee arthroscopy?

A knee arthroscopy (key-hole surgery) is where a camera is inserted into your knee joint and is used to diagnose damage to the cartilage surfaces, ligaments, or meniscus. In addition to functioning as a diagnostic aid, knee arthroscopy can be used to treat damage to those structures.

What is involved in knee arthroscopy surgery?

The steps involved in knee arthroscopy surgery include:

1. Diagnostic Arthroscopy

2-3 small (< 1cm) portals are created to allow passage of a camera and surgical tools into the knee joint. The whole joint is inspected for areas of damage.

2. Therapeutic procedures

The following procedures can be performed in order to treat pathology found within the knee:

Meniscal resection or repair

Trimming or repairing the torn meniscus within the knee. Read more about arthroscopic meniscectomy (trimming) or meniscal repair.

Chondroplasty

A motorized instrument (‘shaver’) or radiofrequency ablation device is used to smooth over any damaged cartilage within the knee.

Microfracture

Small holes are created in the bone beneath the area of cartilage damage. The bleeding that results from the holes can form a clot overlying the damaged cartilage. This clot turns into cartilage (fibrocartilage) in the area of cartilage loss. Although this type of cartilage is different than normal joint cartilage, the fibrocartilage will still act like a buffer.

Removal of loose bodies

Loose pieces of cartilage or bone that are causing catching and locking of the knee joint can be removed.

What is my follow-up schedule after the operation?

Approximately 1-2 weeks of leave from work is required for a desk-based job but depends on the type of work performed arthroscopically.

2 weeks

The wound dressings will be removed and the wound will be reviewed to ensure it has healed. The sutures will be removed at this stage.

8 weeks

The range of motion in the knee will be assessed. It is expected that you will be able to fully straighten the knee and bend it more than ninety degrees.

If a partial meniscectomy has been performed, a return to sport can be commenced from 6-8 weeks post-operatively.

Frequently Asked Questions

What are the risks of having a knee arthroscopy? +

General complications of knee arthroscopy surgery can include:

Infection

Although the risk of infection is extremely small following a knee arthroscopy, it can still occur. A deep infection of the knee joint may require surgical washout of the knee and antibiotics.

Bleeding

Bleeding can occur around the arthroscopic port sites or into the knee joint itself. This is usually self-limiting, but on rare occasions will require another operation to wash out the accumulated blood.

Deep vein thrombosis and pulmonary embolism

Clots can occur in the deep veins of the leg that may dislodge and occlude the arteries in the lungs. DVT presents as leg pain and swelling after your operation. The diagnosis is confirmed with an ultrasound scan and, depending on the type of DVT, may require treatment with blood thinners.

Specific complications of knee arthroscopy surgery can include:

Numbness around the arthroscopic portals

Despite using small (< 1cm) incisions to perform the arthroscopy, small branches of the saphenous nerve that supply the skin overlying the knee can become damaged. This will result in numbness around the incision site. On occasion, the damaged nerve will form into a neuroma that can be painful. If this pain is persistent, surgical removal of the neuroma can be considered.

When can I drive after a knee arthroscopy? +

You will not be able to drive for 4 weeks following a knee arthroscopy. You must be off strong painkillers, be walking without crutches and have a relatively painfree range of motion in the affected knee before your commence driving.

When can I swim after knee arthroscopy? +

The wound should be kept dry for two weeks following the operation. Once the wound healing is reviewed at your 2-week post-operative consultation you will be able to shower with no wound dressings on. Participating in pool based rehabilitation or swimming is not recommended for 4 weeks after your operation as it may increase the risk of infection.

When can I run or cycle after knee arthroscopy? +

This depends on what has been performed arthroscopically. For an arthroscopic meniscectomy, running and riding on a stationary cycle can commence from 2 weeks after surgery as pain and swelling allows.

When can I return to sport after knee arthroscopy and partial meniscectomy? +

If a medial meniscectomy has been performed, an average return to play would be at 6 weeks post-operatively. If a partial lateral meniscectomy has been performed then a return to sport is longer at 6 to 12 weeks post-oepratively depending on the type of sport being played.