Knee Arthroscopy
Knee arthroscopy is a minimally invasive surgical procedure used to diagnose and treat a variety of knee injuries. During the procedure, Dr. Vashisht makes a small incision and inserts a thin instrument equipped with a tiny camera. This camera gives a clear view of the inside of your knee, allowing him to accurately identify and address the underlying problem.
What is knee arthroscopy?
Knee arthroscopy is a minimally invasive surgical procedure used to diagnose and treat a wide range of knee injuries. During the procedure, a small incision is made, and a thin instrument called an arthroscope, equipped with a tiny camera, is inserted into the knee. The camera sends clear, real-time images of the joint to a screen in the operating room, enabling the surgeon to accurately identify and assess any internal issues.
As one of the most commonly performed orthopedic procedures, knee arthroscopy uses small “keyhole” incisions, much smaller than those in traditional open surgery. To repair or remove damaged tissue, the surgeon uses specialized instruments through additional small openings, which helps minimize trauma, reduce pain, and promote faster recovery.
Who needs knee arthroscopy?
Your healthcare provider may suggest knee arthroscopy if you have persistent knee pain that hasn’t improved with nonsurgical treatments like rest, ice, anti-inflammatory medications, or physical therapy. While arthritis can also cause knee pain, arthroscopic surgery is not always effective for osteoarthritis.
Arthroscopy enables your surgeon to closely examine the cartilage, bones, and soft tissues within the knee joint, allowing for accurate diagnosis of various injuries. These injuries often involve the ligaments or cartilage, which are crucial for joint stability and movement.
Knee injuries are especially common among athletes and adolescents, particularly in sports that involve contact, rapid changes in direction, or frequent jumping, such as football, basketball, and volleyball.
Why do providers use knee arthroscopy?
Your healthcare provider uses knee arthroscopy to:
Diagnosing Injuries:
During knee arthroscopy, your healthcare provider carefully examines the inside of the joint to pinpoint the source of pain or swelling. The small camera provides detailed images of the cartilage, bones, and soft tissues, enabling an accurate diagnosis or confirmation of a preexisting condition. These visuals also assist the surgeon in planning the most effective treatment.
Repairing Damaged Tissues and Structures:
If repair is necessary, the surgeon uses specialized arthroscopic instruments to fix torn ligaments, tendons, or cartilage. Guided by real-time images on the monitor, they can precisely stitch or reconstruct soft tissues and even secure small bone fragments when needed. This minimally invasive approach allows for greater accuracy and faster recovery.
Removing Damaged or Inflamed Tissue:
When tissue damage or inflammation is causing pain, the surgeon may use tiny instruments to trim or remove frayed cartilage, damaged bone, or inflamed synovial tissue. This helps relieve discomfort, improve joint function, and prevent further irritation within the knee.
What conditions does knee arthroscopy treat?
You may need knee arthroscopy if you have:
Soft Tissue Injuries:
Soft tissues in the knee include ligaments, which connect bones, and tendons, which attach muscles to bones. These structures are crucial for knee stability and movement. Common soft tissue injuries include bursitis, meniscal tears, patellar tendonitis, anterior cruciate ligament (ACL) tears, and medial collateral ligament (MCL) tears. Such injuries often result from sports, sudden twisting motions, or repetitive overuse.
Fractures:
A fracture occurs when one or more bones in the knee joint break or chip. Sometimes, fragments of cartilage—the smooth, cushioning tissue between bones—can also break off. These injuries often cause pain, swelling, and limited knee motion, and may require surgical evaluation and stabilization.
Inflammation:
The synovium, a thin layer of tissue lining the inside of the knee joint, can become inflamed, resulting in a condition called synovitis. This inflammation leads to pain, swelling, and stiffness, and may arise from overuse, injury, or underlying conditions such as arthritis. Arthroscopy can help both diagnose and treat synovitis by allowing direct visualization and removal of inflamed tissue.
Treatment Details
What happens before knee arthroscopy?
Before undergoing knee arthroscopy, it’s important to tell your healthcare provider about all medications and supplements you are taking. Certain drugs, such as blood thinners, may need to be temporarily paused to reduce the risk of bleeding. Your provider will also give instructions on when to stop eating and drinking the night before the procedure to ensure safety during anesthesia.
Knee arthroscopy can be performed in a hospital or an outpatient surgical clinic. Before the procedure, anesthesia is administered to keep you comfortable and pain-free. Depending on your situation, you may receive:
Local anesthesia: Numbs only the knee area.
Regional anesthesia: Numbs the leg from the waist down.
General anesthesia: Allows you to sleep through the entire surgery.
Your healthcare provider will recommend the most appropriate option based on your overall health, the complexity of the procedure, and your personal comfort.
What happens during knee arthroscopy?
Once you are ready for surgery, your healthcare provider will follow several steps to ensure a safe and precise knee arthroscopy:
Preparation and Stabilization: Your leg is thoroughly cleaned and sterilized to reduce the risk of infection. The knee is then secured in a stabilizing device to keep it steady throughout the procedure.
Insertion of the Arthroscope: A small incision is made near the knee joint, and a slender metal instrument called an arthroscope is inserted. The arthroscope contains a tiny camera that transmits high-definition images of the inside of your knee to a monitor in the operating room.
Diagnosis and Treatment: Guided by these real-time images, the surgeon examines the knee’s internal structures to diagnose injuries and assess the extent of any damage. If repair is needed, additional small incisions are made to insert miniature surgical tools.
Repair and Removal: Using these instruments, the surgeon can repair torn ligaments or cartilage, smooth rough or damaged bone surfaces, and remove inflamed or loose tissue fragments to restore smooth joint movement.
Closure and Dressing: After the procedure, the incisions are closed with sutures or small adhesive strips and covered with a sterile dressing or bandage. The knee is then wrapped to protect it and reduce swelling as recovery begins.
What happens after knee arthroscopy?
Most knee arthroscopies are performed as outpatient procedures, allowing you to go home the same day. The surgery usually takes about an hour, though some cases may require a brief hospital stay for observation or pain management.
When discharged, it’s important to have someone drive you home, as anesthesia can leave you drowsy. Some pain and swelling are normal after surgery, and following proper post-operative care is key to a smooth recovery.
Guidelines for the first few days after surgery:
Limit Weight Bearing: Avoid putting weight on your operated leg initially. Crutches or a walker may be needed until your healthcare provider advises otherwise.
Elevate Your Knee: Keep your leg elevated above heart level as much as possible to reduce swelling and relieve discomfort.
Pain Management: Your doctor may recommend NSAIDs or prescribed pain medications. Take them exactly as directed. You may also receive medications to control swelling or prevent blood clots.
Wound Care: Keep incisions clean and covered. Do not remove bandages or get the area wet until cleared by your provider. Follow instructions on when it’s safe to shower or change dressings.
Once your knee has healed enough, your healthcare provider will likely recommend a physical therapy (PT) program. A tailored PT plan helps restore strength, flexibility, and range of motion. Your therapist will guide you through exercises to strengthen the knee muscles, improve balance, and reduce the risk of future injuries.
Risks / Benefits
What are the advantages of knee arthroscopy?
Minimally invasive procedures like knee arthroscopy generally allow for a quicker recovery than traditional open surgery. Because they require only a few small incisions, patients often return to normal activities sooner, experience less pain, and have a lower risk of infection.
What are the risks or complications of knee arthroscopy?
Complications from knee arthroscopy are uncommon. As with any surgery, there are potential risks, including bleeding and infection.
After the procedure, some patients may experience:
Blood clots
Knee stiffness
Swelling caused by blood collecting in the knee (this is rare)
Recovery and Outlook
When can I go back to my usual activities after knee arthroscopy?
Recovery after knee arthroscopy varies from person to person. Consult your healthcare provider to determine when it’s safe to resume daily activities, such as walking without assistance or driving. They may recommend waiting several weeks before returning to more physically demanding or strenuous activities.
In some cases, adjustments to lifestyle and activity levels may be needed. High-impact sports—especially those involving running or jumping—can place stress on your knee. Talk with your healthcare provider about safer, lower-impact activities that are easier on your joint.
When To Call the Doctor
When should I see my healthcare provider about knee arthroscopy?
Contact your healthcare provider right away if you experience any of the following:
Bleeding from the surgical site
Signs of infection, including fever, significant swelling, or pus draining from the incisions
Severe pain that does not improve with prescribed pain medications
A note from Cleveland Clinic
Knee arthroscopy is a safe and effective procedure that enables healthcare providers to diagnose and treat a variety of knee injuries without large incisions. As a minimally invasive surgery, it typically offers a shorter recovery time than traditional open surgery. Following a recommended physical therapy program after the procedure is important, as it helps restore mobility and supports a faster, smoother recovery.
