Knee arthroscopic (keyhole) surgery is the main method to treat cartilage and ligament injuries of the knee, although some of these can be treated non-operatively.



Doctors use arthroscopy to remove loose bone and cartilage and repair damaged tendons and ligaments. The procedure can also be used to confirm that your knee joint is injured or diseased. Arthroscopy is one of the most common orthopaedic procedures done in the UK. Most arthroscopies are done on patients between 20 and 60 years old, but patients of all ages can benefit from the procedure.

Arthroscopy is commonly used to correct such problems as cruciate ligament tears, meniscal tears, loose fragments of bone or cartilage, damaged joint surfaces or softened articular cartilage (chondromalacia), and abnormal alignment or instability of the kneecap. These problems can cause swelling, persistent pain, catching, giving way, and other symptoms that are not helped by medications, knee supports, and exercise.

Arthroscopy takes anywhere from 30 minutes to 2 hours to perform. It is typically done on an outpatient basis, which means you will not have to spend the night in the hospital. Still, you may have to fill out some paperwork such a consent form authorising your treatment. You will also need to have a presurgical medical evaluation.  

You will probably need to arrive at the hospital or surgical center 1 to 2 hours before surgery. Do not eat or drink anything after midnight the night before.

Depending on how long the arthroscopy will last, you will receive one of three types of anaesthesia medicine:

1) local, which numbs only your knee;

2) regional, which numbs below your waist; or

3) general, in which you sleep throughout the procedure.

Once the anaesthesia takes effect, the surgeon will make a few small incisions in your knee; he will use one of these incisions to insert a surgical tool called an arthroscope. The arthroscope is a small, soft tube with a light and a camera on the tip. The camera projects images of the inside of your knee onto a television screen, guiding the doctor as he manoeuvres the instrument. If a problem is detected, the doctor can perform immediate surgery by placing small instruments through the other incisions.

After he removes the arthroscope, the surgeon will close the hole with sutures (stitches) and put a bandage on the incision. You may be given medicine to ease post-op pain. You should be ready to go home in an hour or two. You will probably still be drowsy, so make sure you have someone to drive you home.

You will bounce back much faster from arthroscopy than you would from a major operation. Yet it is important to follow your doctor's instructions to make sure your recovery goes as smoothly as possible. Once the procedure is over, you should eat and drink fluids as soon as you feel up to it; and be sure to eat a healthy diet throughout your recovery.

Every person's recovery is different, but expect to feel a moderate amount of pain and swelling for several days, and minor pain for a few weeks. You can resume normal activities as soon as you are up to it. If you have a job where you sit most of the time, you should be able to return within a week.

By 6 to 8 weeks, you should be able to resume an active lifestyle. However, you will need to avoid activities that put significant amounts of weight on your knee, as well as those that involve twisting manoeuvres, for a long time. The outcome depends largely on the degree of damage found in your knee and how well you follow your doctor's instructions after surgery.

Although arthroscopy is very safe, there is a small chance the procedure will cause bleeding, infection, or a blood clot. The exact risk of complications depends on several factors, including your age, the type of surgery you have, and your overall health.

Always take your pain medication as prescribed. If you feel it is not helping, call your doctor. Do not take more or less on your own. Also watch for side effects, especially drowsiness; do not drive or use power tools until you know how the medicine affects you.

If you have been prescribed an antibiotic to prevent infection, finish all the medication even if you are feeling better. If you are visiting the dentist soon, ask your doctor if you need to take antibiotics beforehand.

For the first 24 hours, you may put an ice pack on your knee to reduce pain and swelling. Place ice in a plastic bag and wrap the bag in a towel to prevent the ice pack from directly touching your skin or bandage. Keep the ice pack on your knee for up to 2 hours at a time. Your doctor may advise you to keep your leg elevated while sitting.

Stay off your feet as much as possible for 24 to 48 hours, keeping your leg raised on two pillows as often as possible.

You will go home with a bandage on your knee. Once the doctor says it is alright to remove it, you can take a shower or short bath. However, do not let running water hit the incisions directly, and do not soak in the tub. Wash your incisions gently with soap and water.

Your doctor will give you specific instructions. To protect your knee, however, your doctor may ask you to use crutches, a cane, or a walker for a short time. As your pain improves and your knee gets stronger, you can gradually put more weight on your leg. You should be able to drive after a week.

A few days into your recovery, you may want to start walking outside, starting with short distances. Avoid running until 6 to 8 weeks after surgery.