Arthroscopy of the Knee

Knee arthroscopy is commonly known as keyhole surgery. It involves a camera attached to a thin telescope that is inserted into the knee via a small incision. With the camera, the surgeon can look inside the knee itself and identify any problems. If the camera reveals any problems the surgeon can use small instruments that can be inserted via a second incision in the knee.

Common problems that are treated by arthroscopic surgery include meniscal cartilage tears, worn articular cartilage and problems with the soft tissues within the knee joint such as synovial plicas.

In addition, complex surgery such as cruciate ligament reconstruction can be performed using keyhole surgery techniques.

Medial Meniscal tear

What happens in surgery?

The surgery in generally performed as a day case under a general anaesthetic. The operation usually takes around 20 minutes to perform although the time taken may be longer for more complex procedures.

At the end of the operation your knee is injected with a local anaesthetic to minimise the post-operative pain. No stitches are required and the small wounds are closed with steristrips.

Types of arthroscopic knee surgery

Arthroscopic Menisectomy

Post Resection

In this operation a torn cartilage or meniscus is trimmed using special keyhole surgical instruments. The meniscus is a crescent shaped rim of cartilage between the femur (thigh bone) and tibia (shin bone). If it is torn, it can catch in the knee causing pain. Only the torn part is removed, leaving the remaining uninjured cartilage behind. Arthroscopic menisectomys have a high rate of success providing relief from knee pain.

Arthroscopic Chondroplasty

In this operation, damaged articular cartilage on the ends of the bones is trimmed. Flaps of worn articular cartilage can catch as the knee moves and create pain and discomfort. By trimming these areas of cartilage pain and mobility can be improved.

It is important to recognise that worn articular cartilage is, potentially, the start of osteoarthritis in the knee and that your knee will not be 'fixed' after an arthroscopic Chondroplasty. You may even find that the knee deteriorates further within a few years of the procedure. The rate of deterioration obviously depends on how extensive the worn cartilage is at the time of surgery.

Arthroscopic soft tissue debridement

Sometimes folds of tissue in the lining of the knee can catch and become inflamed. These tissue folds are called plicae. Not everybody has them and, even if you do, they may not be symptomatic. However, a plica may cause pain on the inside of the knee and around the patella.

The initial treatment is to have a course of physiotherapy. The majority of people should have a significant improvement in knee pain after physiotherapy, but if the course makes no difference it may be necessary to perform arthroscopic surgery. The plicae can be trimmed with a small arthroscopic shaver and the symptoms relieved.

What happens after surgery?

You will be mobilised after surgery by a physiotherapist and will be able to walk out of the hospital 3-4 hours after the surgery. You will need to have outpatient physiotherapy for a few weeks after your operation to get your knee to settle as quickly as possible.

Your mobility will improve each day after surgery. We expect you will be able to walk without crutches the next day and be comfortable to drive after 5-7 days. The steristrips need to be kept dry for 5 days and can then be removed.

If you have an office-based job you will need to take at least a week off work and possibly up to two weeks if your job is more physically demanding.

Your knee should be back to normal 8 weeks after your surgery.

Clare Park Hospital | Crondall Lane | Crondall | Farnham | Surrey | GU10 5XX

© Joint Reaction 2008