Knee Arthroscopy

What is involved?

A knee arthroscopy, otherwise known as keyhole surgery, is a procedure whereby a small camera is inserted into the knee joint cavity through a stab incision at the front of the knee.  The camera is used to identify any pathology within the knee such as a meniscal tear or an articular cartilage defect that can then be treated using arthroscopic instruments.  A second portal is then created on the other side of the front of the knee through which a variety of instruments can be passed to treat underlying pathologies.  These include meniscal tears which can be repaired using special sutures or resected using arthroscopic scissors, articular cartilage defects which can be filled in using microfracture techniques or repaired using arthroscopic screws.  This technique can also be used to perform the majority of ligament reconstruction operations in conjunction with other small incisions around the knee

 

Why might I need a knee arthroscopy?

Knee arthroscopy is one of the most commonly carried out procedures in orthopaedics.  A multitude of knee pathologies and symptoms such as pain, swelling, instability and mechanical locking of the knee can be treated using arthroscopic techniques as detailed above.  Your treating surgeon will have an in-depth conversation with you about the symptoms you are suffering from and examine your knee to come to a diagnosis.  If your symptoms are related to a pathology that can be treated with keyhole surgery they may recommend an arthroscopy.

 

What happens after surgery?

Arthroscopic surgery is normally carried out as a daycase procedure under general anaesthetic.  Local anaesthetic will also be infiltrated around the knee to improve post-operative pain.  Immediately following the operation you will be able to fully mobilise, often without crutches. You will normally go home on the same day and will be followed up by your surgeon at 2 weeks to ensure things are progressing as planned.  Often the wounds do not require stitches and are closed with dressings alone.  These should stay on for 2 weeks following surgery and will be removed in the clinic at the appropriate time.

 

Recovery milestones

Week 0 – 2

It is important to rest the knee, elevate the leg, use ice and compression bandaging and appropriate analgesia to help with the pain and swelling following surgery.  You will normally be fully mobile throughout this time but often if you do too much on the knee over this first 2 weeks it will delay your ultimate recovery. 

 

Weeks 2 – 6

Over this period your gait pattern will return to normal and you will be able to go out for longer walks comfortably.  However we would not recommend in the first 6 weeks that you consider doing walks of over an hour at a time in order to prevent the knee becoming sore and swollen again.

 

Weeks 6 - 12

Over this period of time you can return to normal sporting activities. 

 

Frequently asked questions

  1. Can I have a knee arthroscopy for knee arthritis?

    The answer to this is normally no.  Evidence has shown that arthroscopic washouts, or ‘scrapes’, do not provide significant improvement in symptoms over a prolonged period of time. As such that the risks of the surgery normally outweigh the benefits.  We therefore would not normally recommend arthroscopy in the presence of significant knee arthritis.  The one caveat is that if you have significant locking symptoms secondary to loose bodies created by the arthritis, these can be improved with arthroscopic surgery. 

  2. When can I run after surgery?

    We would normally recommend not returning to long distance running for approximately 2-3 months following surgery to reduce the chance of flaring the knee up.

  3. When can I fly after surgery?
We would normally recommend not flying for 6 weeks following surgery and potentially 3 months for a long haul flights although the risks should be discussed in your particular case with your treating doctor.  We would also recommend taking anti-venous thromboembolism precautions when flying following surgery.