Knee Arthroscopy

Knee arthroscopy is a common surgical procedure performed using an arthroscope (a viewing instrument), to look into the knee joint to diagnose or treat a knee problem. It is a relatively safe procedure and a majority of patients discharge from the hospital on the same day of surgery.

The knee joint is one of the most complex joints of the body. The lower end of the thighbone (femur) meets the upper end of the shinbone (tibia) at the knee joint. A small bone called the patella (kneecap) rests on a groove on the front side of the femoral end. A bone of the lower leg (fibula) forms a joint with the shinbone.

To allow smooth and painless motion of the knee joint, articular surfaces of these bones are covered with a shiny white slippery articular cartilage. Two C-shaped cartilaginous menisci are present in between the femoral end and the tibial end.

Menisci act as shock absorbers providing cushion to the joints. Menisci also play an important role in providing stability and load bearing to the knee joint.

Bands of tissue, including the cruciate and collateral ligaments, keep the different bones of the knee joint together and provide stabilization to the joint. Surrounding muscles are connected to the knee bones by tendons. The bones work together with the muscles and tendons to provide mobility to the knee joint. The whole knee joint is covered by a capsule, which further stabilizes the joint. This capsule is also lined with a synovial membrane that secretes synovial fluid for lubrication.

Indications for Knee arthroscopy

The knee joint is vulnerable to a variety of injuries. The most common knee problems where knee arthroscopy may be recommended for diagnosis and treatment are:

Procedure

Knee arthroscopy is performed under general anaesthesia or sometimes under spinal anaesthesia. Your anaesthetist will decide the best method for you depending on your age and health condition.

The repair procedure may include any of the following:

After the repair, the knee joint is carefully examined for bleeding or any other damage. The saline is then drained from the knee joint. Finally, the incisions are closed with sutures or steri-strips, and the knee is covered with a sterile dressing.

After the Surgery

Most patients are discharged the same day after knee arthroscopy. Recovery after the surgery depends on the type of repair procedure performed. Recovery from simple procedures is often fast. However, recovery from complicated procedures takes a little longer. Recovery from knee arthroscopy is much faster than that from an open knee surgery. 

 

Patients are allowed to full weight bear on the operated leg after routine arthroscopy with only a soft bulky crepe bandage and without braces. Crutches or a knee brace may be recommended for several weeks in more complex surgery such as meniscal repair or ligament reconstruction. 

The operated knee is iced intermittently (cryotherapy) over the dressing for the first 24-48 hours as tolerated. The bulky dressings are removed the next day and the adhesive inner dressings are kept until wound review two weeks after surgery. In most cases, rehabilitation and physiotherapy can commence straight away.

Analgesics are prescribed to manage pain. Therapeutic exercises aim to restore motion and strengthen the muscles of the leg and knee.

Risks and complications

Knee arthroscopy is a safe procedure and complications are very rare. Complications specific to knee arthroscopy include bleeding into the knee joint, infection, knee stiffness, blood clots or continuing knee problems.

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