Knee arthroscopy is a closed operation performed by inserting a camera and fine surgical instruments into the knee joint through two or three small incisions. It is one of the most commonly performed surgical procedures in orthopedics, and it is possible to both identify and treat many intra-articular problems in a single session. The operation is usually done as a day case — the patient returns home the same day.
The main indications for knee arthroscopy are: repair or partial trimming of meniscus tears, removal of intra-articular loose bodies, treatment of cartilage damage (microfracture, debridement), cleaning of synovitis (inflammation of the joint lining), treatment of plica syndrome, and irrigation in the case of joint infection (septic arthritis). Ligament reconstructions are also performed with arthroscopic assistance but are planned as a separate operation.
Before surgery, intra-articular pathology is evaluated with MRI. However, MRI does not always give a definitive diagnosis — especially in cartilage damage and small meniscus tears, there can be discrepancies between MRI findings and arthroscopic findings. For this reason, during surgery the surgeon systematically evaluates the entire joint, and pathologies not visible on MRI are also treated.
The operation is performed under spinal or general anesthesia and takes an average of thirty to forty-five minutes. Two portals (each about five millimeters) are usually made at the front of the knee. A camera is inserted through one and surgical instruments through the other. At the end of the operation, sutures are placed or the incisions are closed with steri-strips. A drain is usually not needed.
The recovery process varies according to the procedure performed. After a simple meniscus trimming, the patient can walk the next day bearing full weight and returns to daily activities within two to four weeks. If a meniscus repair was performed, the patient walks with partial weight for four to six weeks and full recovery takes three to four months. In cartilage microfracture procedures, the patient walks with crutches for six to eight weeks.
For the first three days after surgery, the RICE protocol (rest, ice, compression bandage, elevation) is applied. Starting quadriceps muscle exercises immediately prevents joint stiffness and muscle wasting. Straight-leg raises and isometric quadriceps contractions are the simplest but most effective early-period exercises. The physical therapy program usually begins two to four weeks after surgery.
Knee arthroscopy is an operation with a low complication rate — the rate of serious complications is below one percent. The most common problems are intra-articular swelling, temporary pain, and numbness at the portal site. Deep vein thrombosis and infection are rare but complications to watch for. If pain, swelling, or fever develops in the calf after surgery, consult your doctor immediately.
Is arthroscopy the solution for every knee pain? No. In advanced knee arthritis (gonarthrosis), the long-term benefit of arthroscopic irrigation and debridement has not been proven. In arthritic knees, arthroscopy should be considered only if a mechanical problem (a loose body, or a meniscus tear causing locking) accompanies it. Correct patient selection directly determines the benefit gained from arthroscopy.