Knee Arthroscopy

Contents

Overview of the Procedure

Knee arthroscopy is a minimally invasive surgical procedure that allows orthopaedic surgeons to visualize, diagnose, and treat problems inside the knee joint. At KLSMC, our specialists perform this procedure using a small camera (arthroscope) that is inserted into the knee through tiny incisions, typically 5-10mm in length. The arthroscope displays real-time images on a high-definition monitor, enabling the surgeon to examine the knee structures with exceptional detail and precision.

During the procedure, the patient is placed under anesthesia (either general or regional). The surgeon makes 2-4 small incisions around the knee and inserts the arthroscope through one of them. Sterile fluid is pumped into the joint to expand it, providing a clearer view and working space. Additional small incisions serve as entry points for specialized surgical instruments used to address various knee conditions. After completing the necessary treatment, the fluid is drained, incisions are closed with sutures or surgical tape, and the knee is bandaged.

Types of the Procedure

Diagnostic Knee Arthroscopy

This procedure is performed to evaluate and accurately diagnose knee problems when MRI or other imaging studies have been inconclusive or when symptoms persist despite conservative treatment. It allows direct visualization of the meniscus, cartilage, ligaments, and other knee structures, providing valuable information for treatment planning.

Meniscus Surgery

Arthroscopy is commonly used to address meniscus tears, either by repairing the torn tissue (meniscus repair) or removing the damaged irreparable portion (partial meniscectomy). A meniscectomy involves the removal of the frayed or torn parts of the meniscus that cannot be sutured back together. This procedure helps reduce mechanical irritation in the joint, relieving pain and improving function. The decision between repair and removal depends on the tear pattern, location, and the patient’s age and activity level.

Cartilage Procedures

Arthroscopic techniques address damaged cartilage through various methods, including debridement (cleaning up loose cartilage), microfracture (creating small holes in the bone to stimulate cartilage growth), or chondroplasty (smoothing damaged cartilage). Our preferred method is to do microdrilling (holes are closer and deeper compared to microfracture) with our KLSMC patented microdrill.

Plica Resection

The synovial plica is a normal fold in the joint lining that, in some people, can become inflamed or thickened due to repetitive motion or injury. When this causes knee pain or a catching sensation (commonly known as plica syndrome), arthroscopic plica resection can be performed. This involves carefully removing the problematic plica band to relieve discomfort and restore smooth joint movement.

Ligament Reconstruction

While the actual reconstruction of ligaments (such as the ACL or PCL) involves more extensive techniques, arthroscopy is used during these procedures to visualize the joint, prepare the attachment sites, and assist with proper graft placement.

Synovial Treatment

For conditions involving the synovium (joint lining), such as synovitis or plica syndrome, arthroscopy can be used to remove inflamed tissue or problematic plica bands that are causing pain or mechanical symptoms.

Lateral Release

Patients with lateral patella release maltracking experience anterior knee pain especially with climbing stairs/squatting. This is due to overload of the patella forces on the lateral aspect of the patello-femoral joint and eventually leads to cartilage thinning.

An arthroscopic-assisted lateral patella release will restore normal patella maltracking to achieve normal force distribution and hence reduce pain. The procedure involves releasing tight structures on the outer side of the knee, particularly the lateral retinaculum, which helps the kneecap track more centrally within its groove. This is especially beneficial for patients with chronic kneecap instability or pain from lateral pressure syndrome.

What Happens After the Knee Arthroscopy?

After surgery, you will be admitted for observation.

Pain management typically involves a combination of over-the-counter and prescription medications for the first few days. Ice therapy is recommended to reduce swelling and discomfort. You’ll receive specific instructions on wound care and how to manage the dressings.

Physical therapy often begins the next day after surgery, with the initial focus on regaining range of motion and basic knee control. Follow-up appointments will be scheduled to monitor your healing progress, remove any non-absorbable sutures, and adjust your rehabilitation program as needed.

What Are the Benefits / Risks of Knee Arthroscopy?

Benefits:

Minimally Invasive: Smaller incisions compared to open surgery, resulting in less post-operative pain
Faster Recovery: Quicker return to activities compared to traditional open surgery
Reduced Scarring: Small incisions heal with minimal visible scarring
Detailed Visualization: Superior view of joint structures for accurate diagnosis and treatment
Versatility: Can address multiple knee problems during a single procedure
Less Tissue Disruption: Surrounding healthy tissues experience minimal trauma

Risks:

Infection: Though uncommon with arthroscopic procedures, surgical site infections can occur
Bleeding: Minor bleeding into the joint or around incision sites
Blood Clots: Deep vein thrombosis is a rare but serious potential complication
Implant Problems: Loosening, wear, or dislocation of the prosthetic components over time
Nerve or Vessel Damage: Injury to structures near the surgical site
Stiffness: Inadequate rehabilitation can lead to limited range of motion
Anesthesia Risks: Standard risks associated with anesthesia

How Long Is the Recovery Period from Knee Arthroscopy?

Recovery timelines vary significantly based on the specific procedure performed within the arthroscopy:

Basic Diagnostic Arthroscopy or Minor Debridement:

Initial Recovery (1-2 weeks): Control swelling, regain basic mobility. Many patients walk without crutches within days.
Functional Recovery (2-4 weeks): Return to normal daily activities and light exercise.
Full Recovery (4-6 weeks): Most patients can resume all regular activities, including sports.

Meniscus Procedures:

For partial meniscectomy, recovery follows a timeline similar to minor debridement, with most activities resumed by 4-6 weeks.
For meniscus repair, recovery is more prolonged, with protected weight-bearing for 4-6 weeks and full recovery taking 3-6 months.

Cartilage Procedures:

Recovery from microdrilling or similar cartilage procedures typically requires 6-8 weeks of protected weight-bearing and full recovery over 4-6 months.

Ligament-Related Procedures:

When arthroscopy is part of ligament reconstruction, recovery follows the timeline of the reconstruction, typically 9-12 months for full return to sports.

At KLSMC, our sports medicine specialists and physical therapists work together to create a customized rehabilitation program that optimizes your recovery timeline based on your specific procedure and goals.

What Can You Do to Help Recovery After Knee Arthroscopy?

Follow Weight-Bearing Instructions: Adhere to your surgeon’s guidelines on how much weight to put on your operated leg
Control Swelling: Use ice therapy for 15-20 minutes several times daily and keep your leg elevated when sitting or resting
Perform Prescribed Exercises: Complete your rehabilitation exercises as instructed to restore normal knee function
Attend Physical Therapy: Participate actively in all scheduled therapy sessions
Manage Pain Appropriately: Take medications as prescribed to control discomfort
Maintain Proper Wound Care: Keep incisions clean and dry until fully healed
Monitor for Complications: Watch for signs of infection or unusual symptoms
Progress Activities Gradually: Increase your activity level step by step without rushing the process
Wear Compression Garments: If recommended, use compression wraps or sleeves to control swelling
Maintain Overall Health: Focus on nutrition, hydration, and rest to support your body’s healing processes

Next Steps

If you’re experiencing knee pain or have been diagnosed with a knee condition that may benefit from arthroscopic treatment, here’s how to proceed at KLSMC:

Schedule a Consultation: Call our appointment line at +603-2096 1033 or use our online booking system to arrange an evaluation with one of our orthopaedic specialists.
Prepare for Your Visit:
a. Bring any previous imaging studies (X-rays, MRIs) related to your knee
b. Make a list of your symptoms, including when they started and what activities make them worse
c. Note any previous treatments or therapies you’ve tried
d. Prepare questions about the procedure, recovery, and expected outcomes
Assessment Process: Your initial consultation will include a thorough physical examination and review of your medical history. If not already completed, diagnostic imaging such as an MRI may be ordered to help diagnose your condition.
Treatment Planning: If knee arthroscopy is recommended, our team will discuss the specifics of your procedure, what to expect during recovery, and answer any questions you may have.
Financial Considerations: Our patient care coordinators can provide information about procedure costs, insurance coverage, and payment options.

Don’t let knee pain limit your mobility and quality of life. Contact KLSMC today to learn how our experienced surgical team can help you return to the activities you enjoy.

FAQ

Is knee arthroscopy major surgery?

Knee arthroscopy is considered minor to intermediate surgery, significantly less invasive than traditional open knee procedures. It uses small incisions (usually 5-10mm), causes less tissue disruption. However, while the surgical approach is minimally invasive, the internal procedures performed can vary in complexity. Your recovery timeline will depend more on what was done inside your knee than on the arthroscopic approach itself. Despite being less invasive, arthroscopy still requires proper rehabilitation and recovery time.

What can I expect the first week after knee arthroscopy?

The first week after knee arthroscopy typically involves managing swelling and discomfort while beginning basic movement. You’ll likely experience some pain, swelling, and stiffness, which gradually improve over the weeks. Depending on your specific procedure, you may use crutches briefly or begin walking immediately. Initial bandages usually remain in place for 48-72 hours, after which showering is permitted with incisions covered. Basic exercises often begin immediately, focusing on gentle range of motion and muscle activation. Most patients can return to desk work within a few days to a week, though you will need to elevate your leg periodically and limit prolonged standing or walking.

How long before I can drive after knee arthroscopy?

The timeline for returning to driving varies based on several factors, including which knee was operated on and the specific procedure performed. Generally, for left knee surgery with an automatic transmission, driving may resume when you’re off pain medications and comfortable moving the leg, typically within 3-7 days. For right knee surgery (affecting the brake/accelerator foot), most surgeons recommend waiting until you have adequate control. Key requirements include being off narcotic pain medications, having sufficient range of motion to operate pedals safely, and having the strength and reaction time to brake in an emergency. Always follow your surgeon’s specific recommendations.

Will I need physical therapy after knee arthroscopy?

Most patients benefit from physical therapy after knee arthroscopy, though the duration and intensity vary based on the specific procedure performed. For minor procedures like diagnostic arthroscopy or simple debridement, you might need only a few sessions to learn appropriate exercises. For more extensive procedures like meniscus repair or cartilage work, a comprehensive physical therapy program lasting 6-12 weeks is typically recommended. Physical therapy focuses on restoring range of motion, rebuilding strength, improving balance and proprioception, and eventually progressing to sport-specific or functional activities. Research shows that supervised rehabilitation improves outcomes and reduces the risk of recurrent problems.

What activities should I avoid after knee arthroscopy?

In the early recovery period (first 1-2 weeks), avoid activities that increase swelling, such as prolonged standing, walking, or sitting with your leg down. High-impact activities (running, jumping, pivoting sports) should be avoided until cleared by your surgeon—typically 4-6 weeks for minor procedures but potentially several months for more extensive treatments. Squatting with heavy weights should be avoided until full strength returns. For meniscus repairs, deep squatting and pivoting are restricted for 3-4 months to protect the healing tissue. Always follow your surgeon’s specific guidelines, as restrictions vary significantly based on the procedure performed and your individual healing progress.