Knee arthroscopy: 5 things you need to know

Knee arthroscopy is a widely used orthopaedic procedure that allows surgeons to both diagnose and treat a range of knee conditions using minimally invasive techniques.

Understanding how it works, who it is suitable for, and what recovery involves, can help patients to make informed decisions about their care.

What is knee arthroscopy?

Knee arthroscopy is a keyhole surgical procedure used to examine and treat problems inside the knee joint. It involves the use of a small camera, known as an arthroscope, which is inserted through tiny incisions in the skin.

This camera provides a clear and detailed view of the structures within the knee, enabling the surgeon to assess damage accurately. Fine surgical instruments can then be introduced through additional small incisions to carry out the necessary treatment without the need for open surgery.

What treatments can be performed using knee arthroscopy?

A variety of knee conditions can be managed using arthroscopy, depending on the underlying problem.

Common procedures include treatment of meniscal tears, either by repairing the damaged tissue or removing the affected portion. Cartilage damage can also be addressed using techniques such as microfracture or chondroplasty to improve joint surface function.

Arthroscopy is also frequently used during ligament procedures, including reconstruction of the anterior cruciate ligament. In addition, it can be used to remove loose fragments within the joint, which may result from previous injury.

The procedure allows the surgeon to confirm the diagnosis visually before proceeding with treatment using specialised instruments.

Who should have a knee arthroscopy?

Knee arthroscopy is generally considered for patients who continue to experience symptoms despite appropriate non-surgical treatment. These symptoms may include pain, swelling, locking, or instability of the knee.

Before recommending surgery, a thorough clinical assessment is carried out. This usually includes imaging, such as MRI scans, to provide detailed information about the structures within the knee.

All treatment options are discussed in advance, including the potential benefits and risks of surgery, as well as alternative approaches. This ensures that the chosen treatment is appropriate for the individual’s condition and expectations.

What is recovery like?

In most cases, knee arthroscopy is performed as a day-case procedure, allowing patients to return home on the same day. Many individuals are able to walk shortly after surgery, sometimes with the support of crutches.

Recovery will vary depending on the specific procedure performed. Some patients may need to reduce weight-bearing or use a knee brace, particularly after meniscal repair or cartilage procedures.

Return to normal daily activities often occurs within two to six weeks. However, recovery may take longer in more complex cases, such as ligament reconstruction, where a return to sport can take several months.

A structured physiotherapy programme is usually recommended to support recovery and restore strength and mobility.

What is a ‘knee washout’?

The term ‘knee washout’ refers to a procedure that was previously used to treat established osteoarthritis by flushing out the joint using arthroscopy.

This approach has been widely reviewed, and current evidence does not support its routine use for most patients with osteoarthritis. Guidance from the British Association for Surgery of the Knee (BASK) advises against arthroscopy in these cases, as it doesn’t provide meaningful long-term benefit.

Knee arthroscopy remains an effective and appropriate treatment for many specific knee conditions, but careful patient selection is essential to ensure the best outcomes.