Overview
Knee arthroscopy is a minimally invasive surgical procedure that allows many knee conditions to be treated through small incisions using a small camera and specialized instruments. One of the major focuses of my Sports Medicine Fellowship training was arthroscopic surgery, and it remains one of the procedures I perform most frequently.
Arthroscopy provides excellent visualization of the knee while minimizing damage to the surrounding muscles and soft tissues. This typically results in smaller incisions, less pain, a lower risk of infection, and a faster recovery compared with traditional open surgery. The knee is divided into three compartments that are carefully evaluated during arthroscopy: the medial compartment, the lateral compartment, and the patellofemoral compartment.
Common Arthroscopic Procedures
Meniscectomy
Removal of the torn portion of the meniscus while preserving as much healthy tissue as possible. I think of this much like pruning a tree—first removing the damaged branches, then reshaping what remains to preserve as much healthy meniscus as possible.
Meniscus Repair
Peripheral tears within the red zone may be repaired using sutures rather than removed. Because the meniscus must heal, rehabilitation is substantially longer and includes weight-bearing and motion restrictions that are not required after a simple meniscectomy.
Chondroplasty
Remove unstable flaps of articular cartilage and transition as smoothly as possible from good to bad areas.
Loose Body Removal
Once identified, loose bodies are usually removed quickly through the arthroscope.
ACL Reconstruction (Arthroscopically Assisted)
The arthroscope allows evaluation of the entire knee while treating associated injuries such as meniscus tears or cartilage damage. The reconstruction is then completed through small incisions using specialized techniques.
Recovery
Most knee arthroscopy procedures are performed as outpatient surgery. Patients generally have two small portal incisions closed with dissolving stitches that do not require removal. Incisions are typically kept dry for approximately one week. Most procedures allow immediate weight-bearing, although rehabilitation varies depending on the procedure performed. Simple meniscectomy and loose body removal often allow return to unrestricted activities within 3–4 weeks, whereas meniscus repair and ACL reconstruction require substantially longer rehabilitation.
Complications
Knee arthroscopy has an excellent safety profile and a very low complication rate.
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Infection: Very rare following arthroscopic surgery.
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Blood Clots (DVT/Pulmonary Embolism): All patients are routinely placed on postoperative anticoagulation, most commonly a baby aspirin for approximately one month. Patients with previous history of deep vein thrombosis (DVT) or pulmonary embolism (PE) generally require stronger anticoagulation following surgery.