Closed (minimally invasive) surgical method in which a camera is introduced through a few millimeter-sized incisions to visualize the inside of the knee joint and to treat meniscal, cartilage, and ligament problems.
Indication
- Meniscal tear (especially with catching, locking, or sudden knee pain)
- Anterior cruciate ligament (ACL) or posterior cruciate ligament tears
- Cartilage damage (chondral lesion, osteochondral defect)
- Loose bodies in the joint (bone or cartilage fragments)
- Recurrent patellar (kneecap) dislocation or chondromalacia
- Biopsy or partial synovectomy in synovial diseases
- Unexplained mechanical knee complaints unresponsive to conservative treatment
Preparation
- Pre-operative MRI to map the tear or damage
- Anesthesia evaluation, blood tests, and ECG (when needed)
- Discontinuation of blood thinners and certain herbal products with physician approval
- No food or drink for 6-8 hours before the procedure
- Smoking is preferably stopped at least 2-4 weeks beforehand to speed healing
How it's performed
- General or regional (spinal/epidural) anesthesia is administered
- Two to four small incisions (portals), a few millimeters in size, are created around the knee
- The joint is distended with fluid; a small camera (arthroscope) is inserted
- Based on the findings, a torn meniscus is repaired or its damaged portion is debrided, the cartilage is contoured, and ligament reconstruction is performed when needed
- The joint is irrigated, the small incisions are closed, and a compressive dressing is applied
- The procedure is generally completed with same-day discharge or after a single overnight stay
Post-procedure
- Cold application, elevation of the knee, and pain medication when needed during the first 24-48 hours
- Walking with crutches in the first few days; the amount of weight-bearing depends on the specific procedure
- Early physical therapy (begins in week 1-2): range-of-motion and edema control
- After meniscal repair, a 4-6 week restriction on full weight-bearing may apply; return is faster after a simple meniscectomy
- Return to sport after anterior cruciate ligament reconstruction generally takes 6-9 months
Risks
- Intra-articular infection (rare, below 1%)
- Risk of deep vein thrombosis (DVT) or pulmonary embolism (reduced with appropriate prophylaxis)
- Vascular or nerve injury (especially the saphenous nerve, rare)
- Joint stiffness or restricted motion
- Recurrence of symptoms or development of a new tear
- Anesthesia-related reactions
FAQ
What is the difference between knee arthroscopy and open surgery?
Arthroscopy is performed through small incisions; tissue trauma, pain, and recovery time are generally less than with open surgery. However, in some complex situations open surgery may be more appropriate.
When can I walk after the procedure?
Most patients can take a few steps with crutches on the same day. The time to full weight-bearing depends on the specific procedure; it may take days after a simple meniscectomy and weeks after meniscal repair or ligament reconstruction.
When can I return to sports?
Low-impact activities are generally possible within 4-6 weeks; contact sports within 6-12 weeks after a simple meniscectomy; and approximately 6-9 months after anterior cruciate ligament reconstruction. The decision is made together with the physical therapy team and the surgeon.
Does a meniscal tear always require surgery?
No. The location and type of the tear, the patient's age, and activity level are decisive. Some tears improve with physical therapy and activity modification; surgery is considered when there is mechanical locking, catching, or no response to conservative treatment.
Related Information
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