Knee Arthroscopy

Overview

Knee arthroscopy is one of the most commonly performed orthopedic procedures. Like shoulder arthroscopy, it is a technique rather than a single operation. The surgeon works through small entry holes (portals) with a camera and thin tools. What gets done through the scope depends on what is found. The surgeon may trim a torn meniscus (partial meniscectomy), stitch one back together, remove loose pieces of bone or cartilage, smooth damaged cartilage (chondroplasty), or remove inflamed joint lining (synovectomy). Sometimes the goal is simply to look inside and confirm the diagnosis. The camera gives a direct view of the cartilage, the menisci, and the ligaments in more detail than an MRI can show. The portals are small (typically two to three, each about 1cm). Recovery is fast compared to open surgery, and most knee arthroscopies are outpatient procedures.

How the Procedure Works

You are under general or spinal anesthesia, so you feel nothing during the surgery. Your knee rests in a leg holder that lets the surgeon bend and straighten it for a clear view. One small portal on the outer side of the knee holds the camera. A second portal on the inner side holds the working tools. Sterile fluid fills the joint and keeps the view clear. The surgeon then checks each part of the knee in turn: the cartilage surfaces, both menisci, and the ligaments. Once the problem is found, it is treated. A torn meniscus is trimmed or stitched. Loose pieces are removed. Damaged cartilage is smoothed, or treated to help new tissue form (microfracture). The portals are closed with a stitch or skin-closure strips.

When to Consider Knee Arthroscopy

Mechanical symptoms from a meniscus tear
Catching, locking, or giving way from a torn meniscus that has not improved with conservative care.
Loose bodies
Loose pieces of cartilage or bone that float in the joint and cause locking or catching.
Diagnostic uncertainty
When imaging does not fully explain the symptoms, a direct look inside the joint can guide treatment.

Conditions This Treats

Physicians Who Perform Knee Arthroscopy

Michael S. Vrana, M.D.

David B. Templin, M.D.

Trent Twitero, M.D.

Risks & Why We Still Recommend It

Every operation carries risk. This procedure is offered because the condition, when left untreated, can cause persistent symptoms from a mechanical problem inside the knee that is unlikely to get better on its own. The decision to proceed weighs the risks of surgery against the limitations the condition places on daily function. Surgery does not remove risk; it addresses a problem that is otherwise progressive. Whether it is appropriate is determined for each patient in consultation with the surgeon.

Risks include infection, bleeding, blood clot (a clot in the leg or lung), stiffness, nerve or vessel injury, and progression of arthritis in the affected compartment. We recommend the procedure when a mechanical problem inside the joint is clearly the source of your symptoms and is unlikely to get better on its own.

Frequently Asked

questions we hear in clinic

Will I be asleep during the surgery?

You are under general or spinal anesthesia, so you feel nothing during the surgery.

Will I go home the same day?

Most knee arthroscopies are outpatient procedures, and recovery is fast compared to open surgery.

How big are the incisions?

Small. The surgeon works through portals, typically two to three, each about 1cm. They are closed with a stitch or skin-closure strips.

What can actually be fixed through the scope?

A torn meniscus can be trimmed or stitched back together, loose pieces of bone or cartilage removed, damaged cartilage smoothed (chondroplasty) or treated to help new tissue form (microfracture), and inflamed joint lining removed (synovectomy). What gets done depends on what is found.

Why operate if an MRI already showed the problem?

The camera gives a direct view of the cartilage, the menisci, and the ligaments in more detail than an MRI can show. When imaging does not fully explain the symptoms, a direct look inside the joint can guide treatment, and sometimes the goal is simply to confirm the diagnosis.