Arthroscopic knee surgery may be a treatment option for certain types of knee pain. Arthroscopic surgery is a procedure that involves inserting a small camera inside the joint. Through other small incisions, instruments can be inserted to repair or remove damaged structures. Arthroscopic knee surgery is often called “scoping the knee” or knee arthroscopy.
Medical professional placing bandages on a patient’s knee.
Many different surgical procedures that are commonly performed arthroscopically were once performed through the larger incisions. The advantage of arthroscopy he is being able to perform those surgical procedures without damaging normal structures around the joint. By being less invasive, the hope is there will be less pain and a faster recovery.
However, arthroscopic surgery is still a major surgical procedure, involves risks, and requires appropriate postoperative rehabilitation. It is important that you understand the nature of any surgical procedure being considered, the risks involved, and the postoperative recovery that will be necessary to achieve a successful result.
Reasons to Perform Arthroscopic Knee Surgery
Not all causes of knee pain can be effectively treated with an arthroscopic procedure. Some of the reasons to perform an arthroscopic knee surgery include:1
- Torn Cartilage/Meniscus Surgery: Meniscectomy is the official name of the surgery that involves the removal of a portion of the meniscus cartilage from the knee joint. The meniscus is a shock-absorbing wedge of cartilage that sits between the bone ends to provide cushioning and support. Smaller meniscus tears can usually be trimmed to relieve the symptoms of a torn meniscus.
- Meniscus Repair: A meniscus repair is a surgical procedure done to repair the damaged meniscus. The meniscus repair can restore the normal anatomy of the knee and has a better long-term prognosis when successful. However, the meniscus repair is a more significant surgery. The recovery is longer, and, because of limited blood supply to the meniscus, repair of the meniscus is not always possible.
- ACL Reconstruction: The anterior cruciate ligament, or ACL, is one of four major knee ligaments. The ACL is critical to knee stability, and people who injure their ACL often complain of their knee giving out from under them. Therefore, many patients who sustain an ACL tear opt to have surgical treatment of this injury. A majority of the ACL surgery is performed arthroscopically.
- Plica Excision: A plica is a remnant of tissue left over from fetal development. In early development, your knee was divided into separate compartments. The dividers of the compartments are gradually lost over time, but some remnant remains. When this remnant tissue is more prominent, it is called a plica. When the plica is irritated, it is called plica syndrome. A plica resection is performed to remove this irritated tissue.2
- Lateral Release: The kneecap moves up and down the end of the thigh bone in a groove of cartilage. The kneecap can be pulled to the outside of this groove, or may even dislocate from the groove, causing pain with bending of the knee joint. A lateral release is performed to loosen the ligaments that pull the kneecap toward the outside of the groove.3
- Microfracture: Microfracture is a treatment used to stimulate the body to grow new cartilage in an area of damaged cartilage.4 In a microfracture procedure, the firm outer layer of bone is penetrated, to expose the inner layers of bone where marrow cells exist. These cells can then access the damaged area and fill in the gap of cartilage.
- Autologous Chondrocyte Implantation: In this procedure, arthroscopic surgery is used to identify areas of cartilage damage and harvest cartilage cells.5 The person’s own cells are then grown in the lab and reimplanted in the joint in a separate procedure, which is an open surgery rather than arthroscopic surgery.
- Cartilage Transfer/OATS: Cartilage transfer involves moving cartilage from healthy parts of the joint to damaged areas. Small plugs of cartilage are removed, with a portion of underlying bone, and transferred to the area of damage. The plugs are taken from areas of the joint where the cartilage surface is not needed.
Performing Arthroscopic Knee Surgery
Knee arthroscopy can be done under general, regional, or local anesthesia. After adequate anesthesia, your surgeon will create ‘portals’ to gain access to the knee joint. The portals are placed in specific locations to minimize the potential for injury to surrounding nerves, blood vessels, and tendons. Through one portal, a camera is placed into the joint, and through others, small instruments can be used to address the problem. Patients who have arthroscopic knee surgery under a regional or local anesthesia can often watch their surgery on a monitor to see what is causing their problem.
The length of the knee arthroscopy procedure varies depending on what your doctor needs to accomplish. After surgery, your knee will be wrapped in a soft bandage. Depending on the type of surgery performed, your doctor may or may not allow you to place weight on the affected leg.1 Most patients will work with a physical therapist to regain motion and strength of the joint. The length of rehabilitation will also vary depending on what procedure is performed at the time of surgery.
Complications of arthroscopic knee surgery include infection, swelling, and blood clots in the leg.1 Complications are unusual after knee arthroscopy, and while they are cause for concern, knee arthroscopy is considered a low-risk surgical procedure.
A Word From Verywell
Arthroscopic knee surgery is among the most common surgical procedures performed by an orthopedist. A variety of surgical procedures can be performed arthroscopically, utilizing small incisions and minimizing soft tissue damage. Not every surgical procedure can be performed through the small incisions, and there are some procedures that may be better performed through direct visualization rather than through a scope. That said, arthroscopy has tremendous benefits for many types of knee surgery, and can help people return to athletic and daily activities much sooner than they used to be able to.