Understanding Minimally Invasive Knee Surgery

Arthroscopy is a common surgical procedure in which a joint (arthro-) is viewed (-scopy) using a small camera. Arthroscopy gives doctors a clear view of the inside of the knee. This helps them diagnose and treat knee problems.

Technical advances have led to high-definition monitors and high-resolution cameras. These and other improvements have made arthroscopy a very effective tool for treating knee problems. According to the American Orthopaedic Society for Sports Medicine, more than 4 million knee arthroscopies are performed worldwide each year.

Arthroscopy is done through small incisions. During the procedure, an orthopedic surgeon inserts the arthroscope (a small camera instrument about the size of a pencil) into your knee joint. The arthroscope sends the image to a television monitor. On the monitor, your surgeon can see the structures of the knee in great detail. Your surgeon can use arthroscopy to feel, repair or remove damaged tissue.

Almost all arthroscopic knee surgery is done on an outpatient basis. Arthroscopy can be performed under local (numbs just your knee), regional (numbs below the waist), or general anesthesia (puts you to sleep). The anesthesiologist will help you decide which method would be best for you. If you have local or regional anesthesia, you may be able to watch the procedure on a television monitor.

The orthopedic surgeon will make a few small incisions in your knee. A sterile solution will be used to fill the knee joint and rinse away any cloudy fluid. This helps your orthopedic surgeon see your knee clearly and in great detail.

Your surgeon’s first task is to properly diagnose your problem. Your surgeon will insert the arthroscope and use the image projected on the screen to guide it. If surgical treatment is needed, your surgeon will insert tiny instruments through another small incision.

Arthroscopy for the knee is most commonly used for:

  • Removal or repair of torn meniscal cartilage
  • Reconstruction of a torn anterior cruciate ligament
  • Trimming of torn pieces of articular cartilage
  • Removal of loose fragments of bone or cartilage
  • Removal of inflamed synovial tissue

Recovery from knee arthroscopy is much faster than recovery from traditional open knee surgery. Keep your leg elevated as much as possible for the first few days after surgery. Apply ice to relieve swelling and pain. Your surgeon will see you in a few days to check your progress, review the surgical findings, and begin your postoperative treatment program.

Your doctor will prescribe pain medication to help relieve discomfort and may also recommend medication such as aspirin to lessen the risk of blood clots.

You should exercise your knee regularly for several weeks after surgery. This will restore motion and strengthen the muscles of your leg and knee. A formal physical therapy program may improve your final outcome.

Unless you have had a ligament reconstruction, you should be able to return to most physical activities after 6 to 8 weeks, or sometimes sooner. Higher impact activities may need to be avoided for a longer time. If your job involves heavy work, it may be longer before you can return to your job. Discuss when you can safely return to work with your doctor.

You will need to talk with your doctor before returning to intense physical activities. The final outcome of your surgery will likely be determined by the degree of damage to your knee.