Arthroscopy of the knee is surgery undertaken by an orthopaedic surgeon, which allows for diagnosis and treatment of problems within the knee joint. It is often referred to as a “key hole” surgery. Small incisions around the knee joint allow the surgeon to use an arthroscope connected to a camera which allows visualisation of the structures within the knee joint. Small incisions mean a faster recovery after surgery and often this sort of surgery can be performed as a day surgery.
Arthroscopy can only be undertaken after your surgeon has conducted a thorough medical history and examination of you knee, often supplemented by further investigations such as X-rays or MRI scans. After this a decision will be made whether to proceed to surgery. Surgery can be undertaken for either further diagnosis of a knee problem or treatment of this problem.
Arthroscopy not only allows faster recovery from surgery, but also better visualisation of the joint than can often be seen even with a large incision.
Common problems that can be treated by arthroscopy are:
- Meniscal tears (cartilage damage);
- Ligament injuries;
- Loose fragments within the joint;
- Damaged joint surfaces;
- Synovitis (inflammation of the joint lining).
Meniscal injuries can occur during a twisting or bending movement of the knee. They can also be damaged as a result of wear and tear due to ageing. These injuries will often result in knee pain and swelling, as well as clicking and occasionally locking of the knee joint. Torn fragments of the meniscus can be removed arthroscopically. Occasionally, meniscal injuries can be repaired using sutures within the knee joint.
Ligament injuries can occur with falling or twisting injuries. These can lead to episodes of instability where the knee gives way. Some knee ligaments do not require surgery and will heal on their own. The cruciate ligaments will not heal without surgery and often require surgery for reconstruction. This can be performed arthroscopically.
Loose Fragments of Bone or Cartilage
Loose fragments of bone or cartilage can cause irritation and swelling throughout the knee joint. They may occasionally cause locking within the knee joint and damage to the joint surfaces. These can be removed using the arthroscope.
Damaged Joint Surfaces
Damage to the surfaces of the joint can occur as a result of a twisting injury or blow to the knee, or as a consequence of ageing or wear and tear. This can cause pain and swelling throughout the knee joint. When all of the cartilage has been worn away and the bone underneath is exposed this is known as osteoarthritis. In the early stages arthroscopy may benefit damaged joint surfaces. In severe disease other surgery is required such as a bone realignment procedure or total knee replacement.
Synovitis is inflammation of the lining of the knee joint. This can cause swelling and pain and restrict movement. If this is severe the lining of the joint can be removed with arthroscopy, which often improves symptoms.
Why have arthroscopy?
Arthroscopy is a generally a safe procedure that can often be performed as a day surgery procedure. Arthroscopy lessens the discomforts and risks associated with procedures performed through large incisions. It allows for a quicker return to work and sporting activities. Most patients will return to work or school within 2 weeks of their surgery. It will take at least 6 weeks to return to sports.
What are the risks?
Complications from arthroscopy are uncommon. These include infection, swelling of the knee / bleeding within the knee, only minor improvement of symptoms, damage to blood vessels or nerves.