Knee Arthroscopy

How is it performed?

A knee arthroscopy is a minimally invasive surgical procedure used to repair or remove damaged structures within the knee joint. Sometimes a knee arthroscopy is called a knee “scope” when used to “clean up” the knee joint from inflamed and torn structures. 

Your surgeon will make small incisions called ports around your knee joint to insert an arthroscope which will project an image of your knee onto a screen. Your surgeon will move the camera of the arthroscope around your knee joint to examine the structures within your knee joint for damage. Once the damaged areas have been identified, your surgeon will insert surgical tools into your knee joint through the ports to remove or repair the damaged structures. 

Different types of procedures that can be performed during a knee arthroscopy include:

• ACL reconstruction: to create a new ACL from a tendon graft to replace a torn ACL
• PCL reconstruction: to create a new PCL from a tendon graft to replace a torn PCL
• Meniscus repair: to reattach a torn meniscus
• Meniscectomy: to remove a torn meniscus portion
• Lateral release: to loosen the patellar retinaculum, connective tissue that holds the patella (kneecap) in place, to decrease pulling of the patella out of alignment
• Plica removal: to remove irritated synovial membrane folds
• Arthroscopic debridement: to shave down frayed cartilage edges (chondroplasty) and remove torn pieces of cartilage and bone fragments from within the knee joint (loose body removal)
• Microfracture surgery: to drill holes into bone to increase blood flow and stimulate new cartilage growth
• Autologous chondrocyte implantation: to remove cartilage tissue, grow it in a lab, and implant it back into the knee joint to repair damaged cartilage
• Osteochondral autograft transplantation: to transplant healthy cartilage tissue from one area of the knee joint to another damaged area to repair damaged cartilage

If surgery is needed to repair or reconstruct your MCL or LCL, the operation will be performed as an open procedure where a small incision will be made on either side of your knee to access the damaged ligament. Knee arthroscopy can only be used to treat damage to structures within the knee joint, while the MCL and LCL are ligaments on the outside of the knee joint.

Surgery Recovery Timeline

Full recovery from knee arthroscopy will depend on the extent of the procedures performed during the operation. Knee arthroscopies that involve removal of damaged structures like bone spur fragments, cartilage, and torn meniscus portions typically require less rehabilitation and most people recover within 6-8 weeks. More involved procedures performed during a knee arthroscopy, such as a meniscus repair or reconstruction of the ACL or PCL, will require more extensive rehabilitation and can require six months to a year for full recovery.

If you have a sedentary job, you can generally return to work one to two weeks after your surgery. Jobs that require prolonged standing, walking, or bending can require you to take off 6-8 weeks or more depending on your progress with rehabilitation and how physically demanding your job duties are.

You may have weight bearing restrictions after knee arthroscopy in which you will need to limit the amount of weight you put through your leg while standing and walking in order to protect your knee joint as it heals. Oftentimes after knee arthroscopy, your surgeon will allow “weight bearing as tolerated,” which means that you will be able to stand, walk, and bear as much of your body weight through your operated leg as you can comfortably handle without significant pain. This is common for knee arthroscopies that involve a meniscectomy, lateral release of the patellar retinaculum, or removal of bone spurs, cartilage, or synovial membrane. 

More involved procedures like ACL or PCL reconstructions, meniscus repairs, or microfracture surgery may involve an initial period of non-weight bearing where you will not be able to put any weight on your operated leg until cleared by your surgeon.

You likely will need to use crutches to help you walk in the initial days and weeks after knee arthroscopy to help decrease the amount of weight on your leg. Your surgeon will inform you if and for how long you may have weight bearing precautions and when it is safe to begin full weight bearing on your operated leg. A physical therapist will be able to instruct you on how to use the crutches properly and when you are ready to safely stop using them when your strength, mobility, and gait (walking) pattern improve. Crutches are generally used for 4 weeks or less, but may be needed for a longer period of time if you had a more involved surgery.