A knee sprain is one of the most common musculoskeletal injuries. It can damage important joint structures, including the menisci, articular cartilage and ligaments. Knee arthroscopy is the principal surgical method for treating knee injuries. It involves inspecting the knee through small skin incisions, approximately 4–5 mm long, called arthroscopic portals. A miniature camera and instruments are introduced into the joint through these portals. This allows most injuries to be treated, shortens the hospital stay and speeds recovery compared with traditional open techniques.

Arthroscopy comes from “arthro”, meaning joint, and “skopein”, meaning to look. Literally, it means “to look inside a joint”.

The procedure uses a camera with precision optics to magnify the structures of the joint.

What is arthroscopy?

Knee arthroscopy is a minimally invasive procedure. A miniature camera approximately 4–5 mm in diameter is used to inspect the inside of the joint. Several small incisions, usually two or three, approximately 5–7 mm long are made in the skin over the knee. An arthroscope, or miniature camera, and miniaturised surgical instruments are introduced through them.

What is arthroscopy used for?

Arthroscopy can be both diagnostic and therapeutic. Diagnostic arthroscopy uses high magnification and high-definition images to show all joint structures precisely. It is particularly useful when clinical examination and imaging such as ultrasound and MRI do not clearly establish the cause of the patient's symptoms. Therapeutic arthroscopy can treat many injuries resulting from knee trauma as well as chronic diseases using arthroscopic techniques.

When is arthroscopy used?

Traumatic injuries:

  • meniscus injury
  • ligament injuries, including the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL)
  • articular cartilage injuries
  • recurrent patellar dislocation
  • post-traumatic loose bodies in the knee

Chronic diseases:

  • synovial membrane overgrowth in inflammatory and rheumatic diseases
  • early stages of knee osteoarthritis

What can be done during arthroscopy?

  • suture a torn meniscus or remove only the damaged part if the injury cannot be repaired
  • reconstruct the anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL)
  • repair articular cartilage damage using microfracture, defect-covering membranes, stem cells, platelet-rich plasma and other methods
  • remove overgrown synovial membrane
  • remove a loose body from the knee

What happens after arthroscopy?

After diagnostic arthroscopy and most therapeutic arthroscopies, patients can leave hospital within the first day. Some procedures, such as ligament reconstruction or extensive removal of overgrown synovial membrane, require a two-day stay. Aftercare depends on the extent of the procedure. Following diagnostic arthroscopy, patients use forearm crutches for a few days; the operated limb does not need immobilisation. Following therapeutic arthroscopy, patients use forearm crutches for several weeks, usually two to four, depending on the procedure. A knee brace is sometimes needed to protect the operated knee while allowing the patient to move. After therapeutic arthroscopy, every patient undergoes rehabilitation according to an individually selected programme.

Arthroscopy versus open techniques

Advantages of arthroscopy over open surgery include:

  • considerably less pain
  • considerably lower risk of postoperative complications
  • faster return to full function
  • excellent cosmetic results with small, almost invisible scars