Knee arthroscopy

Your health expert: Henry Maxwell, Consultant Orthopaedic Surgeon
Content editor review by Eleanor Bird, January 2023
Next review due Jan 2026

Knee arthroscopy is a type of keyhole surgery used to diagnose and treat knee pain or other knee problems. It can be used for inflammation, damage, injury and infections.

An image showing the different parts of the knee

About arthroscopy

Your doctor may recommend you have a knee arthroscopy if you have ongoing knee pain and other symptoms.

Knee arthroscopy may not make your knee pain and stiffness better if you already have osteoarthritis. So it’s not often recommended to people who only have osteoarthritis pain.

But you may be offered a knee arthroscopy if:

  • you have osteoarthritis and your knee also catches or gives way
  • weight loss and exercise haven’t helped the pain associated with osteoarthritis after at least three months

During a knee arthroscopy, your surgeon will use a camera to look inside your knee for damage to the cartilage (meniscus), joint lining and ligaments. Your surgeon may also:

  • treat your knee – they may repair or remove any damaged tissue and cartilage (meniscus)
  • take small tissue samples (biopsies), which may help to diagnose problems such as infections
  • do some more complicated surgery, including surgery to repair torn knee ligaments or to treat an unstable kneecap

Your surgeon will use an arthroscope (a thin metal tube containing a camera) and small surgical instruments during your knee surgery. Images are shown on a screen. Your surgeon or doctor can save these images to show you after your surgery.

You should recover more quickly from knee arthroscopy than if you have open knee surgery.

Preparation for knee arthroscopy

Before your knee arthroscopy, you’ll meet the surgeon to discuss your operation and how you can prepare for it. This may be different from what’s described here because your operation will be designed to meet your individual needs.

If you smoke, you’ll be asked to stop. Smoking makes you more likely to get an infection after surgery, which can slow down your recovery. It can also make your surgery less likely to work and more likely to lead to complications.

Knee arthroscopy is usually done under general anaesthesia, but you may be able to have it under local or regional anaesthesia. A local anaesthetic numbs your knee and you’ll stay awake during surgery. A regional anaesthetic is a local anaesthetic that numbs a wider area of your leg. You’ll also stay awake for this but may be given a sedative to help relax you.

If you have a general anaesthetic, you’ll be asleep during the procedure. A general anaesthetic can make you sick. So, it’s important not to eat or drink anything for a specific amount of time before your arthroscopy. Your healthcare team will give you clear instructions about this.

You may be asked to wear a compression stocking on your other (unaffected) leg. This will help to prevent blood clots forming in the veins in your leg. Blood clots can cause deep-vein thrombosis (DVT). You may need to have an injection of an anti-clotting medicine (or tablets) as well.

You’ll usually be able to have knee arthroscopy and go home from hospital on the same day. But if you’ve had a regional anaesthetic, you may need to stay overnight. You’ll be able to leave the hospital once you can walk safely again.

Your surgeon will discuss with you what will happen before, during and after your surgery. If you’re unsure about anything, don’t be afraid to ask. It’s important that you are fully informed, so you feel happy to give your consent for the operation to go ahead. You will be asked to do this by signing a consent form.

Knee arthroscopy procedure

Knee arthroscopy usually takes less than an hour. But this depends on how much work your surgeon needs to do inside your knee joint.

You’ll be lying down on a table with your knee in a position so your surgeon can see it clearly. Your surgeon will wait for the anaesthetic to start working. Then they’ll make two or three small cuts (incisions) in the skin around your knee.

They’ll put sterile fluid into your knee joint to rinse it out. This will help them to see the inside of your knee more clearly. They’ll then insert a thin metal tube containing a camera (the arthroscope) into your knee joint and examine it by looking at images on a TV monitor.

Your surgeon will move the arthroscope around your entire knee, so they don’t miss anything. They may also take some photographs. Once they’ve diagnosed the problem, for most conditions they’ll carry out treatment at the same time.

This might include the use of other surgical tools to repair or remove damaged tissue, such as cartilage. If your cartilage becomes damaged by injury or wear-and-tear, it can cause pain and swelling. If this happens, the damaged cartilage may need to be removed.

Once they’ve finished looking inside your knee and performing any necessary treatment, your surgeon will drain the fluid out. Then they’ll close the cuts with stitches or sticky strips and wrap a dressing around your knee. When they have finished, they may inject local anaesthetic into your knee (around the cuts) for pain relief.

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Aftercare for knee arthroscopy

You’ll need to rest until the effects of the anaesthetic have worn off. It may take several hours before the feeling comes back into your knee. Take care not to bump or knock it during this time.

You may notice some discomfort and also some swelling as the anaesthetic wears off. This is a normal response to surgery, and you’ll be offered pain relief if you need it.

You’ll be able to go home when you feel ready. This is usually when you are mobile, can eat and drink, and control any pain you may have by taking tablets. Make sure someone can take you home. Ask someone to stay with you for a day or so while the anaesthetic wears off.

You may not be able to put weight on your leg for up to a week after your surgery, so you may need some help to stand or walk. Your hospital may give you crutches or a knee brace to take home. Your surgeon or nurse will give you advice on how to use these, and for how long.

A physiotherapist may give you some exercises to do. These will help you to move your knee and stop it getting stiff.1 Keep doing these exercises when you get home, they’ll help you recover more quickly.

Your nurse will give you some advice about caring for your wounds before you go home. You’ll usually have two to four cuts around your kneecap. These will be covered with a waterproof dressing. Your wounds will be closed with stitches, skin glue or wound closure tape (steri-strips). Or they may be left open to heal on their own. How long it takes for dissolvable stitches to disappear depends on which type you have. If you have non-dissolvable stitches, these are usually removed at your GP practice a week or two after your surgery.

You may be asked to wear a compression stocking while you recover. This will improve blood flow in your leg and reduce your chances of getting a blood clot.

You will be given a date for a follow-up appointment. This will usually be within six weeks after your surgery.

Recovery for knee arthroscopy

Everyone recovers from knee arthroscopy differently. How long it takes you to recover will depend on lots of things, including if you had any treatment during your knee surgery. It takes most people two to six weeks to recover completely. You may feel more tired than usual, so don’t do too much too soon. Ask your friends, family and neighbours to help you with practical tasks, such as food shopping or lifting heavy items.

After knee joint surgery, your knee is likely to feel sore and swollen. Try keeping your leg up and applying a cold compress such as ice or a bag of frozen peas. This may help to reduce swelling and bruising. Don’t put ice directly onto your skin because it can damage the skin; wrap the ice in a towel first.

While you are recovering, you should try to keep dressings clean and dry. Cover dressings with a plastic bag when washing if they are not waterproof. Your surgeon or nurse will tell you when it is safe to have a bath or shower and when you can take the dressings off.

If you need pain relief, you can take over-the-counter painkillers, such as paracetamol or ibuprofen. Always read the patient information that comes with your medicine. If you’re worried about anything, or have any questions, ask your pharmacist.

A general anaesthetic can affect you in many ways. You may find you’re not so co-ordinated or that it’s difficult to think clearly. This should pass within 24 hours. In the meantime, don’t drive, drink alcohol, operate machinery or sign any important documents. Always follow your surgeon’s advice.

You may be able to walk around almost straight after your surgery. But this will depend on why you had surgery and the type of surgery you had. Some surgeons recommend a week or two of rest, followed by gentle exercise and then sports later.

After around two to three weeks, you may be able to do some more strenuous activities. Stick to walking, swimming, gentle cycling and light exercise, as long as you’re comfortable. If you’re swimming, you may find breaststroke difficult. You should avoid impact sports for at least six weeks and may not be able to do some sports for the first six months. If unsure, check with your surgeon first.

You may feel ready to drive again a week after keyhole knee surgery but follow your surgeon’s advice. It’s important to let your insurance company know about your arthroscopy. Some companies have strict policies and won’t insure a driver until several weeks after their surgery.

Getting back to work or your daily routine may help you recover more quickly. But how much time you need to take off work after your knee surgery will depend on your job. If you work in an office, you may be able to go back to work within a couple of weeks. If your job involves heavy physical work, you may need to take up to six weeks off. Your surgeon and employer should be able to advise you.

You should avoid travelling by air for at least four to six days after your surgery. If you want to travel, you may have to delay your trip because of the risk of developing deep-vein thrombosis (DVT). This will depend on whether or not you have any other risk factors for DVT (such as your age) and the length of your flight. After having knee surgery under general anaesthesia, your risk of DVT is higher than if you hadn’t had surgery.

Always tell your surgeon if you’re planning to fly and follow their advice. It’s worth contacting the airlines to check their policies too.

Side-effects of knee arthroscopy

After keyhole knee surgery, you may:

  • have some pain and swelling around your knee – this can last for up to a week and is completely normal
  • notice small scars on your knee from the cuts
  • feel more tired than usual
  • notice you can’t bend your knee properly for the first few days

Speak to your healthcare team if your knee starts to bleed.

Complications of knee arthroscopy

Knee arthroscopy can cause a few complications. These include:

  • deep-vein thrombosis (DVT)
  • an infection inside your knee joint
  • clear fluid leaking out of your joint and out onto your skin
  • damage to the nerves in your skin, which can lead to you losing the feeling in the skin over your knee
  • muscle weakness – this can often be treated with physiotherapy 
  • compartment syndrome – this is when pressure builds up in a muscle to dangerous levels
  • accidental damage to the inside of your knee joint

If you have a torn or damaged cartilage removed from your knee joint during knee arthroscopy, this could make you more prone to osteoarthritis later. This is because removal of the cartilage increases pressure between the bones in the knee.

Alternatives to knee arthroscopy

Your doctor may be able to diagnose your knee problem by examining your knee or you may have an X-ray or a magnetic resonance imaging (MRI) scan.

Some knee problems can also be treated without surgery, using physiotherapy and medicines.

It takes most people between two and six weeks to recover from knee arthroscopy. However, everyone recovers differently. How long you take to recover depends on many factors, including the reasons for your surgery and if you had any treatment during your surgery.

Recommendations to help you to recover more quickly include:

  • eating a healthy diet
  • stopping smoking
  • maintaining a regular routine
  • doing any physiotherapy exercises you have been given

For more information, see our section on recovery.

Your knee may not recover completely after surgery. This will depend on why you had the surgery and how severe the damage was to your knee.

Some people still have some knee pain and stiffness after keyhole knee surgery. If you have osteoarthritis, knee arthroscopy may not give you long-term improvement in pain or function. Your surgeon will explain the pros and cons of surgery to you before you decide whether or not to go ahead.

For more information, see our section on recovery.

Knee arthroscopy is a type of keyhole surgery. Your surgeon will make a small cut or a series of small cuts around your knee. This means it is less invasive than some other types of surgery.

Knee arthroscopy surgery is usually performed under general anaesthesia, which means you will be asleep during the operation. It may also be performed under local or regional anaesthesia. In either case, you should be able to go home on the same day.

For more information, see our section on procedure.

It’s important to exercise regularly after your knee arthroscopy to get back your knee’s movement and strength. But you’ll need to take things easy at first. Your physiotherapist may recommend some exercises to do at home. You can also start with some gentle outdoor exercise, such as walking.

You should be able to get back to your usual activities after six weeks, but this will depend on your procedure. Your surgeon or physiotherapist will be able to advise you.

For more information, see our section on recovery.

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