What Is Knee Arthroscopy?
Minimally invasive keyhole surgery to diagnose and treat a wide range of knee conditions, with a faster recovery than open surgery.
Knee arthroscopy is a minimally invasive surgical procedure. A small telescope with a camera, called an arthroscope, is inserted into the knee. This is done through an incision usually around 5 to 10 millimetres long. The camera projects a magnified view of the inside of the joint onto a screen. This lets the surgeon inspect the cartilage surfaces, the menisci, the cruciate ligaments and the joint lining (synovium) in detail.
Through one or more additional small incisions, fine instruments can be passed into the knee to carry out treatment. Depending on the findings, this might include trimming or repairing a torn meniscus, removing a loose body, or tidying damaged cartilage. Treatment may also involve releasing scar tissue or taking a sample of the joint lining for analysis.
Because the incisions are small, knee arthroscopy is generally associated with less soft tissue disruption than open knee surgery. It is most often carried out as a day case. It is a surgical treatment rather than a cure for underlying joint wear. It sits within a wider care pathway that usually begins with assessment, imaging and non-surgical management. Your consultant will only recommend surgery where the clinical picture and examination findings support it. The scans must also point to a problem that arthroscopy can realistically improve.
Who May Benefit From Knee Arthroscopy?
Knee arthroscopy may be suitable for adults who have persistent, well-localised knee symptoms that suggest a mechanical problem inside the joint. Common features include:
- Knee pain that has not improved after a reasonable period of physiotherapy and activity modification
- Locking, where the knee sticks and will not fully straighten
- Catching, clicking or a sensation of something moving inside the joint
- Recurrent swelling after activity
- Giving way or a feeling that the knee cannot be trusted on stairs or uneven ground
- Pain along the joint line, particularly with twisting or squatting
- Uncertainty about the diagnosis despite examination and scans
Arthroscopy is not appropriate for everyone with knee pain. Current UK guidance from NICE advises against arthroscopic washout and debridement for knee osteoarthritis unless there is a clear history of mechanical locking. This is because evidence suggests limited benefit for degenerative knee pain alone. Where significant arthritis is present, options such as injections, structured exercise therapy or weight management may be discussed instead. In advanced cases, partial or total knee replacement may also be considered. Your clinician will advise based on your individual assessment.
Conditions and Problems Commonly Treated
Meniscal tears
The menisci are two crescent shaped cartilage shock absorbers in the knee. Traumatic tears, often from twisting injuries in sport or at work, can cause pain, swelling and locking. Depending on the tear pattern, blood supply and your age, a tear may be repaired with sutures. Alternatively, the unstable portion may be trimmed.
Loose bodies
Fragments of cartilage or bone floating within the joint can cause sudden locking or sharp pain. These can usually be removed arthroscopically.
Cartilage (chondral) damage
Localised areas of damaged joint surface may be assessed and, in selected cases, treated with cartilage preservation or restoration techniques.
Other indications
- Inflamed or thickened joint lining causing swelling
- Scar tissue or stiffness following injury or previous surgery
- Assessment of ligament injuries and preparation for reconstruction
- Diagnostic evaluation where imaging findings and symptoms do not match
Potential Benefits
Outcomes vary between individuals, and no procedure can guarantee a specific result. However, where the problem is genuinely mechanical, knee arthroscopy may:
- Reduce pain related to a torn or unstable structure inside the joint
- Relieve locking or catching and improve range of movement
- Reduce episodes of swelling
- Support a return to work, exercise and daily activities
- Provide a clear diagnosis when scans have been inconclusive
- Preserve knee cartilage where treatment is possible at an early stage
Consultation and Assessment
Careful assessment is the most important part of deciding whether knee arthroscopy is appropriate. A typical consultation includes:
- A detailed history covering how symptoms started, what makes them worse, and how they affect work, sleep and activity
- Review of previous treatments such as physiotherapy, injections or medication
- A physical examination of both knees, including alignment, movement, ligament stability and specific meniscal tests
- Review or arrangement of imaging, usually weight bearing X-rays and often an MRI scan
- Discussion of the likely diagnosis and all reasonable options, including doing nothing
- An explanation of the potential benefits, risks and expected recovery, so you can give informed consent
If surgery is not the right answer, that will be said plainly. Alternatives such as a structured rehabilitation programme or a knee pain review will be recommended instead.
How the Procedure Is Performed
Knee arthroscopy is usually carried out in a hospital theatre as a day case. This means most patients go home the same day. It is most often performed under general anaesthetic, although a spinal anaesthetic may be suitable for some patients. The anaesthetist will discuss this with you beforehand.
During the operation, the leg is cleaned and prepared, and small incisions are made at the front of the knee. Sterile fluid is then used to expand the joint and improve the view. The surgeon inspects all compartments of the knee systematically before carrying out any treatment. The instruments and fluid are then removed, and local anaesthetic may be injected for comfort. The small wounds are then closed with sutures or adhesive strips and covered with a dressing.
The procedure itself commonly takes around 30 to 60 minutes, though this depends on what needs to be done. Including admission, anaesthetic and recovery, expect to be at the hospital for most of the day. You will need a responsible adult to take you home and stay with you overnight.
Recovery and Aftercare
Recovery varies considerably depending on what was found and treated. A straightforward meniscal trim or removal of a loose body usually allows earlier weight bearing than a meniscal repair. A repair often requires a period of protected movement and sometimes a brace.
- First few days: rest with the leg elevated, use ice as advised, take simple pain relief, and keep the dressings dry. Gentle knee bending and straightening exercises usually begin early.
- First two weeks: swelling and bruising are common. Wounds are checked and any sutures removed at around 10 to 14 days.
- Physiotherapy: a tailored programme helps restore quadriceps strength, movement and confidence, and is an important part of the outcome.
- Driving: only when you can perform an emergency stop safely and comfortably, and after checking with your insurer.
- Work: desk based roles are often resumed within one to two weeks, while manual work may take longer.
- Sport: a graduated return, often between six weeks and several months, depending on the procedure.
Seek prompt medical advice if you develop increasing pain, spreading redness, wound discharge or fever. Also seek help for calf pain, swelling or breathlessness, which may indicate infection or a blood clot.
Risks and Considerations
Knee arthroscopy is generally considered a low risk procedure, but complications can occur with any operation. Possible risks include:
- Pain, swelling and stiffness that take time to settle
- Infection, which is uncommon but may require antibiotics or further surgery
- Blood clots in the leg or lung
- Bleeding into the joint
- Numbness around the incisions from small skin nerve injury
- Anaesthetic related risks
- Ongoing symptoms, or the need for further treatment such as repeat surgery or joint replacement in the future
It is also important to understand the limitations. Arthroscopy does not reverse established arthritis. Evidence summarised by organisations such as Cochrane and reflected in NICE guidance indicates limited benefit for degenerative knee pain without true mechanical locking. Alternatives that may be discussed include physiotherapy, weight management, analgesia, injections and, where appropriate, partial or total knee replacement.
Why Choose Mr Shanmugasundaram Rajkumar?
Why Choose Mr Shanmugasundaram Rajkumar? Mr Shanmugasundaram Rajkumar is a Consultant Trauma and Orthopaedic Surgeon with 16+ years of consultant experience. His practice covers hip and knee surgery, complex trauma and joint replacement. He is fellowship trained in lower limb arthroplasty and knee surgery. He also has previous experience at Wrightington Hospital, a long established centre for joint replacement surgery.
- Honorary Senior Clinical Lecturer at the University of Glasgow
- College Tutor/ Regional Surgical Advisor for the Royal College of Physicians and Surgeons of Glasgow
- Specialist expertise in knee arthroscopy, cartilage preservation and primary and revision hip and knee replacement
- Uses 100% ODEP 10A rated hip and knee implants, with outcomes recorded through the National Joint Registry
- Experienced in modern evidence based joint replacement surgery
- Active researcher involved in randomised controlled trials and UK and European multicentre studies
- Published in peer reviewed orthopaedic journals and a reviewer and consulting editor for international surgical journals
- National lecturer and medical educator in Trauma & Orthopaedics
Care follows evidence based standards set out by bodies such as the British Orthopaedic Association. The focus is on honest advice about whether surgery is likely to help.
Location and Areas Served
Consultations and knee arthroscopy surgery are available in Glasgow. Patients also travel from Renfrewshire, Paisley and the wider west of Scotland. Appointments are arranged to allow enough time for a thorough assessment and review of your scans. You will also get a clear discussion of the options available to you.
Frequently Asked Questions
Is knee arthroscopy painful?
The procedure itself is not felt, as it is performed under anaesthetic. Afterwards, most patients describe soreness, aching and swelling for a few days. This is usually managed with simple pain relief, ice and elevation.
How long does the operation take?
Commonly around 30 to 60 minutes, depending on the findings and what treatment is required.
How long is recovery?
Many people return to light activities within one to two weeks. Full recovery after a meniscal repair or cartilage procedure can take several months. Your recovery plan will be tailored to you.
Will I need to stay in hospital?
Knee arthroscopy is usually a day case procedure, so most patients go home the same day with a responsible adult.
Am I suitable for this procedure?
Suitability depends on your symptoms, examination findings and imaging. Arthroscopy tends to help most where there is a clear mechanical problem inside the joint rather than generalised arthritic pain.
Are there alternatives?
Yes. Physiotherapy, activity modification, weight management, pain relief, injections and, in advanced arthritis, knee replacement may all be appropriate depending on your diagnosis.
When should I book a consultation?
If knee pain, swelling, locking or instability is limiting your work, sleep or activity, despite conservative treatment. An orthopaedic assessment may then be worthwhile. General information about knee symptoms is available from the NHS.
At a glance
Anaesthetic
General or spinal, often day-case
Operation time
20–45 minutes
Hospital stay
Day-case, home same day
Recovery
Days to a few weeks
Incisions
Two or three small keyhole cuts
Fees & insurance
New Consultation
£180
Follow-up
£110
Insurers
Bupa · AXA Health · Aviva · Vitality · WPA
Self-pay
All-inclusive quotation on request
A written quotation is provided before any procedure is booked.
Discuss your knee
Request an appointment at Ross Hall Hospital, Glasgow.