Knee Arthroscopy

What is an arthroscope?

An arthroscope is a small fibreoptic telescope that is inserted into the joint. It contains a system of lenses, a light source as well as a small video camera. This is connected to a monitor that allows the surgeon to examine the joint. The arthroscope is almost always used with other tools that are inserted through another small incision. These tools are used for grasping, cutting and probing.

Knee arthroscopy:

Nowadays, knee arthroscopies are among the most common procedures performed and is used to diagnose and treat various conditions of the knee.

Common conditions that are treated during arthroscopic surgery often include one or more of the following:

  • Removal / Repair of medial (inside) or lateral (outside) meniscal tears.
  • Removal of damaged cartilage.
  • Removal of loose bodies causing locking in the knee.
  • Removal of inflamed joint membranes in conditions like rheumatoid arthritis.
  • Washout of infected joints.
  • Articular cartilage grafts.


Historically a knee arthroscopy was used to clean up the joint, by removing torn bits of cartilage or meniscii that were present in the knee. However, there is mounting evidence that these surgeries are not only unnecessary, but it may lead to accelerated wear and tear in the joint. Aging of the meniscus (cartilage), and even tears, are common findings on an MRI in older individuals.

Dr Pretorius is very experienced in arthroscopic surgery and uses it to treat various conditions in the knee. Arthroscopic partial meniscectomy / trimming of the meniscus (cartilage) inside the knee is only indicated, if the damage is large enough to cause symptoms, like locking or catching. More often than not, a small degenerative meniscal tear will settle over time with non-operative treatment.

Common symptoms of meniscal injuries include:

  • Swelling.
  • Catching or pain, especially with rotation on the knee.
  • Locking.
  • The feeling that the knee wants to give way.
  • Persistent pain along the joint line.

Before and during surgery:

You will be admitted through the day surgery unit on the day of your surgery. The knee will be prepared for surgery, and this normally involves shaving the leg around the operation area and prepping the knee with an antiseptic solution.

You will meet the anaesthetist, who will discuss the anaesthetic with you.

After the anaesthetic is administered, a tourniquet will be applied to your upper leg and the surgery performed through a few small cuts. The surgery normally takes between 30 – 45 minutes to complete. These cuts will be sutured following the surgery and they will be covered by a dressing and a compression bandage applied.

General risks of surgery:

  • Knee arthroscopy surgery is usually done using general anaesthesia. Anaesthesia is very safe. Unexpected death from an anaesthetic is very rare.
  • Antibiotics are routinely used during surgery to prevent infection – some patients may have an allergic reaction or anaphylaxis.
  • Wound infection.
  • Bleeding in the wound with haematoma (big collection of blood) formation.
  • Pain / numbness around the incision.
  • Allergies to the antiseptic solutions that are used to clean the surgical site.
  • Allergies to sutures and / or dressings
  • Deep vein thrombosis – there is always a risk of DVT with surgery of the lower limb.
  • Nausea and vomiting after surgery.


Specific Risks with Knee Arthroscopic Surgery:

  • Infection in the knee joint – extremely rare.
  • Injury to nerves.
  • Numbness / pain / bruising from the use of the tourniquet.
  • Damage to other structures in the knee, especially the articular surface.
  • Pain and symptoms may persist in the knee because of the underlying disorder or problem.
  • Ongoing swelling in the leg.

Recovery after knee arthroscopy:

The nurses in the recovery room will monitor your recovery by regularly checking your vital signs (pulse, blood pressure etc), consciousness and pain levels.

Once awake, you will be transferred back to the day surgery unit.

Most patients can weight bear and walk on the knee, but it is advisable to bring crutches with you and to make use of it for a few days.

You will be supplied with a follow-up date for removal of sutures and a wound review.

It is important to keep the surgical area clean and dry and to keep the wound dressings intact.

The big compression bandage on your knee, may be removed the next day. It is advisable to keep your wounds covered with a waterproof dressing until your review by Dr Pretorius.

It is important to move around to prevent blood clots. It is also important to do some range of motion exercises and simple quadriceps strengthening exercises.

You will be supplied with strong pain medication to use for the first few days. As soon as you are able, it is advised to cease the use of stronger pain medication and control the pain with ice packs, paracetamol and regular anti-inflammatory medication.

Depending on your surgery, recovery might vary. It is quite common to continue with pain and swelling for a few weeks after the surgery. Most people can drive within the first week and most people will be able to return to work within 2 – 4 weeks. Return to sport will be discussed when coming for your follow-up visit. Recovery after surgery is different for every patient. After care and the rehabilitation process are as important as the surgery, if not more so. Your commitment is really important for effective recovery and the best outcome.

Please contact the surgery immediately if you have any of the following:

  • Any redness, swelling, bleeding or drainage from your incision site.
  • Any fever or chills.
  • Any increase in pain around the incision site.
  • Any pain in your calf or thigh with increased swelling in the leg.
  • Any other concerns you may have.


Please find links to useful information regarding knee arthroscopy: