A displaced “bucket-handle” tear of the medial meniscus

Knee arthroscopy is a day case procedure under a general anaesthetic, which involves making two or three small incisions around the knee, usually either side of the patellar tendon on the front of the knee. This allows a small camera to be inserted into the knee to inspect the joint surfaces, the ligaments and the menisci. Instruments can be inserted to allow surgical procedures as described below to be performed.

The small incisions are closed with stitches that will need removal after 7-10 days, and you will have a wool and crepe bandage that can be removed after 24 hours.

Following a straightforward arthroscopy, you should be able to take your full weight through the knee, although you will require crutches for support for a few days. You should be back to driving when you can safely perform an emergency stop and control your vehicle; this is usually after a week. You should be back to work between two and four weeks following surgery depending on the type of work you do.

Partial Meniscectomy

The torn portion of the meniscus has been removed with a punch and a shaver

During your knee arthroscopy, the damaged portion of the meniscus is trimmed away. This should relieve symptoms of locking, catching and giving way. Following a partial meniscectomy, you are unlikely to require a brace or any restrictions in movement, and will be able to bear weight as tolerated.

You are likely to need crutches for only a few days. You should be able to return to driving when you are able to safely control the car and perform an emergency stop, which is usually after a week. As a rough guide, you should be able to return to work at around two weeks, although you may need to refrain from heavy manual work for up to six weeks.

You should be able to return to your regular sporting activities as discomfort allows; in reality it is likely to be between 6 to 12 weeks before you are able to resume competitive sports.

Meniscal repair

A meniscal suture is used to repair the torn fragment of the meniscus and promote healing

Meniscal repair is only possible where the tear is peripheral (i.e. close to the knee joint capsule) where the blood supply to the meniscus is better. The advantages of repairing rather than removing the meniscus fragment are that preserving the meniscus means that contact pressures through that compartment of the knee are reduced. This theoretically reduces the risk of developing arthritis in the future. However, if the blood supply to the torn fragment is poor, the meniscus is not repairable, and the fragment needs to be excised.

During a meniscal repair, the torn fragment is reattached using stitches. Following a meniscal repair, you will be placed into a knee brace to restrict deep flexion (bending the knee too far) and will require crutches for six weeks. You may be advised to be partially weight bearing which means only putting part of your weight through the affected knee. You are unlikely to be able to return to driving until you are out of the brace. Deep squats and contact sports should be avoided for 3 months following a meniscal repair to avoid disrupting the repair.

What are the risks of arthroscopy?

Any operation carries with it small risks. The risk of an infection or blood clot (deep vein thrombosis) is extremely low (less than 1 in 1000). The knee will be sore, swollen and stiff to start off with but generally improves rapidly. There may be some early underlying arthritis or other damage to the knee joint which could potentially give you some on-going symptoms, although these should be much less intrusive than your symptoms before surgery.