Orthopedics-Online

Arthroscopy of the knee joint

What is an arthroscopy of the knee joint?

The arthroscopy of the knee (Knee arthroscopy) represents an advanced method of examination and treatment of the knee joint.
It is a so-called “keyhole surgery” procedure, which is characterized by the fact that no large incisions have to be made. The surgeon can insert the approx. Pencil-thick arthroscope (i.e. the joint camera) and other tools that are necessary for the Intervention is needed.
This has several advantages, because the smaller wounds also significantly shorten the healing time.
In addition, the duration of the procedure is significantly reduced.
Arthroscopy is used both diagnostically and therapeutically: the joint can be examined from the inside and, if necessary, treated directly according to the findings.

Is the arthroscopy performed on an outpatient or inpatient basis?

The knee arthroscopy can either be carried out as an inpatient, i.e. with a permanent hospital stay, or on an outpatient basis, with the patient being able to be home hours after the operation.

The knee arthroscopy is often performed on an outpatient or short-term inpatient basis in a clinic. If there is no care at home or if there are previous illnesses, the procedure is carried out as an inpatient.

How long does an arthroscopy of the knee take?

The duration of the knee arthroscopy depends on

the treatment carried out
the extent of the damage to the knee
the surgeon's experience
possible accompanying therapies

Accordingly, the duration of the arthroscopy can vary widely.
An arthroscopy for diagnosis can be completed within 20 minutes. The various rooms and structures within the joint are visited and inspected.
In many cases, minor treatments follow the joint mucous membranes or the menisci. An experienced surgeon can complete this procedure within 20-30 minutes.
Lengthy interventions on the articular cartilage, menisci, synovial membrane or cruciate ligaments can delay the operation.
Cruciate ligament surgery can also be performed as part of an arthroscopy. This can extend the procedure to 1 to 1.5 hours.

The duration of the procedure is calculated from the first skin incision. The total duration of the treatment also includes induction of anesthesia as well as immediate preparations for the operation, so that the total treatment can take several hours.

Get more information about the Duration of a knee arthroscopy

Why is an MRI done before the arthroscopy?

An MRI of the knee joint should always be done before an arthroscopy in order to confirm the indication for arthroscopy and to optimize surgical planning in advance. In the MRI, without causing damage to the knee, it is possible to assess which structures in the knee joint are damaged and whether surgical therapy can / must be carried out at all.
Nowadays, magnetic resonance imaging (MRI) is often used to diagnose knee joint injuries, as it is a non-invasive procedure without exposure to radiation or endangering the patient.

Read more on this topic at: MRI of the knee

Appointment with a knee specialist?

I would be happy to advise you!

Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)

The knee joint is one of the joints with the greatest stress.

Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

You can find me in:

Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main

Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert

How well can cartilage damage be treated with arthroscopy?

Cartilage damage in the knee is the most common indication for therapeutic arthroscopy of the knee. It occurs either through long-term strain on the knee from work or sport, especially in older patients, or after sports accidents.
Cartilage damage in the knee is often treated conservatively at first. If this is not enough, arthroscopy is used.

There are different ways of treating cartilage damage, depending on the type of injury. In principle, the chances of successful and sustainable treatment of a cartilage in young people are higher due to the better blood circulation.
If a cartilage is frayed and broken open, so that recurring pain and swelling of the knee occur, a so-called "cartilage smoothing" can be carried out in arthroscopy. The frayed pieces of cartilage are removed and the surfaces are adjusted and smoothed.
In young patients there is a possibility of microfracturing in the case of advanced cartilage damage. The bone is punctured in several places, so that a blood clot forms on the joint surface, which is then transformed into a cartilage-like connective tissue.
With particularly severe cartilage defects, young people can even benefit from a cartilage cell transplant. If the individual requirements for a cartilage transplant are met, the procedure can deliver good results in many cases. In particular, the patient's age, blood flow and the location of the cartilage defect are important factors for the success of the transplant.

Read more on the topic: Surgery for knee osteoarthritis

Follow-up treatment of a knee arthroscopy

You will usually have check-ups the day after the operation and one week after the operation.
After the procedure, the knee should always be protected and cooled.
It may be necessary to relieve the knee joint for some time by using forearm supports when walking. The operated leg should only "run along" when it is in contact with the ground.
Various treatment methods, such as physiotherapy and electrotherapy, complement the relief of the joints.
If you have osteoarthritis that cannot be improved by arthroscopy, follow-up treatment with hyaluronic acid is recommended.
With hyaluronic acid treatment, symptoms of osteoarthritis such as pain and restricted mobility can be significantly reduced.

Individual follow-up care after a knee arthroscopy should always be discussed with the attending physician. It varies greatly depending on the reason for the procedure.

Do you need drainage after knee arthroscopy?

The surgeon usually decides whether to insert a drain during the operation.
In many cases, drainage is not necessary, since no bleeding occurred during the arthroscopy.
However, if it becomes apparent that there is bleeding in the knee, drainage can be useful for the first few days after the procedure. Even if the arthroscopy of the knee is performed in the so-called "blood void", drainage may be necessary due to the increased blood flow to the knee after the blood has been switched off.

Light bruises on the knee can resorb on their own, but large effusions must be punctured and suctioned off with a needle. To prevent this, the decision about drainage must be made individually, as drainage can in turn be associated with further risks and complications.

When can I put weight on the knee again after an arthroscopy?

The duration of the relief depends on the procedure performed and the symptoms after the knee arthroscopy.
Cruciate ligament operations, cartilage transplants or other interventions that are associated with a subsequent healing phase often require longer relief.
In the case of pure arthroscopy, however, no relief has to be performed. As soon as possible after the operation, the leg should be fully loaded to prevent thrombosis and muscle wasting and restricted mobility. There may be pain in the knee for about 4-5 days after the arthroscopy, which makes it impossible to bear weight for the time being. If possible, within these 4 days, the leg should be fully loaded despite the pain.

Exercise can only be restarted approximately three to six weeks after the procedure, provided that the joint heals smoothly. The exact time of resumption of training must always be discussed with the attending physician.

Arthroscopy Risks

Since knee arthroscopy is a minimally invasive procedure, the risks and complications are very low.
A rare but important complication is infection. By spreading bacteria into the small wounds, structures in the skin, soft tissue or joints can become infected.
Furthermore, the joint endoscopy can cause new damage to the joint. Joint structures, blood vessels or nerves can be injured by the instruments if carelessly.
If the leg is not stressed quickly after the procedure, blood clots can form in the leg during immobilization, which in the worst case can cause pulmonary embolism.
The most common side effects to be expected during an arthroscopy of the knee are pain and swelling. These should subside after about 5 days. If this is not the case, you should consult your doctor.

Pain after an arthroscopy

Of course, minimally invasive surgery such as knee arthroscopy is also associated with pain. However, this pain is usually easy to control.

For the first few days, the knee should not be exposed to any load; elevation also helps against swelling. Consistent cooling of the knee also ensures that swelling goes down and the pain in the knee is alleviated.
In addition, pain relievers can be taken after an arthroscopy, which should be taken after consulting a doctor. For example, Ibuprofen or diclofenac. These are usually sufficient to relieve the pain in the first few days.
However, if the pain persists or worsens, a doctor must be informed so as not to overlook and treat the development of inflammation after the arthroscopy.

More information on this topic at: Pain after knee surgery

Swelling from an arthroscopy of the knee

An arthroscopy of the knee can also lead to knee swelling in the affected area. This is the case with almost every arthroscopy, because although it is a small procedure, arthroscopy is an invasive procedure and causes reactions in the tissue.
The skin incision and work in the knee injures the smallest vessels, and lymphatic tracts are also damaged. This is how swelling occurs.

Arthroscopic knee swelling can usually be treated well with simple measures. This is how you should keep your knee after surgery