Knee Arthroscopy: An Orthopaedic Surgeon’s Guide

A surgical team is shown operating on a patient's leg, with various instruments and sterile drapes in the surrounding environment.

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Knee arthroscopy is a minimally invasive procedure that allows orthopaedic surgeons to examine and treat knee joint issues without requiring large incisions. Using a specialised instrument called an arthroscope, equipped with a tiny camera, surgeons can view the inside of the knee on a monitor. This enables precise navigation of small surgical tools through minor incisions to repair or remove damaged tissue. Due to its minimally invasive nature, knee arthroscopy typically results in reduced pain, minimal scarring, and a faster recovery compared to traditional open surgery.

Common Conditions Addressed By Knee Arthroscopy

Meniscal Tears: Arthroscopy can trim damaged meniscal cartilage (partial meniscectomy) or repair the tear to relieve pain and restore knee function.

Ligament Injuries: Torn ligaments, such as the ACL, can be reconstructed or repaired using arthroscopy to stabilise the knee joint and enhance overall function.

Chondromalacia: Arthroscopy smooths rough or damaged cartilage surfaces to reduce pain and improve joint mobility. While this can manage symptoms, it does not reverse cartilage degeneration.

Loose Bodies: Bone or cartilage fragments that limit movement and cause discomfort are removed during arthroscopy to restore smooth joint function.

Synovitis: Inflamed synovial tissue, which leads to pain and swelling, can be excised through arthroscopy to improve knee comfort.

Symptoms That May Require Arthroscopy

Unexplained and persistent knee pain: Pain that continues despite rest and basic treatments may suggest an underlying issue that requires further investigation.

Reduced range of motion or joint stiffness: Difficulty fully bending or straightening the knee can point to structural problems within the joint.

Locking or catching sensations: A knee that feels stuck or catches during movement may indicate a mechanical issue, such as a loose fragment or torn cartilage.

Chronic swelling resistant to conservative treatments: Swelling that persists despite rest, ice, compression, and elevation could signal deeper joint damage.

Preparing for Knee Arthroscopy

Preparing for knee arthroscopy involves the following steps:

Medical Evaluation: A comprehensive evaluation, including blood tests, and possibly an EKG or X-ray, ensures the patient’s readiness for surgery.

Medication Review: Patients should inform their surgeon about all medications or supplements they are taking. Adjustments may be necessary, particularly for blood-thinning medications.

Fasting: Patients are typically asked to avoid eating or drinking for 6–12 hours before the procedure to minimise anaesthesia-related risks.

What to Expect During Knee Arthroscopy

Below is an outline of what typically happens during the procedure.

Anaesthesia: The procedure is performed under either general anaesthesia (the patient is asleep) or regional anaesthesia (numbing the lower body), depending on the patient’s condition and the surgeon’s recommendation.

Incisions and Access: Small incisions, about a quarter of an inch, are made around the knee to insert the arthroscope and surgical instruments.

Diagnosis and Treatment: The arthroscope provides real-time video of the knee joint, allowing the surgeon to diagnose the issue and perform treatments, such as repairing cartilage or removing loose fragments, as needed.

Closure and Dressing: Once the procedure is complete, the incisions are closed with stitches or sterile strips and covered with a bandage. These small incisions lower the risk of infection and promote faster healing.

The entire procedure typically takes 30–60 minutes, depending on the complexity, and many patients can walk shortly afterward with support.

Recovery and Rehabilitation After Knee Arthroscopy

Immediate Post-Surgical Care

Pain Management: Pain relief is achieved with over-the-counter or prescribed medications, depending on the severity of discomfort. Following the prescribed dosage schedule ensures effective pain control.

Swelling Control: Applying ice packs to the knee and keeping the leg elevated helps reduce swelling and improve comfort. These measures should be continued regularly during the first few days after surgery.

Wound Care: The surgical site should be kept clean and dry for the first 24–48 hours. After this period, follow your surgeon’s specific instructions for cleaning and dressing the wound. Proper wound care reduces the risk of infection and supports faster healing.

Rehabilitation Process

Physical Therapy: Recovery after knee arthroscopy typically involves a structured physical therapy program. Early exercises focus on improving range of motion, reducing stiffness, and gradually building strength. Following a tailored rehabilitation plan under professional guidance is required to ensure optimal recovery.

Activity Progression: Patients are encouraged to gradually increase their activity level under medical guidance. Walking aids may be required initially.

Most patients resume regular activities within a few weeks, though strenuous activities or sports may take several months. Ongoing physical therapy may be recommended to support long-term knee health.

Potential Risks and Complications

While knee arthroscopy is generally safe, some risks include infection, which may cause redness, swelling, or fever, and blood clots, as reduced mobility can increase the risk of deep vein thrombosis. Internal bleeding within the knee joint, though uncommon, may occur and require further attention. Knee stiffness is another potential issue, often managed effectively with physical therapy. There is also a small risk of nerve or blood vessel damage near the knee during the procedure.

Conclusion

Knee arthroscopy offers a modern, minimally invasive solution for diagnosing and addressing various knee joint conditions. With its shorter recovery times and less post-operative discomfort, it has become a preferred alternative to open knee surgery. Patients who follow post-operative care instructions and participate in rehabilitation frequently experience significant improvements in knee function and quality of life. While there are risks involved, they are rare and manageable under the care of an experienced orthopaedic surgeon.

If knee pain or limited mobility is affecting your daily life, consult us today to discuss whether knee arthroscopy is the right option for you.

Dr. Ambrose Yung

Specialist Orthopaedic Hip & Knee Surgeon

Dr Ambrose Yung Wai Yin is a Senior Orthopaedic Hip & Knee Surgeon with over 20 years of experience in the field of orthopaedics.

Areas of Expertise:

Knee Surgery: Complex procedures like revision knee arthroplasty, partial knee replacement, and primary total knee replacement.
Minimally Invasive Surgery: Shoulder, ankle, and knee surgeries with minimal scarring and quicker recovery times.
Limb Reconstruction: Specialized in both upper and lower limb reconstruction.

Computer-guided Knee Replacement: Dr. Yung trained at the prestigious Oxford University Hospital in the UK, where he specialized in computer-guided partial and total knee replacements.

Dr. Chee Kin Ghee

Specialist Hand & Orthopaedic Surgeon

Dr Chee Kin Ghee is a specialist hand surgeon with over 20 years of experience in hand and orthopaedic surgery.

His clinical expertise includes treatments for complex hand, wrist, and upper limbs injuries, wrist and finger joint replacement, minimally invasive hand and wrist surgery, and nerve compression release surgery

Dr Chee was awarded a 1-year fellowship (HMDP by MOH) & trained at world-renowned Wrightington Hospital Upper Limb Unit, UK.
He was trained in the management of complex upper limb conditions, including complex joint replacement of the shoulder, elbow, wrist, and hand, as well as modern minimally invasive upper limb surgery.

Dr. Low Mun Hon

Dr Low Mun Hon has over 20 years of experience managing trauma and orthopaedic clinical care. Prior to this, he has been in private practise as a practitioner at Singapore Sports & Orthopaedic Clinic (SSOC).

Dr. Low graduated from Monash University Medical School (Melbourne). Thereafter, he pursued his internship at The Alfred Hospital in Melbourne.

He subsequently continued his practice of medicine at Singapore General Hospital (SGH). During this period, he was awarded the membership of the Royal College of Physicians and Surgeons at Glasgow in 2008 & Master of Medicine in Orthopaedic Surgery (National University of Singapore) in the same year.
Dr Low had previously worked as an orthopaedic trainee at various local teaching hospitals i.e. Ng Teng Fong General Hospital (NTFGH), Tan Tock Seng Hospital (TTSH), KK Women’s and Children’s Hospital (KK Hospital) and Singapore General Hospital (SGH).

Justin Lim Xuan Li

Physiotherapist

Justin is a skilled and experienced physiotherapist who specializes in the treatment of neuro-musculoskeletal conditions (nerve, muscle and joint).

Over the years, he honed his clinical skills across all sectors of healthcare, allowing him to attain mastery of the sophisticated human body and address complex problems effectively, allowing him to successfully address complex neuro-musculoskeletal conditions at an accelerated pace.

Justin graduated from Trinity College Dublin and started his career in National Healthcare Group Polyclinics. His skills quickly gained recognition and was appointed as a clinical educator for physiotherapy students and even tasked to develop Clinical Practice Guidelines.
Subsequently, he continued his practice in community care settings such as Thye Hwa Kwan Rehabilitation Centres and Saint Andrew Community Hospital, where he focused on developing his skills for geriatric rehabilitation and improving quality of care in rehabilitation centres. He then moved on to private practice in Parkway East Hospital, specializing in post operative and outpatient rehabilitation.

Chan Jing Cheng (JC)

Physiotherapist

JC has over 12 years of experience in treating Chronic pain, Orthopaedic and Geriatric conditions.

He had worked at various Private Hospitals, Singapore General Hospital, NTUC Health Elder Care and Lions Home for the Elders.
He is passionate about solving complex musculoskeletal disorders and helping clients relief pain from trauma and illness.
He has a special interest in the Shoulder, Spine, Hip and Knee joint conditions.
He has helped thousands of clients go through rehabilitation smoothly and achieved higher satisfaction after orthopaedic surgery.

Zita Sham

Physiotherapist

Zita graduated with a Diploma in Physiotherapy from Nanyang Polytechnic (Singapore) in 2014 and started working in Ng Teng Fong General Hospital to serve her sponsorship bond.

Later in 2015, she pursued a Bachelor’s Degree in Physiotherapy from Trinity College Dublin, which was provided in Singapore Institute of Technology.

After completion of her studies, Zita worked in the Day Rehabilitation Centre in Jurong Community Hospital for 6 years, where she focused on community rehabilitation for a variety of patients. Patients that were mainly seen consisted of post-operative, geriatric and neurological conditions.
Zita also has a passion in musculoskeletal and sports physiotherapy and is looking to pursue that. She is also keen to provide home-based physiotherapy to reach out to those in need of her expertise.

Joanna Lim

Hand Occupational Therapy

Joanna’s primary specialization and passion is in hand therapy and upper limb rehabilitation, having more than 10 years of experience in this field.

Joanna obtained her Diploma in Occupational Therapy (Merit) from Nanyang Polytechnic in 2006. Under the MOH Health Science Scholarship, she graduated from La Trobe University, Australia, with a Bachelor’s degree in Occupational Therapy (1st class Honors) the following year. Upon graduation, she worked in Changi General Hospital and Sengkang General Hospital.

She has worked with hand and orthopedic surgeons in both inpatient and outpatient settings, providing quality therapy services for clients with a variety of hand and upper limb conditions, including fractures, sprains/strains, tendon injuries, nerve injuries, repetitive strain disorders and complex trauma injuries.
During her tenures at CGH and SKGH, Joanna was a Senior Occupational Therapist and held the role of Hand Therapy and Upper Limb Rehabilitation Unit Leader. She was in charge of clinical supervision and management of staff, manpower planning, and daily operations of the unit.