Arthroscopic knee surgery—such as anterior cruciate ligament reconstruction or treatment of a unstable patella

Arthroscopic knee surgery, also known as knee arthroscopy, makes it possible to view the inside of the knee joint through small incisions while performing surgical procedures. Arthroscopic surgery may be used, for example, in anterior cruciate ligament reconstruction and in certain surgeries for a unstable kneecap.

The type of surgery that is appropriate depends on your symptoms, the degree of instability, any other injuries to the knee, and your expectations for the knee’s function. During an initial evaluation, the specialist will determine which treatment is best suited to your situation.

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When arthroscopic surgery is used to stabilize the knee

During arthroscopic surgery, a small camera is inserted into the knee joint through a small incision. The camera allows the surgeon to examine the structures inside the joint, while fine instruments can be inserted through other small incisions. This allows the surgeon to both assess the knee and perform parts of the planned procedure.

Arthroscopic surgery can be the treatment itself or form part of a larger stabilizing procedure.

Anterior Cruciate Ligament Reconstruction

The anterior cruciate ligament helps stabilize the knee. An injury often occurs during a twisting motion and is commonly seen during sports, among other activities. After the injury, some people find that their knee feels loose or gives way during certain movements.

Not everyone with an anterior cruciate ligament (ACL) injury needs surgery. For some people, physical therapy can restore satisfactory function. ACL reconstruction may be appropriate if you continue to experience significant instability or if you wish to return to activities or work that place high demands on knee stability.

During reconstruction, the damaged cruciate ligament is replaced with tendon graft, which is positioned and secured so that it can take over the cruciate ligament’s stabilizing function. Arthroscopic surgery is used as a key part of the procedure to work inside the knee joint.

Surgery for an Unstable Patella

If the kneecap has been dislocated, the knee may feel unstable afterward. After an initial injury, the condition is usually treated without stabilizing surgery, using methods such as rest, bandaging, and rehabilitation.

If your kneecap repeatedly dislocates completely or partially, or if you experience persistent discomfort due to instability, stabilizing surgery may be an option. In this procedure, the stabilizing ligament on the inner side of the kneecap can be reconstructed.

Arthroscopy may be part of the treatment, for example, if there is a need to examine the knee joint more closely or to treat damage to the cartilage or bone inside the joint. Stabilizing the kneecap itself may also require small surgical incisions in addition to the arthroscopic ports.

Here's How the Treatment Works

The specific surgical procedure is tailored to the injury or instability being treated. During the arthroscopic portion of the surgery, a camera and instruments are inserted through small incisions around the knee. The knee joint is irrigated with sterile fluid, giving the surgeon a clear view of the structures within the joint.

If you are scheduled to undergo anterior cruciate ligament reconstruction, the knee joint will be examined at the same time for any other injuries that may affect your treatment. In cases of patellar instability, the procedure depends, among other things, on the cause of the instability and on whether there are any injuries inside the knee joint.

Before your surgery, you will receive information about the treatment that has been planned specifically for you.

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Here's How a Program Works

Before surgery

Before surgery, you will be examined by an orthopedic surgeon. The doctor will assess your symptoms, the stability of your knee, and any imaging studies. In the case of a cruciate ligament injury, physical therapy before a potential surgery can be an important part of the treatment process and can also help determine whether surgery is necessary.

Once your surgery has been scheduled, you will receive specific instructions regarding, among other things, preparation, medication, and fasting.

During the operation

The arthroscopic portion of the procedure is performed through small incisions around the knee. The camera allows the surgeon to view the internal structures of the knee and perform the planned treatment using small instruments.

Whether the surgery involves cruciate ligament reconstruction, treatment of an injury inside the joint, or a stabilizing procedure around the kneecap depends on the diagnosis and treatment plan established prior to the procedure.

After surgery

After the surgery, you will be monitored until you are ready to go home. It is common to experience pain, tenderness, and swelling in the knee at first.

The extent to which you may put weight on and move your knee depends on the type of surgery you’ve had. You will therefore receive individualized instructions regarding weight-bearing, exercises, and any assistive devices before you go home.

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Rehabilitation After Stabilization Surgery on the Knee

Rehabilitation is an important part of treatment. Among other things, the goal is to regain mobility, strength, and control around the knee and gradually prepare you for the activities you want to return to.

The course of recovery depends largely on the type of surgery. After cruciate ligament reconstruction, a longer and gradual rehabilitation process is required because the reconstructed cruciate ligament needs time to heal and adapt. Similarly, after stabilizing surgery for the patella, the level of stress and the exercise regimen are tailored to the specific procedure.

Your surgeon and physical therapist will advise you on when you can increase your activity level and return to work, exercise, and sports.

Possible complications

As with other surgeries, complications can arise after arthroscopic surgery or knee stabilization surgery. These may include infection, bleeding, blood clots, changes in sensation around the surgical site, or persistent discomfort in the knee.

After the surgery, you will receive information about what symptoms to watch for and who to contact if you experience any signs of complications.

Is surgery the right treatment for you?

The need for surgery is assessed on a case-by-case basis. For both cruciate ligament injuries and instability around the kneecap, we will evaluate how much the knee bothers you, whether it gives out during daily activities or during exercise, what treatments you have already tried, and what your expectations are for the knee’s function.

During the initial evaluation, the specialist will review your symptoms and treatment options with you so that a plan can be developed that is tailored to your injury and your activity level.