Sports MedicineKneeSurgery Center

Knee Arthroscopy

Fellowship-trained sports medicine surgeons Christopher Raffo, MD, John Christoforetti, MD, and James Gardiner, MD use arthroscopic technique as the standard approach for knee surgery, combining precise diagnosis with treatment through small incisions.

Duration: 30–60 minutesAnesthesia: General or regional

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What is knee arthroscopy?

Knee arthroscopy is a minimally invasive surgical technique that uses a small camera (arthroscope) inserted through a tiny incision to see inside the knee joint and perform treatment through additional small portals. It is the standard approach for most knee surgery — from meniscus repair and cartilage treatment to ligament reconstruction — and takes 30 to 60 minutes depending on what is found and treated.

Why this approach — at MOS

At MOS, arthroscopic technique is the standard of care for knee surgery. We use a structured systematic examination of the entire joint at the beginning of every case — not just the area identified on MRI — because co-existing pathology (a cartilage lesion alongside a meniscus tear, or an early ACL injury alongside a lateral meniscus tear) influences treatment decisions and should not be missed.

We use high-definition 4K arthroscopic imaging systems that provide exceptional visualization detail. The quality of visualization directly affects the quality of tissue assessment and treatment — particularly for subtle cartilage lesions and posterior compartment pathology. Our fellowship-trained surgeons perform arthroscopy on a high-volume basis across all knee conditions, maintaining the procedural consistency that improves outcomes.

Who is a candidate?

Indications

Meniscus tear (repair or resection)
ACL or PCL reconstruction
Cartilage damage (microfracture, OATS, debridement)
Loose body removal (fragments of bone or cartilage floating in the joint)
Synovitis biopsy or plica excision
Knee infection washout (septic arthritis irrigation)
Patellar instability procedures (MPFL reconstruction)
Diagnostic arthroscopy when MRI is inconclusive and symptoms significantly limit function

Contraindications

Conditions fully manageable with conservative treatment — arthroscopy is not indicated to "look inside" the knee when no treatable pathology is identified on imaging
Advanced osteoarthritis with primarily degenerative symptoms — arthroscopy does not alter the natural history of arthritic disease and is not recommended for pain relief in this setting
Active skin infection over the planned portal sites
Medical contraindications to anesthesia

Conservative Treatment First

Knee arthroscopy is rarely performed as a standalone exploratory procedure in the modern era. Before recommending any knee surgery, MOS surgeons complete a thorough clinical evaluation — history, physical examination, and appropriate imaging — to identify the specific pathology driving symptoms. Physical therapy, activity modification, NSAIDs, and injections are tried first for conditions that have non-surgical options. Surgery is planned only when a specific treatable lesion is identified that has not responded to conservative management, or when the injury type (locked knee, acute ACL tear in an athlete) makes early surgery clearly appropriate.

The procedure

What Is Knee Arthroscopy?

The arthroscope is a pencil-thin instrument containing a high-definition camera and a light source. It transmits a magnified, high-resolution image of the joint interior to a monitor, allowing the surgeon to see structures that would require a large open incision to expose directly. A second small portal admits the working instruments — shavers, scissors, suture passers, and energy devices.

Arthroscopy is both a diagnostic and a therapeutic tool. In some cases, the pre-operative MRI fully defines the problem and arthroscopy proceeds directly to treatment. In others, the arthroscope resolves diagnostic uncertainty when symptoms don't match imaging or when multiple structures may be involved. The ability to inspect the entire joint systematically — medial compartment, lateral compartment, patellofemoral joint, intercondylar notch, posterior recesses — at the beginning of every procedure ensures that no co-existing pathology is missed.

What Happens During Knee Arthroscopy?

You arrive at the ambulatory surgery center and are prepared with general or regional anesthesia. The operative knee is positioned in a leg holder with a lateral post to facilitate joint opening. A tourniquet is applied. After sterile preparation, two or three small portal incisions (4–5 mm each) are made around the knee. The arthroscope enters through one portal; sterile saline fluid is pumped through the joint to distend it and improve visualization. Working instruments enter through the other portals.

The surgeon methodically inspects every accessible compartment of the knee before treating any pathology. Treatment performed through the same portals may include: trimming a torn meniscus, placing sutures through a repairable tear, performing microfracture on a cartilage defect, removing loose bodies, excising an inflamed plica, or beginning the tunnel drilling for a ligament reconstruction.

At the conclusion, the fluid is expelled, portals are closed, and a compressive dressing is applied. Most patients go home 1–2 hours after surgery. The small portal incisions are typically closed with a single suture or adhesive strips and leave minimal scarring.

Recovery timeline

Day 0–2

Ambulatory with crutches for comfort if needed. Ice and elevation. Most patients bear weight the day of surgery.

Week 1–2

Return to light activity. Swelling management. Physical therapy begins.

Week 2–6

Progressive strengthening. Return to most daily activities for isolated diagnostic or limited procedures.

Month 1–6

Return to sport timeline depends on what was treated. Simple loose body removal: 2–4 weeks. Meniscectomy: 4–6 weeks. Cartilage procedures or ligament reconstruction: 4–12 months.

Recovery after knee arthroscopy varies widely based on what was performed, not just that an arthroscope was used. A patient who had a loose body removed walks normally within days. A patient who had complex meniscus repair plus cartilage treatment has a 4–6 month recovery. The label "knee scope" should not imply quick recovery without understanding the specific procedures performed. MOS physical therapists design recovery protocols matched to each patient's specific surgical findings and treatment.

Frequently Asked Questions

Is knee arthroscopy always minimally invasive?

Knee arthroscopy uses small portal incisions rather than one large open incision, making it less invasive than traditional open surgery. However, "minimally invasive" refers to the incisions — the surgery performed inside the joint can be simple or complex depending on what needs treatment. The portals themselves are small; the scope of surgery varies.

How long do the incisions take to heal after knee arthroscopy?

The portal incisions are 4–5 mm and typically heal within 7–14 days. Sutures are removed at the first post-operative visit (usually 10–14 days). The incisions are placed in anatomically less conspicuous areas when possible and generally leave minimal scarring.

Can knee arthroscopy make my knee worse?

Knee arthroscopy performed for an appropriate indication and specific pathology is safe. However, research has shown that arthroscopy for degenerative knee pain without specific mechanical pathology does not provide meaningful benefit over physical therapy, and carries the risks of any surgery. This is why proper patient selection — treating specific lesions, not diffuse arthritis — is critical. Your surgeon will discuss whether your symptoms and imaging findings constitute an appropriate indication for surgery.

What is the difference between a diagnostic and therapeutic arthroscopy?

Diagnostic arthroscopy refers to using the arthroscope to look inside the joint to establish a diagnosis. Therapeutic arthroscopy means treatment is also performed. In practice, the two are almost always combined — if you are undergoing general anesthesia, findings are addressed at the same time. Pure diagnostic arthroscopy without treatment has been largely replaced by high-quality MRI in most situations.

Will I be awake during knee arthroscopy?

Most patients are under general anesthesia (asleep). Regional anesthesia (a nerve block that numbs the leg) is often added for post-operative pain control. Some very short procedures can be performed under spinal or regional anesthesia alone with sedation, but for most knee arthroscopy, general anesthesia provides the most comfortable experience.

Related conditions

Patellar Tendinitis (Jumper's Knee)ITB Syndrome (Iliotibial Band Syndrome)Pes Anserine Bursitis Baker's Cyst (Popliteal Cyst)Osgood-Schlatter Disease

Medically reviewed by Christopher S. Raffo, MD

Last reviewed May 20, 2026