Knee Arthroscopy

ΠΕΡΙΕΧΟΜΕΝΑ

The knee constitutes the largest and perhaps the most complex joint in the human body. It is the central axis that supports our weight, absorbs shock with our every step, and allows us to perform simple daily movements, such as walking and sitting, but also highly demanding sports activities, such as running, jumping, and abrupt changes of direction. However, when this joint is injured or undergoes wear, the patient’s quality of life is degraded immediately and dramatically. Fortunately, modern orthopedics has evolved impressively. Knee arthroscopy represents today a minimally invasive surgical technique—a true revolution—widely used for the diagnosis and definitive treatment of various conditions and sports injuries of the knee joint. It is a modern, exceptionally safe, and effective method that offers rapid recovery, minimal postoperative pain, and nearly zero complications compared to the traditional “open” surgical operations of the past.

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What is Knee Arthroscopy?

The term originates from the Greek words “arthrosis” (joint) and “skopein” (to look at/observe). Knee arthroscopy is an innovative, minimally invasive surgical technique during which the specialized orthopedic surgeon utilizes a specific, advanced tool called an arthroscope. The arthroscope is a microscopic endoscope—with a thickness roughly equal to a pencil (around 4-5 millimeters)—which features a high-definition camera (often 4K) and a powerful fiber-optic lighting system at its tip.

Through a very small incision in the skin, the arthroscope is introduced into the interior of the joint. The camera transmits live and magnified images of the inside of the knee onto a large monitor within the operating room. This method allows the orthopedic surgeon to inspect with absolute detail, diagnose with millimeter precision, and, simultaneously, address (with the use of micro-instruments) any anatomical problems without requiring the large, traumatic incision (arthrotomy) that used to cause extensive damage to muscles and tissues.

The Anatomy of the Knee

To understand the importance of arthroscopy, it is helpful to know the basic elements that the surgeon examines:

The Menisci (Medial and Lateral): Two C-shaped fibrocartilaginous discs that function as the knee’s “shock absorbers,” absorbing impacts.
Articular Cartilage: The smooth, white protective layer covering the ends of the bones (femur, tibia, patella), allowing them to glide without friction.
Cruciate Ligaments (Anterior and Posterior): They cross in the center of the knee and prevent excessive movement of the bones forward or backward.
Synovial Membrane (Synovium): Lines the joint and produces the synovial fluid for its lubrication.

When is Knee Arthroscopy Indicated?

Arthroscopy is not the first solution for every knee pain. Initially, evaluating conservative treatment is always recommended. However, when the patient’s symptoms do not subside with conservative methods—such as targeted medication, rest, specialized physical therapy programs, or intra-articular injections (hyaluronic acid, PRP)—then surgical intervention becomes the only option. Some of the most common conditions definitively treated with arthroscopy include:

Meniscus Tear (Medial or Lateral meniscus): This constitutes the most frequent indication. The surgeon can either remove the broken, unstable piece (partial meniscectomy) or, in young patients with an appropriate tear type, suture it (meniscus repair), saving the tissue.
Anterior Cruciate Ligament (ACL) Tear: One of the most serious sports injuries. Ligamentoplasty is performed arthroscopically, meaning the replacement of the torn ligament with a new graft (usually from the patient’s own tendons).
Chondropathies and Wear of Articular Cartilage: Lesions on the bone surface (osteochondral defects) can be cleaned or treated with microfracture techniques that stimulate the body to produce new, substitute cartilage.
Removal of Loose Bodies: Small pieces of bone or cartilage that have detached and float freely inside the joint, causing pain and “locking” (like a pebble inside a gear).
Synovitis or Inflammatory Joint Diseases: In cases of rheumatoid arthritis or persistent inflammation, cleaning and removal of the inflamed synovial membrane (synovectomy) is performed.
Patellar Instability Repair: When the patella moves out of its position (dislocation), arthroscopy helps relax tight tissues or repair the ligaments that keep it centered.
Early-stage Knee Arthritis: An “arthroscopic cleaning” (debridement) can be performed to remove osteophytes and inflammatory elements, offering significant relief and delaying the need for total arthroplasty.

Symptoms That Can Lead to Arthroscopy

It is important to be able to recognize the signs that indicate an intra-articular injury. Symptoms that may render a medical examination and possibly an arthroscopic procedure necessary include:

Persistent, acute knee pain: Pain that does not subside with conservative treatments, worsens with walking, running, or climbing up/down stairs, and often wakes you up at night.
Edema (Swelling) and Stiffness: Fluid frequently appears in the knee (effusion) as a result of the body’s reaction to inflammation or mechanical damage (e.g., from a torn meniscus that irritates the cartilage).
Sensation of “Locking” or Catching: The patient feels that the knee “sticks” in a certain position and can neither bend nor straighten it completely.
Instability (Giving Way): The feeling that the knee suddenly “gives out” or empties when you bear weight on it, a fact directly related to cruciate ligament tears.
Crepitus (Friction sounds): A characteristic “click” or friction sound accompanied by pain during movement.

How is Knee Arthroscopy Performed? (The Procedure)

Arthroscopy is now considered a routine operation for specialized surgeons and is usually performed as a same-day procedure (Day Clinic), without the need for an overnight stay (hospitalization) at the hospital.

Preparation

Prior to surgery, the necessary preoperative checkup (blood tests, electrocardiogram) takes place.
Your doctor will provide instructions on when you must stop eating or drinking (usually 6-8 hours before) and how to manage any medication you are already taking.

The Surgery Step-by-Step

Anesthesia: Administered following consultation with the anesthesiologist. It can be spinal (epidural), regional, light general anesthesia, or—in specific cases—local anesthesia, depending on the nature of the condition, medical history, and patient preference.
Creation of small incisions (Portals): The surgeon typically makes two (or three, if needed) microscopic incisions of 5-10 millimeters, right below the patella.
Joint distension: Through one incision, the knee is filled with sterile normal saline. This fluid “inflates” the joint, clears away blood, and creates the necessary space for optimal visibility.
Arthroscope Insertion and Examination: The arthroscope is inserted through the first incision, transmitting high-definition images from the interior. The doctor meticulously maps out all anatomical elements.
Execution of surgical actions: Specialized micro-tools (such as small scissors, mechanical shavers, or radiofrequency thermal tools) are inserted through the second (and third) incision for the cleaning and definitive restoration of localized lesions.
Closure of incisions: The fluid is removed, and the microscopic incisions are closed with 1-2 sutures or even with special adhesive strips (steri-strips). A compression bandage is applied.

The entire process lasts on average 30 to 60 minutes, depending on the nature and complexity of the operation.

Benefits of Knee Arthroscopy

Arthroscopic surgery has replaced major surgeries because it presents immense, proven advantages:

Small incisions and minimal trauma: The muscles and tendons around the knee are not cut, which means less postoperative pain.
Faster recovery: Returning to daily activities (walking, driving, office work) occurs in record time.
Reduced risk of complications: The postoperative infection rate is virtually zero (less than 0.1%), as the joint is not opened to room air.
Excellent aesthetic result: The microscopic scars heal flawlessly and, after some time, become almost invisible.
Absolute Precision: The camera allows the surgeon to see points at the back of the knee that were impossible to examine with the old open method.

Rehabilitation and Recovery

The duration of rehabilitation depends directly on the type of procedure (e.g., it is much faster in a simple meniscus removal compared to a meniscus repair or a cruciate ligament reconstruction). The general timeline usually includes:

The First Days (Protection Phase)

Rest is required for the first 48-72 hours.
The international R.I.C.E. protocol (Rest-Ice-Compression-Elevation) is applied: rest, frequent application of ice to reduce edema, use of an elastic bandage, and elevation of the leg above the level of the heart.
The use of crutches may be necessary for a few days to avoid full weight-bearing on the limb, depending on the doctor’s instructions.

Weeks 1-2 (Restoring Movement)

The patient is encouraged to walk. Gentle kinesiototherapy begins to avoid postoperative stiffness.
Knee flexion and extension improve gradually, and sutures are typically removed between 10 to 14 days.
At this stage, returning to office work is frequently permitted.

Weeks 3-6 (Strengthening)

Systematic physical therapy begins to strengthen the thigh muscles (quadriceps and hamstrings) and fully improve mobility and proprioception (balance). The knee starts to feel completely normal.

Months 2-3 (Return to Sports)

For patients who underwent simple procedures, a full return to intense sports activities (running, football) is feasible.
Caution: In complex operations, such as ligament restoration (ACL), the biological integration of the graft requires time, and a full return (Return To Play) lasts from 6 to 9 months.

Postoperative Care and Prevention of Complications

The success of the surgery is completed at home. For the best, fastest, and safest recovery, the patient must faithfully follow the doctor’s instructions:

Incision protection: Keep the wounds clean and dry until the sutures are removed. Swimming in the sea or bathing in a tub is prohibited for the first 15 days.
Avoid excessive load: Do not push the knee to its limits during the first weeks; biological healing requires time.
Regular physical therapy: Dedication to the exercise program for restoring strength and flexibility is the “secret” to success.
Maintaining a healthy body weight: Every extra pound increases the pressure the knee receives, putting a strain on the cartilage.
Use of equipment: Follow instructions for using supportive equipment, such as special functional braces, if recommended after ACL reconstruction.

Prevention of Knee Injuries and Wear

Prevention is always better than treatment. To reduce the risk of future injuries and avoid the need for a repeat arthroscopy in the future, follow these basic rules:

Strengthen the muscles around the knee: Strong quadriceps and hamstrings function as the joint’s “active brace,” absorbing loads.
Avoid overtraining: Do not ignore discomforts. Avoid repetitive strains, especially if you feel fatigue.
Warm-up and Stretching: Never start intense exercise with cold muscles. Do a proper warm-up and stretches after exercise (cool-down).
Proprioception: Incorporate balance exercises into your routine.
Proper equipment: Use correct technique in your sport and high-quality footwear for proper shock-absorbing support.

A Few Words About the Doctor (Dr. Polyzois)

Arthroscopic knee surgery requires specialization, absolute precision, and vast experience, as the margin for error is minimal. Orthopedic Surgeon Mr. Polyzois provides a guarantee for the correct management of your condition.

He is the only Orthopedic Surgeon in Greece specializing in shoulder and upper limb surgery (with vast experience in knee conditions as well) with a background of holding a permanent directorial position (substantive Consultant) for 10 consecutive years in the National Health Service (NHS) of Great Britain. During his many years of tenure in top hospitals abroad, he managed the most complex cases of sports injuries and cartilage lesions, performing thousands of successful arthroscopic surgeries. He regularly participates in the largest international conferences, faithfully applying the most modern and strict medical protocols of Sports Medicine, with the sole guide of fully and quickly returning the patient to their normal life.

Cost and Prices for Knee Arthroscopy

One of the most frequent and completely natural questions from patients concerns the financial cost of arthroscopy. The philosophy of our clinic is that top-tier medical care, modern techniques, and patient safety must be affordable. The total cost for the operation is structured strictly on an individualized basis.

It depends on the type of lesion (a simple meniscus removal has a different cost and demands compared to a meniscus repair or a full ACL reconstruction), the length of stay at the clinic (usually only day surgery is required, which drastically reduces expenses), as well as the specialized disposable materials (absorbable screws, special sutures) that will be needed. Our team has ensured the maximum possible transparency (with no hidden charges) and maintains excellent cooperation with all private insurance companies, while the use of the state provider (EOPYY) is also supported to cover a large part of the clinical expenses (medications, hospitalization). During your visit and after the definitive diagnosis, you will receive a full, detailed briefing and a financial proposal completely tailored to your needs.

Knee arthroscopy is a modern, safe, and effective solution. If you are experiencing persistent pain or mobility problems, do not put your life on pause. Movement is life! Contact the doctor for specialized orthopedic care, tailored to your needs.

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Συχνές ερωτήσεις

When can I climb stairs after arthroscopy?

This depends directly on the type of surgery. If a simple arthroscopy for the removal (cleaning) of a torn meniscus has been performed, the patient can usually climb up and down stairs with care (using the handrail and placing one foot on each step at a time) within 2-4 days. Conversely, if a meniscus repair, cartilage damage treatment, or ACL reconstruction has been done, flexion under load—such as climbing stairs—is prohibited or significantly restricted for the first 4 to 6 weeks to protect tissue healing.

Can the weather (humidity/cold) affect the knee after the operation?

Yes, this is a very common phenomenon. Many patients complain of a dull pain, “tugging,” or sensitivity in the knee, both in the scars and inside the joint, when the temperature drops, humidity increases, or barometric pressure changes (when it is about to rain). The drop in barometric pressure causes tissues to expand slightly, pressing on nerve endings in a joint that was previously inflamed or operated on. The symptom is completely benign, expected, and usually improves dramatically over the months and with proper warming of the area.

How important is body weight after the surgery?

Body weight is the most critical exogenous factor for knee health. To understand the analogy, it is estimated that for every single extra pound of body weight, the knee receives an additional pressure of nearly 4 pounds during activities like walking or going down a flight of stairs! This means that 5 excess pounds translate to 20 pounds of extra load on the sensitive articular cartilage. Losing and maintaining a healthy body weight constitutes the best “life insurance” for your operated knee, preventing premature wear and osteoarthritis.

Can I sleep in any position after arthroscopy?

During the first 1-2 weeks, the ideal sleeping posture is on your back, with the leg straightened and slightly elevated (on 1-2 pillows placed under the heel or calf, and NOT right under the knee, so as not to encourage stiffness in flexion). This helps subside the postoperative edema. If you wish to sleep on your side, it is recommended to place a soft pillow between your knees to avoid direct pressure on the operated joint and poor alignment of the spine. After the first few weeks, you will gradually be able to sleep freely in the position that comforts you.

How important is muscle strengthening after arthroscopy?

It is of absolutely pivotal importance. Surgery corrects the mechanical problem, but functional recovery depends on your muscles. Following any injury or operation on the knee, the quadriceps muscle (at the front of the thigh) presents rapid atrophy (loses volume and strength). Without strong muscles, the knee remains unstable and all forces are absorbed directly by the joint, causing pain. An individualized physical therapy program focusing on progressive strengthening is the necessary prerequisite to return to your activities with absolute safety.

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