Arthroscopic Surgery

Arthroscopy, which literally means looking inside a joint, is both a way of diagnosing joint problems and a way of treating them. The surgeon uses an arthroscope, a slim fibre-optic camera attached to a narrow tube, which is passed through a small opening and sends a magnified, live image of the inside of the joint onto a screen. Working from that clear view, the surgeon passes fine instruments through one or two further tiny openings to trim, repair, reconstruct or remove the damaged tissue. The same technique covers a wide range of operations, from smoothing or repairing torn cartilage and stitching a torn meniscus to reconstructing a snapped ligament or repairing a torn tendon, all carried out through openings of about half a centimetre rather than a long incision.

Arthroscopy is recommended for structural joint problems that cause pain, swelling, locking, catching, giving way or loss of movement and that have not settled with rest, medication, injections or physiotherapy. In the knee it treats meniscus tears, anterior cruciate ligament tears, damaged cartilage, loose fragments and instability. In the shoulder it repairs rotator cuff tears, treats impingement, frees a frozen shoulder and stabilises a joint that keeps dislocating. It is also used for problems of the hip, ankle, elbow and wrist, including ankle cartilage damage, tennis elbow and wrist conditions such as carpal tunnel syndrome and ganglion cysts. It is most valuable when the damage is to soft tissue or cartilage that can be repaired or tidied, rather than a joint so worn that it needs replacing.

The choice of anaesthesia depends on the joint and the operation, and may be general, where the patient is fully asleep, spinal, which numbs the lower body for knee and ankle work, or local for a smaller procedure. After the skin is cleaned and the joint is gently filled with sterile fluid to open up the space, the surgeon makes a small incision and inserts the arthroscope, with one or two more small incisions for the working instruments. The light and camera at the tip show the interior on a screen, and once the problem is confirmed the corrective work is carried out, whether that is trimming or stitching cartilage, reconstructing a ligament with a graft or repairing a tendon. At the end the instruments are removed, the small openings are closed with a stitch or adhesive strips and a dressing is applied. The procedure usually takes about 30 minutes to 2 hours depending on what is repaired.

A good candidate has a joint problem confirmed by examination and imaging such as an MRI scan, is in a general state of health that allows safe anaesthesia, and has symptoms that justify surgery rather than continued non-surgical care. Preparation includes a review of the scans, blood tests where needed and an anaesthetic assessment, with regular medicines and any blood thinners adjusted on medical advice. Stopping smoking helps healing, particularly for ligament and tendon repairs. For international patients, an existing MRI and clinical report can often be reviewed before travel so the likely procedure is planned in advance, while the final examination and confirmation of the operation are completed in person, since the exact repair is sometimes decided once the joint is seen directly through the arthroscope.

Recovery is quicker than after open surgery because the tissues around the joint are barely disturbed. Many knee and shoulder patients go home the same day, and for simpler knee procedures walking with support often begins the same day, while more complex reconstructions need a brace, crutches or a sling and a more gradual programme. Physiotherapy is central to the result and usually starts within days, guiding safe movement and rebuilding strength. When planning a trip abroad, it is sensible to allow about 5 to 10 days in the destination city so the wounds can be checked, early movement established and a clear home rehabilitation plan provided before flying, with longer stays for major reconstructions. Because immobility on long flights raises the risk of blood clots, the team advises on timing, moving in the cabin and any precautions. After returning home, follow-up continues remotely by message or video, with interpreters and coordinators on hand, and physiotherapy can be continued near home.

Performed by an experienced surgeon in a properly equipped centre, arthroscopy is a safe procedure with a strong track record, and because it avoids a large incision the risks are lower than with open surgery, though no operation is entirely without risk. Expected early effects such as swelling, bruising, stiffness and mild discomfort settle within days to weeks with rest, elevation and physiotherapy. Less common risks include infection, bleeding into the joint, a blood clot in the leg, stiffness, injury to nearby nerves or vessels, or a repair that does not fully heal and occasionally needs revision; careful surgery, early movement and good rehabilitation keep these uncommon. Most patients return to work and daily life quickly and, after completing their physiotherapy, regain a stable, pain-free joint and often go back to sport. Choosing a qualified surgeon, completing the assessment and following the rehabilitation plan closely are the keys to a safe experience and a lasting result.