Knee Arthroscopy

A Comprehensive Guide to Knee Arthroscopy

Knee arthroscopy surgery is performed as an arthroscopic (keyhole) technique. The surgeon will perform the procedure via 2 very small cuts (portals). Each portal is only about 3-5mm long, through which specialised instruments - including a telescopic camera - are guided.

Arthroscopic surgery to the knee is normally performed as a day case procedure and usually under a short general anaesthetic. Occasionally more complicated reconstructive procedures can also be performed during the procedure. Once inside the joint a myriad of issues can be treated - some can be completely cured, whereas others, only partially or not at all.

Getting the diagnosis right

The key to successful arthroscopy is to identify the problem pre-operatively with the use of careful examination, special investigations (frequently an MRI scan or X-ray) before discussing appropriate surgical options. In your initial consultation, your surgeon will go through your exact pathology and abnormalities within your knee. He or she will discuss whether this can be treated fully or partially using a keyhole (arthroscopic) technique.

Please note: an MRI is the best investigation for soft tissue injury within the knee and will clearly show meniscal tears, loose bodies and cartilage surface defects. An X-ray is a better investigation for osteoarthritis within the knee or a first line investigation for fractures of the bone. In the case of a younger person, most of the time an MRI scan will suffice but occasionally a surgeon will find it useful to obtain both X-ray and MRI scans.

Questions you may want to ask your surgeon

When should a knee arthroscopy be considered?

Knee arthroscopy will be indicated when the condition causing pain and instability within the knee is curable using an arthroscopic technique. The most common reasons for undergoing a knee arthroscopy are:

• a partial meniscectomy (ie. to treat a tear to your shock absorber cartilage)
• a meniscal repair surgery (to repair a torn meniscus)
• removal of a loose body
• treatment of a cartilage surface defect
• removal of impinging bands of tissue (ie a plica)
• to remove proliferative synovial tissue that has built up inside the knee (a synovectomy)
• the debulking (occasionally) of synovitis, the tissue that produces fluid inside the knee.

Please note: the key to successful knee arthroscopy, and a cure, is your surgeon making an accurate diagnosis and a careful plan of what is going to be achieved during the procedure.

How quickly do you recover from a knee arthroscopy?

Typically patients will be able to walk out of hospital within a few hours of surgery and be able to drive within approximately three days - as long as they can do an emergency stop. Most patients post-arthroscopy will be functioning normally within about two weeks but it does depend on the exact nature of the issue troubling them and whether this has been completely or partially cured by the procedure. Complete recovery does take longer depending on the condition.

Physiotherapy is very useful to increase range of motion, build muscle and improve confidence with the knee. It rather depends on the nature of the condition being treated arthroscopically but most patients find that some outpatient sessions of physiotherapy will be helpful. Please note: your surgeon and treating hospital physiotherapists should discuss physiotherapy and outpatient rehabilitation in your consultation.

What are the potential complications of knee arthroscopy surgery?

Typical complications include ongoing pain and instability, or the initial problem not being solved by the arthroscopy. This largely depends on the exact diagnosis. Removing a loose body - which can lock the knee - is an extremely successful arthroscopic procedure, returning the patient to normal. As is a meniscal tear on its own - again cure rates can be as good as 99%. However a meniscal tear with other ongoing issues within the knee, such as a degenerate knee may not be successful to operate on.

Complications can be divided into the following: 1. Initial pain and instability may persist if the problem has not been cured. 2. Certain issues within the knee may not be curable arthroscopically. 3. Infection (very rare). 4. Other systemic complications such as deep vein thrombosis or pulmonary embolus. 5. The need for further surgical intervention following an arthroscopic procedure. 6. General anaesthetic related complications.

Should complications relating to your surgery occur which require you to have further treatment in theatre (another operation within 12 months), our Protect my Care insurance policy will refund the cost of your original care. This policy is included in your care at no extra cost to you.

How to judge the best surgeon and hospital

Surgeon and hospital performance

It's recommended that you see a fellowship trained, sub-specialist consultant knee surgeon who frequently undertakes complex ligament reconstructive work around the knee (eg. ACL reconstructions). These surgeons would normally have the technical skills to perform the full range of arthroscopic procedures and joint preservation surgery, including cartilage repair, and have the experience to achieve consistent results.

A better recovery, with a lower chance of complication is derived from hospitals carrying out large volumes of your procedure. A dedicated orthopaedic ward with experienced and specialised nurses and physiotherapists is also a strong indicator of performance; with a dedicated pain control team making sure your post-op stay is as pain-free as possible.

Patient experience

Hospitals collect two main types of information from patients: direct reviews and outcome scores. Compare my Care look carefully at reviews and outcome data before helping you choose the hospital and surgeon to suit your needs.

Paying for treatment

The price of knee arthroscopy surgery ranges from £3,000 to over £7,000 with the biggest differentiating factors being: the exact nature of the procedure being performed under the keyhole technique, and the hospital you select.

Hospital figures quoted generally consist of hospital costs, surgeons fees, anaesthetic fees and occasionally extra imaging. However, depending on the hospital in question, the price quoted on its website will most likely be a guide price (and subject to variation).

Please note: meniscal repairs, meniscal root repairs and other complex procedures may incur extra costs over what is quoted for a knee arthroscopy but in most cases these should be agreed with your surgeon prior to the procedure.

Typically prices won't include other aspects of your treatment such as the initial diagnostic work up. Compare my Care aims to provide you with a fixed price for your procedure, hospital stay and surgeon follow up. Without a fixed price the cost of your surgery could be more than you expected.

How Compare my Care works for you

Compare my Care works by analysing surgeon and hospital volume and performance data, each hospital's facilities and CQC ratings, and available patient experience information to help patients find the best private healthcare providers for their care.

Our experienced concierge team will work with you to arrange an initial consultation with the surgeon at your selected hospital.

Please note: Compare my Care does everything possible to secure a fixed price for each procedure, but individual medical needs may result in diagnostic and treatment variation which can impact costs.

Introducing Protect my Care

‘Protect my Care’ is a unique ‘cash-back' insurance policy provided by Compare my Care. It was created to give patients additional protection and peace of mind when paying for their own surgery - and comes at no extra cost to the patient.

All surgeries come with risks but in the hands of a super-specialist surgeon these can be reduced further. However, in the rare event that a repeat surgery is needed within 12 months, patients will be refunded the cost of their original procedure - to spend as they see fit.