Arthroscopic knee surgery involves making 2-4 ¼" incisions in the knee and inserting an arthroscope into the knee to examine the cartilage, ligaments, and other structures. The arthroscopy serves two main purposes: to confirm the diagnosis of knee pathology and to repair the damage (if it is repairable). New technologies and techniques make it possible to repair a large variety of knee injuries entirely with the use of an arthroscope.

An arthroscope is a thin metal tube about ¼" in diameter with a small TV camera mounted inside it. It can be inserted into many joints to examine and repair the joints through tiny incisions. The most common joint examined this way is the knee.

Arthroscopic surgery is the most common knee surgery performed in the U.S. and is appropriate for patients of essentially all ages depending on their knee problems. Arthroscopic knee surgery is frequently done for injuries such as meniscus tears, anterior cruciate ligament (ACL) tears, damaged knee cartilage, knee infection, and knee inflammation. Occasionally, knee arthroscopy will be performed even if the exact cause of knee pain is unknown in order to confirm the diagnosis and then do the repair (usually at the same time). Most knee arthroscopies are done under general anesthesia, but it is possible to use other types of anesthesia including epidural, spinal, or rarely, local anesthesia. The actual surgery time varies widely, from 10 minutes to three hours depending on how extensive the repair. Most knee arthroscopies are done as day surgery meaning you come in the morning of surgery and go home the same day.

Some knee injuries will heal well with non-surgical treatments such as rest, ice, physical therapy, etc. Meniscal tears frequently will not heal on their own because the meniscus has a very poor blood supply and therefore poor healing potential. Meniscus repair is generally preferable to meniscus removal because the meniscus serves an important shock-absorbing function within the knee, but repair of the meniscus is usually not possible. Patients with ACL tears will frequently go through several weeks of physical therapy before having surgery to improve the outcomes of the surgery.

Prior to any surgery, your doctor will give you a complete medical examination and evaluate your overall health and your health history. You may be required to get additional tests such as X-rays and lab tests. Your doctor will also review with you the potential risks and benefits of the operation and will ask you to sign a consent form. It is important that you ask questions and be sure you understand the reason for the surgery as well as the risks.

It is important that you inform your doctor if you have allergies to any medications, what medications you are taking, and if you have bleeding problems. It is also important to inform your doctor if you are pregnant.

Your doctor will also give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, taking or avoiding certain vitamins and medications. Carefully following these instructions will help your surgery go more smoothly.

Depending on the circumstances of your surgery, you may be instructed to do the following:

• Completely empty your colon and cleanse your intestines prior to surgery. You may be requested to drink clear liquids only for one or several days prior to surgery.
• Stop eating or drinking after midnight the night before the operation except medications that your doctor has told you are permissible to take with a sip of water the morning of surgery.
• Plan for your care and recovery after the operation. Find someone to drive you home after the surgery. Allow for time to rest and try to find people to help you with your day-to-day duties.
• Stop smoking at least six to eight weeks prior to surgery as smoking delays wound healing. Smokers are also more likely to have breathing problems during surgery.

After about two to four hours in the recovery room, you will typically leave the hospital. Arthroscopic knee surgery can cause pain and swelling after surgery so pain medication is generally provided for one to three days after surgery.

An ace wrap and cold packs are used after surgery to reduce swelling and control pain. Occasionally (especially with ACL Surgery) a knee brace is used to stabilize the knee after surgery. Depending on the type of surgery, you can usually bear weight immediately or within one to two days. Your surgeon will provide detailed instructions to follow. Keeping the leg and knee elevated in the days after surgery will reduce swelling and also speed healing.

Physical therapy is usually not necessary after knee arthroscopy, but if used will usually begin quickly after surgery. The main focus is to decrease swelling, regain full range of motion and build muscle strength. The typical rehabilitation plan lasts six weeks to six months, performing both weight-bearing and non-weight-bearing exercises, range of motion and strengthening exercises.

A variety of factors may influence the cost of the surgery. They include:

• Insurance coverage
• Pre-existing health
• Insurance co-pay
• Location of the facility

These factors vary depending on you and your situation.

The cost of each procedure can vary dramatically based upon age, location, gender, and insurance coverage. HealthGrades provides detailed cost estimates which include the costs of the procedure, drugs, hospital stay, and more. Each cost estimate is easy to understand and provides medical terms you need to know.

The detailed cost estimate for Knee Repair Surgery (Arthroscopic ACL Meniscal Repair), includes costs for:

• Meniscal transplant
• Arthroscopic cartilage removal or repair (in the middle or side part of the knee)
• and Arthroscopic repair of the frontside or backside ligament.