Arthroscopic Surgery: What to Expect Before, During, and After

Key Takeaways

Arthroscopy is minimally invasive surgery using small incisions and a camera
Common for knees, shoulders, hips, ankles, and wrists
Recovery is faster than open surgery but varies by procedure
Not all joint problems are best treated arthroscopically
Success depends heavily on the underlying condition and patient factors
Physical therapy after surgery is crucial for optimal outcomes

Arthroscopic surgery has revolutionized how doctors diagnose and treat joint problems. If your doctor has recommended this procedure, understanding what’s involved can help you prepare and set realistic expectations.

This guide walks you through everything you need to know about arthroscopic surgery.

What Is Arthroscopy?

The Basics

Arthroscopy (from Greek “arthro” = joint, “skopein” = to look) uses a small camera called an arthroscope to see inside a joint. The surgeon makes small incisions (portals), typically 5-10mm, and inserts the camera and specialized instruments.

How It Works

Small incisions are made around the joint
The joint is filled with sterile fluid for better visibility
A camera transmits images to a monitor
Surgeon performs repairs using specialized instruments
Incisions are closed with sutures or tape

Diagnostic vs. Surgical

Diagnostic arthroscopy:

Looks inside to identify problems
Often done when imaging (MRI, X-ray) is inconclusive
May convert to surgical if problems found

Surgical arthroscopy:

Repairs identified problems
Planned based on prior diagnosis
Most common use today

Common Arthroscopic Procedures

Knee Arthroscopy

Most common procedures:

Meniscus repair or removal (torn cartilage)
ACL/PCL reconstruction
Cartilage restoration
Removal of loose bodies
Synovectomy (removing inflamed tissue)
Lateral release (for kneecap problems)

What it’s NOT good for:

Treating osteoarthritis alone (controversial, often not recommended)
Bone-on-bone arthritis
Significant joint degeneration

Shoulder Arthroscopy

Common procedures:

Rotator cuff repair
Labrum repair (SLAP tears, Bankart)
Subacromial decompression
AC joint repair
Removal of bone spurs
Capsular release (frozen shoulder)

Hip Arthroscopy

Common procedures:

Labral repair
FAI (femoroacetabular impingement) treatment
Removal of loose bodies
Cartilage treatment
Synovectomy

Other Joints

Ankle: Cartilage injuries, impingement, loose bodies Wrist: Carpal tunnel (sometimes), ligament repairs, ganglion removal Elbow: Loose body removal, tennis elbow (sometimes), arthritis debridement

Are You a Good Candidate?

Ideal Candidates

Specific structural problem identified on imaging
Failed conservative treatment (PT, medications, injections)
Good overall health for surgery
Realistic expectations
Committed to rehabilitation
Non-smoker or willing to quit

May Not Be Appropriate For

Severe osteoarthritis (especially knee)
Significant joint degeneration
Unable to participate in rehab
High surgical risk due to other health issues
Unrealistic expectations about outcomes

The Osteoarthritis Question

For knee osteoarthritis specifically, research (including the METEOR trial) has shown:

Arthroscopic surgery is generally NOT more effective than physical therapy alone
“Cleaning out” an arthritic knee doesn’t improve outcomes
Exception: If there’s a clear mechanical problem (loose body, locked knee)

Bottom line: If you have knee OA and are offered arthroscopy, ask specific questions about what the surgery will accomplish.

Before Surgery

Pre-Operative Evaluation

Medical clearance:

History and physical exam
Blood tests
EKG if indicated
Review of medications

Imaging:

X-rays
MRI (usually)
Sometimes CT scan

Pre-surgical instructions:

Medications to stop (blood thinners, certain supplements)
Fasting requirements
Arrival time
What to bring

Preparing Your Home

Set up a recovery area on the main floor if possible
Stock up on easy meals
Arrange help for the first few days
Get crutches or other equipment ready
Have ice packs available
Remove trip hazards

Day of Surgery

Typical timeline:

Arrive 1-2 hours before procedure
Change into hospital gown
IV placement
Meet with anesthesia team
Procedure (30 minutes to 2+ hours depending on what’s done)
Recovery room (1-2 hours)
Discharge same day (most arthroscopies)

The Procedure

Anesthesia Options

General anesthesia:

Completely asleep
Common for longer procedures
No awareness of surgery

Regional anesthesia:

Nerve block numbs the area
May be combined with sedation
Often used for knee and shoulder

Local with sedation:

Less common
For minor procedures
Quick recovery

What Happens During Surgery

Positioning: You’re positioned to access the joint
Prep: Surgical area cleaned and draped
Incisions: Small portals created
Inspection: Camera inserted, joint examined
Treatment: Repairs performed as needed
Closure: Incisions closed, bandaged
Recovery: Moved to recovery room

Duration

Simple diagnostic: 30 minutes
Meniscus repair: 45-60 minutes
ACL reconstruction: 1-2 hours
Rotator cuff repair: 1-2 hours
Complex procedures: 2+ hours

Recovery

Immediately After

In recovery room:

Pain medication given
Vital signs monitored
Ice applied to joint
Movement of fingers/toes checked

Before discharge:

Pain controlled
Able to drink fluids
Stable vital signs
Understand discharge instructions

First Few Days

Expect:

Swelling and bruising
Pain (manageable with medication)
Limited mobility
Need for ice and elevation
Bandage care

Do:

Keep leg/arm elevated
Ice regularly (20 minutes on, 20 off)
Take pain medication as prescribed
Gentle movement as instructed
Watch for warning signs

Don’t:

Get incisions wet initially
Bear full weight unless cleared
Drive while on narcotic pain medication
Ignore increasing pain or swelling

Recovery Timeline by Procedure

Simple meniscus removal:

Weight bearing: Immediately with crutches
Back to desk work: 1-2 weeks
Driving: 1-2 weeks
Full recovery: 4-6 weeks

Meniscus repair:

Weight bearing: Limited for 4-6 weeks
Back to desk work: 2-4 weeks
Driving: 4-6 weeks
Full recovery: 3-6 months

ACL reconstruction:

Weight bearing: Progressive over weeks
Back to desk work: 2-4 weeks
Driving: 4-6 weeks
Return to sports: 6-12 months

Rotator cuff repair:

Sling: 4-6 weeks
Driving: 4-6 weeks
Full recovery: 4-6 months
Return to overhead sports: 6-12 months

Physical Therapy

PT is crucial for successful outcomes:

Goals:

Reduce swelling and pain
Restore range of motion
Rebuild strength
Return to normal function
Prevent re-injury

Typical progression:

Start within days to weeks (depending on procedure)
2-3 sessions per week initially
Home exercises between sessions
Gradually increase intensity
Duration: 6 weeks to 6+ months

Risks and Complications

Common Minor Issues

Swelling lasting weeks
Stiffness requiring PT
Temporary numbness around incisions
Bruising
Fluid accumulation

Less Common but Serious

Infection: Less than 1% but requires prompt treatment
Blood clots: Risk varies by procedure and patient
Nerve damage: Usually temporary
Cartilage damage: From instruments
Continued pain: Surgery may not resolve symptoms

When to Call Your Doctor

Fever over 101.5°F
Increasing redness around incisions
Drainage from incisions (especially cloudy or foul-smelling)
Calf pain or swelling (could be blood clot)
Numbness or tingling that worsens
Pain not controlled by medication

Success Rates

By Procedure

Meniscus repair:

Success rate: 80-90% for appropriate candidates
Lower success in older patients or degenerative tears

ACL reconstruction:

Success rate: 85-95%
Return to sport: ~80%

Rotator cuff repair:

Success rate: 80-95% for pain relief
Re-tear rate: 10-40% depending on tear size

Factors Affecting Outcomes

Better outcomes with:

Appropriate patient selection
Experienced surgeon
Commitment to rehabilitation
Non-smoking
Healthy weight
No other joint problems

Worse outcomes with:

Treating arthritis alone
Advanced degeneration
Poor compliance with rehab
Smoking
Obesity
Unrealistic expectations

Cost and Insurance

Typical Costs

Facility fee: $5,000-$15,000
Surgeon fee: $2,000-$5,000
Anesthesia: $1,000-$3,000
Physical therapy: $1,500-$5,000 total

Insurance Coverage

Most insurance covers arthroscopy when medically necessary:

Deductibles and copays apply
May require prior authorization
Some procedures more scrutinized (knee OA debridement)
Out-of-network costs significantly higher

Frequently Asked Questions

Is arthroscopy considered major surgery?

It’s considered minimally invasive surgery, but it’s still surgery with real risks and recovery time. The term “minor surgery” can be misleading—recovery can take weeks to months depending on what’s done.

How long will I need crutches?

Depends entirely on the procedure. Simple knee scope: 1-3 days. Meniscus repair: 4-6 weeks. Your surgeon will give specific guidance based on what was done.

When can I return to sports?

Simple procedures: 4-6 weeks. Meniscus repair: 3-4 months. ACL reconstruction: 6-12 months. Return is based on healing and rehab progress, not just time.

What if arthroscopy doesn’t help?

Options depend on the underlying condition and may include more intensive physical therapy, different medications or injections, or potentially joint replacement if arthritis is advanced.

Can the same joint be scoped multiple times?

Yes, but outcomes often diminish with repeat procedures. If the first surgery didn’t provide lasting relief, the question becomes whether another scope will help or if different treatment is needed.

Considering your treatment options? Learn about steroid injections or read about when knee replacement becomes necessary.

Last medically reviewed: February 2025

Medical Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Discuss surgical options with your orthopedic surgeon to understand the risks and benefits for your specific situation.