Once a meniscal cartilage has torn it will not heal unless it is a very small tear which is near the capsule of the joint. Once the cartilage has torn it predisposes the knee to develop osteoarthritis (wear and tear) in 15 to 20 years. It is better to remove torn pieces from the knee if the knee is symptomatic.

Torn cartilages in general continue to cause symptoms of discomfort, pain, and swelling until the loose, ragged pieces are removed. Only the torn section is removed and the knee should recover and become symptom-free. If the entire meniscus is removed, the knee will develop osteoarthritis in 15 to 20 years. Nowadays only the torn section is removed and it is hoped that this will delay the onset of long-term wear and tear osteoarthritis.

Occasionally, provided the knee is stable and the tear is a certain type of tear in a young patient (peripheral bucket handle tear), the meniscus may be suitable for repair. If repaired one has to avoid sports for a minimum of three months.

Isolated areas of articular cartilage loss can be repaired using cartilage transplant technology. This is a new and exciting field that is developing in the treatment of specific isolated cartilage defects in younger patients

The process is called Autologous Chondrocyte Grafting. It involves harvesting cartilage cells from the affected knee, sending these cells to a laboratory, and then culturing the cells to multiply into many cells. The large amount of cells produced are then placed back into the affected knee into the defect requiring resurfacing. Results are still short-term follow-up but are looking encouraging.

After a major cartilage or ligament injury has been treated the knee can return to normal function. There is however a small increase in the risk of developing long-term wear and tear (Osteoarthritis) and depending on the degree of injury activity modification may be required. Activities that help prevent knees from deteriorating quickly include:

• Low-impact sports like swimming, cycling, and walking
• Reducing weight and maintaining a healthy diet

You will be admitted on the day of surgery and need to remain fasted for 6 hours prior to the procedure. The limb undergoing the procedure will be marked and identified prior to the anesthetic Once you are under anesthetic, the knee is prepared in a sterile fashion. A tourniquet is placed around the thigh to allow a ‘blood–free’ procedure.

The Arthroscope is introduced through a small (the size of a pen) incision on the outer side of the knee. A second incision on the inner side of the knee is made to introduce the instruments that allow examination of the joint and treatment of the problem.

• You will wake up in the recovery room and then be transferred back to the ward
• A bandage will be around the operated knee.
• Once you have recovered your drip will be removed and you will be shown a number of exercises to do.
• Your Surgeon will see you prior to discharge and explain the findings of the operation and what was done during surgery
• Pain medication will be provided and should be taken as directed
• You can remove the bandage in 24 hours and place waterproof dressings (provided) over the wounds.
• It is NORMAL for the knee to swell after the surgery. Elevating the leg when you are seated and placing ice packs on the knee will help to reduce swelling. (Ice packs on for 20 min 3-4 times a day until swelling has reduced)
• You are able to drive and return to work when comfortable unless otherwise instructed
• Please make an appointment 7-10 days after surgery to monitor your progress and remove the 2 stitches in your knee.

• Postoperative bleeding
• Deep Vein Thrombosis
• Infection
• Stiffness
• Numbness to part of the skin near the incisions
• Injury to vessels, nerves and a chronic pain syndrome
• Progression of the disease process

The risks and complications of arthroscopic knee surgery are extremely small. One must however bear in mind that occasionally there is more damage in the knee than was initially thought and that this may affect the recovery time. In addition, if the cartilage in the knee is partly worn out then arthroscopic surgery has about a 65% chance of improving symptoms in the short to medium term but more definitive surgery may be required in the future. In general arthroscopic surgery does not improve knees that have well-established Osteoarthritis.