Arthroscopic Surgery

Common Causes

• Meniscal tears. The meniscus can be torn suddenly through a twisting injury, or gradually through age-related wear. A meniscal tear typically causes pain on the inner or outer side of the knee, swelling, and a catching or locking sensation during movement.

• Ligament damage. The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) are the most commonly torn. A ligament injury creates a feeling that the knee is giving way or feeling unstable. Without treatment, the joint becomes progressively more vulnerable to further damage.

• Cartilage damage. The smooth lining of the knee joint can be damaged by acute injury or worn down through repetitive strain. Arthroscopic surgery allows Dr. Barrett to repair or remove the damaged cartilage and restore smooth joint function.

• Inflammation of the joint lining. In conditions such as synovitis or rheumatoid arthritis, the lining of the joint becomes chronically inflamed, producing excess fluid and causing persistent pain and swelling. Arthroscopic surgery can remove the affected tissue when other treatments have not provided relief.

• Rotator cuff tears. The group of tendons surrounding the shoulder joint can be partially or completely torn through a sudden injury or gradual wear from repetitive overhead activity. Symptoms include persistent pain, weakness in the arm, and difficulty lifting or rotating the shoulder.

• Shoulder impingement. The tendons of the rotator cuff become pinched beneath the bony arch at the top of the shoulder, causing pain and inflammation that can lead to tendon damage over time if left untreated.

• Labral tears. The labrum is the ring of cartilage that deepens the shoulder socket and helps keep the joint stable. Tears cause a deep ache, a clicking or catching sensation, or a feeling that the shoulder is unstable.

• Recurrent shoulder dislocation. When the structures that hold the shoulder in place are stretched or torn, the joint can become chronically unstable, causing it to dislocate or partially dislocate with relatively little force and causing progressive damage over time.

Benefits

• Minimal disruption. Small incisions mean less impact on the surrounding muscles and tissue, a lower risk of infection, and a much more comfortable early recovery.

• Pain relief. Addressing the underlying problem directly provides lasting relief from pain that had not resolved with rest or physiotherapy.

• Restored movement and stability. Whether it is returning to sport, climbing stairs without pain, or simply reaching overhead, the goal of arthroscopic surgery is to restore the function that the injury has taken away.

• Protection of long-term joint health. Many of the conditions treated arthroscopically worsen progressively if left unaddressed. Treating them at the right time helps to preserve the health of the joint for the future.

Common Arthroscopic Procedures

Partial Meniscectomy

This is a common procedure for a degenerative meniscal tear. The arthroscope is placed through an incision within the knee, providing a comprehensive view of the interior of the joint. Smaller surgical tools are used to trim or remove the damaged portion of the torn meniscus. Only the affected tissue is removed, preserving as much of the healthy meniscus as possible.

Reconstruction of the Anterior Cruciate Ligament (ACL)

ACL injuries are common in athletes who engage in intense physical activity. An ACL tear is repaired using a graft, typically taken from the patient's hamstring,  which is secured in place and gradually integrates with the surrounding bone over time. Because the new ligament needs time to consolidate and heal, this procedure requires a structured post-op rehabilitation programme.

Reconstruction of the Posterior Cruciate Ligament (PCL)

A torn PCL is rebuilt by replacing the torn ligament with a graft, restoring stability to the back of the knee. While some PCL injuries can be managed non-surgically, surgery is recommended when the instability is significant. As with ACL surgery, a dedicated rehabilitation programme is essential to achieving full recovery.

Surgical removal of affected synovial tissue

An arthroscope is inserted through an incision over the joint, and small surgical tools are used to remove the affected or inflamed synovial tissue. A sterile fluid is then used to flush the joint of any remaining debris. The surgery reduces the inflammation and excess fluid production that cause chronic pain and swelling, and allows the joint to move and function more comfortably.

Resection of loose bone fragments

This minimally invasive procedure removes loose cartilage or bone fragments. The fragments can develop as a result of injury, cartilage degeneration, or conditions such as osteochondritis dissecans. Without surgery, the fragments cause significant discomfort by catching between the joint surfaces during movement.

What to Expect Prior to Surgery

1. A pre-operative assessment. Dr. Barrett will review the patient's symptoms through examination to confirm the diagnosis and plan the surgery. General health is also assessed to make sure the patient is fit for the operation and anaesthetic.

2. A medication review. Patients may be asked to stop certain medicines (such as blood thinners or anti-inflammatory drugs) in the days before surgery.

3. Final surgery preparation. The patient may be asked not to eat or drink for several hours before the operation. It is also worth preparing the home environment before surgery. For knee surgery, a walking aid may be needed initially. For shoulder surgery, overhead reaching will be restricted in the early stages.

What to Expect During Surgery

Arthroscopic surgery is performed under either a general anaesthetic (the patient is fully asleep), a spinal anaesthetic (for knee procedures), or a regional nerve block (for shoulder procedures). Dr. Barrett will recommend the most appropriate option on a case-by-case basis. Most procedures take between 30 minutes and 2 hours, depending on the nature and extent of the repair.

1. A small incision is made alongside the joint. The arthroscope is inserted to give Dr. Barrett a clear, real-time view of the interior.

2. Through one or two additional small incisions, fine instruments are used to carry out the necessary work.

3. Once complete, the incisions are closed and dressed. For shoulder procedures, a sling is typically fitted before the patient leaves the theatre.

What to Expect During Recovery

Recovery varies depending on the joint and the specific procedure performed. The following is a general guide:

Days 1 – 5

Swelling, bruising, and discomfort are normal in the first few days and ease progressively. Rest and elevation of the affected joint are important. For shoulder procedures, the arm is supported in a sling. For knee procedures, the leg may or may not be able to bear immediate weight depending on what was done.

Weeks 1 – 6

Physiotherapy begins with gentle movement exercises focused on restoring range of motion and beginning to rebuild strength. For straightforward knee procedures, crutches are often no longer needed within two weeks. Shoulder procedures typically require the sling for 2 to 6 weeks, depending on what was repaired.

Weeks 6 – 12

Most patients are moving more comfortably and returning to light daily activities. Physiotherapy progresses to more active strengthening work as the repaired tissue consolidates.

Months 3 – 12

Full recovery, particularly following ligament reconstruction or significant rotator cuff injury repair, can take up to 12 months. Dr. Barrett will guide the patient's return to exercise and higher-impact activity based on how the joint is responding at each stage.