You often hear about people having gastroscopy and minimally invasive laparoscopic gallbladder surgery in your daily life, but did you know that there is a similar endoscope – knee arthroscopy – for the management of knee lesions? I. What is an arthroscope? An arthroscope is an endoscope about 5 mm in diameter, as thick as a chopstick, with a lens with an illumination device at the end. The arthroscope is inserted into the knee, shoulder, elbow, and ankle joints through two 1cm minimally invasive surgical incisions, allowing the structures inside the joint cavity to be displayed on the screen in the form of magnified high-definition images, which can be used not only to observe joint structures and discover diseased tissues, but also to directly treat joint lesions. What diseases can be treated by knee arthroscopy Knee arthroscopy can deal with various injuries and lesions in the knee joint, such as meniscal injury, cruciate ligament injury, synovitis, patellofemoral joint disease, knee adhesions, cartilage injury, intra-articular fracture, etc. Knee arthroscopy for meniscal injuries III. How is arthroscopic surgery performed? Is it minimally invasive? After the patient is anesthetized and strictly sterilized, a 1cm incision is made on the skin of the knee joint on the left and right side, one of which is used as an observation access for the arthroscope to pass through and the other as an operation access for other instruments to enter. The surgeon examines the intra-articular image projected on the monitor to confirm the diagnosis of the lesion and performs the surgery with various specialized instruments from the operative approach. The incision is closed with sutures and dressings and the sutures are removed 1 week after surgery. IV. What are the advantages and limitations of knee arthroscopy? Advantages of knee arthroscopy: Compared to traditional surgery, arthroscopic surgery does not require incision of the joint capsule and is a minimally invasive procedure with small incisions, less pain, and relatively few complications, making it easy for patients to accept. In addition, arthroscopy provides a precise visualization of the lesion and facilitates a clear diagnosis. Moreover, the surgery does not affect the muscle structure around the joint, so the patient can move around and exercise early after the surgery, which is conducive to the recovery of joint function. Arthroscopy can also perform procedures that were difficult to perform with open surgery in the past, such as partial meniscectomy. Limitations of knee arthroscopy: Early postoperative swelling and fluid accumulation in the joint cavity can occur. In addition, for patients with meniscal injuries over the age of 50, knee pain is the result of a combination of meniscal injury and osteoarthritis (cartilage damage), as early to mid-stage osteoarthritis (cartilage damage) often occurs in this age group. Arthroscopy itself can only address meniscal damage, but not osteoarthritis (cartilage damage). At this point, the role of arthroscopic surgery is equivalent to a car maintenance, one surgery (maintenance) does not turn worn out joints (old car) into new joints (new car), but will mostly relieve pain (improve car performance). Therefore there will be a small percentage of patients who are not satisfied with the results of the procedure. In addition, although arthroscopy is a minimally invasive procedure, it is a more complex technique with a longer learning cycle that tests the surgeon’s experience and mastery level.