March 19, 2026
Author: Dr. Alexandru Grecu — Senior Orthopedic and Trauma Surgeon
Medically reviewed by Dr. Alexandru Florian Grecu, Senior Orthopedic Surgeon · Published: March 19, 2026 · Updated: 2 mai 2026
Knee arthroscopy is one of the most common orthopedic procedures. Yet, many patients come to my office with incomplete or even incorrect information about what this surgery entails. So, I decided to explain in detail what arthroscopy means, when it is indicated, how long it actually takes, and what recovery looks like.
Arthroscopy is a minimally invasive surgical procedure. Through two or three small incisions (each about 5 mm), a miniature video camera (the arthroscope) and the necessary surgical instruments are inserted into the joint. The surgeon operates by watching the image on a screen, without needing to open up the joint.
This technique allows for both a precise diagnosis of intra-articular lesions (which an MRI doesn't always capture) and their treatment in the same session.
Knee arthroscopy is recommended in the following situations: meniscus tears (tears causing locking, pain, recurrent swelling), cruciate ligament injuries (especially anterior cruciate ligament — ACL reconstruction), cartilage damage (chondropathy, chondral lesions), intra-articular loose bodies (fragments of cartilage or bone that "float" in the joint and cause locking), symptomatic synovial plica, and for pre-operative evaluation before larger surgeries.
Not all knee pain requires arthroscopy. Advanced osteoarthritis, for example, is usually treated with a knee replacement, not arthroscopy. The right decision comes after a consultation where I evaluate the clinical exam, X-rays, and, if necessary, the MRI.
This is the question I get most often. The answer depends on what needs to be fixed:
A simple arthroscopy, such as resecting a torn meniscus fragment, takes between 20 and 40 minutes. An anterior cruciate ligament (ACL) reconstruction takes between 60 and 90 minutes. Combined procedures (meniscus + ligament, or meniscus + cartilage) can last between 60 and 120 minutes.
To these durations, you add the anesthesia time (preparation, induction, waking up), which is another 30-45 minutes. Therefore, the patient spends between 1 hour and 2.5 hours in the operating room in total, depending on the complexity.
Most commonly, spinal anesthesia is used, which numbs only the lower half of the body. The patient remains awake and can watch the surgery on the screen if they wish. Alternatively, general anesthesia can be chosen.
Knee arthroscopy is usually performed as a day surgery procedure. The patient comes in the morning, has the surgery, and goes home in the afternoon or evening of the same day. For ligament reconstructions, the hospital stay may be 1-2 days.
Recovery varies considerably depending on the type of procedure:
After a meniscus resection (the most common procedure): walking with partial weight-bearing begins immediately, crutches are needed for only 3-7 days, return to daily activities occurs in 1-2 weeks, and return to sports in 4-6 weeks.
After a meniscus repair (repair, not resection): recovery is longer because the repaired meniscus needs time to heal. Crutches are necessary for 4-6 weeks, full weight-bearing is resumed gradually, and sports are not recommended for at least 3-4 months.
After ACL reconstruction: this is the longest recovery. The protocol includes 6-9 months of progressive physical therapy, with a return to competitive sports at a minimum of 9 months, sometimes 12 months.
Regardless of the type of arthroscopy, post-operative physical therapy is essential. The first exercises start on the day of the surgery: ankle pumps, isometric quadriceps contractions, straight leg raises. Then, the program progressively increases in intensity. A well-followed physical therapy program makes the difference between an excellent recovery and a mediocre one. I always recommend my patients work with an experienced physical therapist, at least in the first few weeks.
Arthroscopy is a safe procedure, but like any surgery, it has risks. The most common are: post-operative swelling and pain (normal, resolve in a few days), joint infection (rare, under 1%), hemarthrosis (blood accumulation in the joint), and joint stiffness (preventable with physical therapy). Serious complications are exceptional.
Arthroscopy is not a miracle cure. It does not solve advanced osteoarthritis, it does not stop the degenerative process, and it cannot repair completely destroyed cartilage. In these situations, we discuss other therapeutic options — from injections (hyaluronic acid, PRP) to joint replacement.
If you have persistent knee pain, locking, or joint instability, schedule an orthopedic consultation to determine the best treatment plan together.