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Treatments
A minimally invasive day-case operation that lets Mr Oni look inside the knee through two small incisions, diagnose the problem precisely, and treat it in the same procedure. Most patients walk out the same day and are back at a desk within a week.
about this treatment
A knee arthroscopy, also known as keyhole knee surgery and sometimes called knee cartilage surgery, is a minimally invasive operation.
Through two small incisions, each only a few millimetres long, Mr Oni passes a thin camera (an arthroscope) into the joint and views the inside of the knee on a screen in high definition. Fine instruments are passed through a second incision to treat what is found, all in the same sitting.
It a common orthopaedic operation and is used to address mechanical problems inside the knee. The most frequent reasons are a torn meniscus (the cartilage cushion), a loose fragment of cartilage or bone floating in the joint, or a flap of tissue that catches as the knee bends. It can also help where stiffness or restricted movement is being caused by scar tissue inside the joint. Depending on what is found, Mr Oni may trim or repair a meniscal tear, remove a loose body, smooth damaged cartilage (a procedure known as arthroscopic debridement), or release scar tissue to restore movement.
It is important to be clear about what arthroscopy does and does not do. Keyhole surgery is very effective for true mechanical problems, but it is not a treatment for arthritis on its own.
Where the underlying issue is wear and tear, the evidence shows that simply washing out or debriding the joint does not give lasting relief, and Mr Oni will instead talk you through options such as injections or joint replacement. He will only recommend an arthroscopy when he genuinely expects it to help.
is this right for me?
Arthroscopy works best when there is a specific mechanical problem to address. Mr Oni recommends it when the history, examination, and imaging all point to something inside the joint that surgery can correct, and not as a general fix for an arthritic knee.
The knee jams, clicks, or catches, often caused by a torn meniscus or a loose fragment getting caught in the joint. These mechanical symptoms respond well to keyhole surgery.
A confirmed meniscus tear that has not improved with rest, physiotherapy, and time, and is still causing pain, swelling, or instability that limits daily life.
Examination and an MRI scan point to a problem arthroscopy can treat. Where the main issue is arthritis rather than a mechanical tear, Mr Oni will guide you towards more suitable options.
Not sure if you qualify?
Many patients come to Mr Oni uncertain whether their symptoms are "bad enough" for treatment. The answer always comes from a proper clinical assessment - not from a website. Book a consultation and Mr Oni will give you an honest view.
outcomes
These are the benefits and outcomes typically expected from this treatment. Realistic expectations matter, so you go into any treatment fully informed.
Keyhole surgery through two small incisions means less pain, minimal scarring, and a gentler recovery than open surgery.
A day-case procedure, so most patients are discharged a few hours after surgery with no overnight hospital stay.
The camera lets Mr Oni confirm exactly what is wrong inside the knee and treat it in the same procedure, avoiding a second operation.
Most patients walk the same day and are back to desk-based work within about a week, far sooner than after open surgery.
Recovery time after a knee arthroscopy is usually quick, but it depends on what was done inside the knee. Trimming a meniscal tear (a meniscectomy) recovers faster than repairing one, which needs to be protected for longer. Mr Oni gives you a personalised timeline at your consultation.
Rest with the leg elevated and ice to control swelling. You can put weight through the knee and walk, using crutches at first if it feels more comfortable.
Swelling settles and many patients are back to desk-based work within a week. Driving is usually possible once you can perform an emergency stop without hesitation, often around one to two weeks.
You will usually see Mr Oni for a follow-up at around two weeks, where he reviews your progress and talks through what was found during the operation. Guided physiotherapy rebuilds strength and movement, and walking distance and everyday activity steadily increase as the knee settles.
Most patients return to sport and more demanding activity from around four to eight weeks after a meniscal trim. A meniscal repair is protected for longer, with a slower, staged return.
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Most people are walking the same day and back to desk-based work within a week. A return to sport is typically around four to eight weeks if a tear was trimmed, and longer if a meniscus was repaired, as a repair needs more time to heal. Your exact timeline depends on what was done inside the knee.
For genuine mechanical problems, such as a locking knee, a loose fragment, or a meniscal tear that catches, keyhole surgery is very effective and relief is often immediate. It is far less effective when the underlying problem is arthritis, which is why Mr Oni assesses each knee carefully and only recommends arthroscopy when he expects a real benefit.
The cost depends on the hospital and whether you are self-funding or using private medical insurance. Mr Oni's team can provide a clear, itemised quote at your consultation.
Many patients do not need crutches at all, while others prefer them for the first day or two for confidence and comfort. You are usually able to put your full weight through the knee straight away, unless Mr Oni advises otherwise after a meniscal repair.
No, arthroscopy is not a treatment for arthritis on its own. The evidence shows that washing out or debriding an arthritic knee does not provide lasting relief. Where wear and tear is the main problem, Mr Oni will discuss more effective options such as Arthrosamid injections or, in advanced cases, knee replacement.
No, it is a minimally invasive, keyhole procedure carried out through two small incisions, usually as a day case, and far less invasive than open surgery. As with any operation there are some risks, including infection, blood clots, and ongoing swelling or stiffness, but serious complications are uncommon. Mr Oni discusses these with you fully before you decide.
Answers written by Mr Tofunmi Oni, Consultant Orthopaedic Surgeon (MBChB BSc PGDip FRCS (Tr & Orth), GMC 7074916), who performs knee arthroscopy at Nuffield Health Tunbridge Wells and The Horder Centre. Mr Oni does not perform ligament reconstruction and refers patients who need it to a specialist ligament surgeon. Figures come from NICE, the NHS, the British Association for Surgery of the Knee and the trials listed in the sources at the end. Last reviewed October 2026.
It depends entirely on what is wrong. For a worn, arthritic knee or a degenerative meniscal tear in middle age, high quality trials and a 2022 Cochrane review show arthroscopy gives little or no benefit over physiotherapy, or even over placebo surgery, and NICE now says simply: do not offer arthroscopic lavage or debridement to people with osteoarthritis. The British Association for Surgery of the Knee says arthroscopy is not appropriate as first line treatment for degenerative tears and recommends three to six months of structured physiotherapy first. Arthroscopy remains the right operation for a knee locked by a displaced tear or loose body, for a repairable tear after injury, and for tears with persistent mechanical symptoms that have not responded to proper rehabilitation. A good knee surgeon declines a lot of arthroscopies.
No. Washing out or trimming an arthritic knee does not improve pain or function in the longer term, which is why NICE and the Royal Colleges advise against it. Over 80% of arthritic knees have meniscal damage on MRI, so finding a tear on a scan in an arthritic knee is expected rather than a reason to operate. Treatment of arthritis centres on exercise, weight management, pain relief, injections where appropriate and, when needed, joint replacement.
It is a common keyhole procedure done through two or three small cuts, usually under general anaesthetic but sometimes under local or spinal, and most knee procedures take 30 minutes to an hour. It is not major surgery in the sense that a joint replacement is, but it is still an operation and still carries risk. Pain and swelling around the small wounds are normal for the first few days and are managed with simple painkillers. Newer nano arthroscopy systems use a 1.9 mm scope and can be done under local anaesthetic for diagnostic cases and some simple procedures.
You go home the same day, usually within a few hours. Most people can put weight on the leg on the day with crutches for comfort for a few days, and short walks are encouraged from the first days. After a simple trim, swelling and discomfort settle over two to six weeks and most people are back to usual activity and sport by six to eight weeks. A meniscal repair takes considerably longer: crutches for two to four weeks, no deep squatting for three months and a return to sport at four to six months.
A desk job is often possible within about a week; a manual job usually needs two to six weeks. You must not drive after a general anaesthetic and should only drive once you can do an emergency stop comfortably, which is usually one to two weeks after a simple arthroscopy and longer after a repair, and never while wearing a brace. The NHS says at least two weeks; the Royal College of Surgeons says at least one. Check with your insurer.
Do not drive until you can do an emergency stop, avoid impact sport for about six weeks, avoid flying in the early days (advice ranges from the first week to considerably longer, so ask your surgeon), and do not overdo it early. Equally, do not rest completely, as stiffness and a slower recovery follow. Keep the leg elevated when sitting, use ice, and contact the hospital or 111 for fever, worsening pain, smelly discharge, or severe swelling or redness.
Low but real. An analysis of 700,000 arthroscopic partial meniscectomies in England found serious complications within 90 days in 0.32% of cases, including pulmonary embolism in 0.08% and infection needing further surgery in 0.14%. The other risk, specific to trimming the meniscus, is that removing cushioning tissue can slightly increase the chance of arthritis later, which is one more reason to repair rather than trim where possible and to avoid operating on degenerative tears that will settle on their own.
Most do not need surgery. The outer third of the meniscus has a blood supply and some acute tears there can heal or be repaired. Degenerative tears in the inner part do not heal, but they very often stop causing symptoms with time and rehabilitation. The NHS states a meniscus tear can get better on its own without treatment, and UK guidance is at least three months of non operative care before surgery is considered, unless the knee is locked.
Usually not constantly. Many tears cause pain only with twisting, squatting or deep bending, and a large proportion of tears seen on MRI cause no symptoms at all; in one study 31% of people over 50 had a tear on MRI and most of those were pain free. Walking is fine and is encouraged after the first few days, and stairs and exercise can continue within comfort while avoiding deep squats and pivoting. If the knee locks, cannot straighten or will not take weight, you need urgent assessment.
For a degenerative tear there is no deadline: three to six months of rehabilitation first is the UK standard, and five year trial data show no disadvantage from choosing physiotherapy over surgery. The exceptions are a locked knee or a tear that might be repairable after injury, where earlier surgery gives better results; repairs done within six weeks succeed about 83% of the time, against 52% for late repairs. Warning signs are a knee that stays bent and will not straighten, recurrent true locking, increasing swelling, giving way, or inability to bear weight.
Often yes. A history of a twisting injury, tenderness along the joint line and provocation tests such as McMurray's and Thessaly's give a reasonable clinical diagnosis, and MRI confirms it and helps plan surgery, with sensitivity around 90% for medial tears. Because tears are so common in people without symptoms, a positive scan does not prove the tear is causing the pain. Conditions mistaken for a tear include osteoarthritis, fat pad or plica irritation, loose bodies and ligament injury.
Meniscal damage and arthritis are closely linked, but it is not clear that leaving a degenerative tear alone causes arthritis, and trimming it does not protect the knee: the sham controlled FIDELITY trial found slightly more X ray arthritis after surgery at five years, while the ESCAPE trial found comparable rates with surgery or physiotherapy. Preserving meniscus, repairing where possible and avoiding unnecessary removal, is the current principle.
NICE NG226, Osteoarthritis in over 16s (October 2022), recommendation 1.7.1. https://www.nice.org.uk/guidance/ng226
Abram SGF, Beard DJ, Price AJ, BASK Meniscal Working Group. Arthroscopic meniscal surgery: a national society treatment guideline and consensus statement. Bone Joint J 2019;101-B:652-9. https://doi.org/10.1302/0301-620X.101B6.BJJ-2019-0126.R1
British Association for Surgery of the Knee, statement on arthroscopic surgery for degenerative meniscal tears (April 2026). https://bask.ac.uk
O'Connor D et al. Arthroscopic surgery for degenerative knee disease. Cochrane Database of Systematic Reviews 2022, CD014328. https://doi.org/10.1002/14651858.CD014328
Sihvonen R et al. Arthroscopic partial meniscectomy versus sham surgery for a degenerative meniscal tear. N Engl J Med 2013;369:2515-24; five year results, Br J Sports Med 2020;54:1332-9.
Noorduyn JCA et al. Effect of physical therapy versus arthroscopic partial meniscectomy in people with degenerative meniscal tears: five year follow up of the ESCAPE trial. JAMA Netw Open 2022.
Englund M et al. Incidental meniscal findings on knee MRI in middle aged and elderly persons. N Engl J Med 2008;359:1108-15.
Abram SGF et al. Adverse outcomes after arthroscopic partial meniscectomy: a study of 700,000 procedures in the national Hospital Episode Statistics database for England. Lancet 2018;392:2194-202.
Rhind J et al. The locked knee. Br J Hosp Med 2024.
NHS.uk, Arthroscopy (reviewed September 2026) and Meniscus tear (reviewed September 2026). https://www.nhs.uk/conditions/arthroscopy/
Royal College of Surgeons of England, Get Well Soon: arthroscopic knee surgery. https://www.rcseng.ac.uk
Liverpool University Hospitals, Meniscal cartilage surgery patient leaflet (2021); East Kent Hospitals, Meniscal repair aftercare advice.
Mr Oni consults and operates at several leading private hospitals across the region, so you can choose the location most convenient for you.
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See Mr Oni at The Horder Centre, The Nuffield Hospital or The Vale Health Clinic.
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