If you’re new to arthroscopy or considering a fellowship, knee arthroscopy is a topic you’ll undoubtedly learn a lot about.
Why the knee, you ask?
It’s one of the most routinely scoped joints in orthopedic practice, whether for sports injuries, meniscus tears, ACL reconstructions, or even diagnostics. As a fellow, you’ll keep your hands busy while honing your skills.
In this blog, we’ll look at the essential knee arthroscopy methods you’ll learn throughout your fellowship, how they’re performed, and why each is crucial in the real-world OR situation.
Why Learn Knee Arthroscopy?
Knee surgeries will most certainly take up a considerable portion of your arthroscopy fellowship training, particularly in hands-on and case-rich programs.
Here’s why knee arthroscopy is important:
- It is minimally invasive, allowing patients to recuperate quickly.
- It enables direct sight of intra articular pathologies.
- It serves as a gateway surgery, boosting confidence for shoulder, hip, and other more complicated scopes.
Core Techniques You’ll Master During Fellowship
1. Diagnostic knee arthroscopy
Before you can mend anything, you need to know how to look.
In this fundamental skill, you will learn:
- Proper portal positioning (anterolateral and anteromedial).
- Systematic joint inspection: patellofemoral joint, medial, intercondylar notch, and lateral compartments.
- Using the arthroscope and probe efficiently.
Fellows typically begin by doing diagnostic scopes under supervision to gain confidence with camera handling and joint mapping.
2. Meniscectomy (partial or total)
Torn meniscus? One of the most prevalent indications for knee arthroscopy.
You’ll learn to:
- Identify tear patterns: horizontal, radial, flap, bucket handle.
- Use tools such as punches, shavers, and biters.
- Remove only the injured part (preserve the meniscus whenever possible).
Pro Tip from Fellows: Always probe before cutting. Many tears are not evident at first glance.
3. Meniscus Repair
Preserving the meniscus has become the gold standard wherever possible.
You will train on:
- Inside-out, outside-in, and all-inside strategies
- When to select which approach
- Anchoring devices include FasT-Fix and Meniscal Cinch
- Post-operative rehabilitation planning
Repair is more technical than meniscectomy, and fellows are typically introduced after a high volume of diagnostic/meniscectomy cases.
4. Anterior Cruciate Ligament Reconstruction
This is one of the most important and sought-after talents in any arthroscopy fellowship.
What You’ll Learn:
- Graft choices include hamstring, BPTB, or allograft.
- Creating a femoral tunnel: transtibial versus transportal approaches
- Graft fixation methods (screws and buttons)
- Notchplasty with Tibial Tunnel Positioning
- Performing a Lachman test after fixation
Many fellows are able to execute ACL reconstructions independently by the end of their training, particularly in high-volume institutions.
5. Plica Excision and Synovectomy
These are frequently performed during diagnostic scopes if hypertrophic plica or synovitis is discovered.
You will learn to:
- Identify many forms of plica (medial, infrapatellar, etc.).
- Use shavers and radiofrequency to remove inflammatory tissue.
- Avoid injuring the cartilage or the fat pad.
Although not as exciting as ACLs, these are quick wins that fellows can complete with minimal assistance.
6. Chondroplasty and Microfracture Technique
Articular cartilage injury occurs often. Your training will cover the following:
- Smoothing ragged cartilage edges with a shaver or RF.
- Using microfracture to promote fibrocartilage repair
- Understand the indications and limitations of cartilage repair treatments.
You’ll also start thinking long-term: when is microfracture enough? When should a patient have OATS or MACI?
What Makes a Great Knee Arthroscopy Fellow?
From talking to fellows and mentors, here are a few insider tips:
- Practice camera control – it’s the difference between a confident and confused scope.
- Understand anatomy from the scope’s view – it’s very different than textbooks!
- Always assist before you lead – watching seniors can teach you more than any video.
- Log your cases – keep a structured record of procedures observed and performed.
How Arthroscopy College Can Help You Master Knee Arthroscopy Techniques?
Arthroscopy College does more than just guide you; we train you hands-on with some of the country’s best arthroscopy experts. Our in-house Fellowship in Arthroscopy is meant to help orthopedic doctors become confident, experienced arthroscopy specialists, particularly in knee surgeries.
1. Learn from Renowned Experts like Dr. Manu Bora
What sets us apart? You’ll have the opportunity to learn firsthand from experts such as Dr. Manu Bora, a top sports injury specialist and arthroscopic surgeon. With years of expertise and thousands of surgeries under his belt, Dr. Bora’s mentorship provides actual insights, practical surgical recommendations, and confidence that textbooks cannot provide.
2. Intensive Hands-on Surgical Training
Our fellows regularly participate in a wide range of arthroscopic knee surgeries, including diagnostic scoping, meniscus treatment, and difficult ACL reconstructions. You’ll collaborate closely with expert surgeons, participate in live procedures, and eventually take the lead with supervision.
3. Structured Learning and Real Surgical Experience
Our program combines clinical exposure with structured learning modules. You will become proficient in:
- Arthroscopic Portal Placement
- Meniscectomy and repair (inside-out, all-inside procedures)
- ACL Reconstruction Techniques
- Microfracture and chondroplasty procedures.
And, because we emphasize real-world application, you’ll finish your fellowship prepared to handle your own cases confidently.
4. Cadaver Labs, Workshops, and Skill Building Simulations
We provide frequent cadaveric labs, arthroscopy dry labs, and simulation-based training to assist you improve your hand-eye coordination, triangulation mastery, and instrument handling abilities both before and after live surgeries.
5. Career Guidance and Post-fellowship Support
In addition to surgical training, we provide career development guidance. Our faculty and alumni network will support you every step of the way, whether you’re taking orthopedic examinations, working in sports medicine hospitals, or starting your own private practice.
Final Thoughts
Mastering knee arthroscopy marks a significant milestone in your career as an orthopedic surgeon. During your fellowship, you will learn not only how to do procedures, but also when, why, and how to do it safely and successfully.
Whether you’re seeking a fellowship or are already enrolled, understanding these procedures can help shape your future career in sports medicine and minimally invasive orthopedics.
