Dr. Kaustubh Sawant — Arthroscopy & Orthopaedic Surgeon

A thin telescope with a camera, usually around four millimetres across, is passed into the joint through a small incision. Sterile fluid is used to open the space so the structures inside can be seen clearly on a monitor. One or two further small incisions allow fine instruments to be introduced if something needs to be treated. The specific anaesthetic, the number of portals and the length of the procedure depend on the joint and on what is found, and are discussed with you beforehand.

It is generally considered when there are mechanical symptoms — locking, catching, giving way, or a knee that will not straighten fully — or when a specific structure such as a meniscus or a cruciate ligament has been injured and symptoms have not settled with rest, medication and physiotherapy. It is not a routine treatment for generalised arthritic pain, where the evidence does not support it and other approaches are usually more appropriate.

Reasonable prompts to seek an opinion include joint pain lasting more than a few weeks despite rest, swelling that recurs, a joint that locks or gives way, a clear injury during sport, difficulty bearing weight, or night pain that disturbs sleep. Sudden severe pain after trauma, obvious deformity, or an inability to move or weight-bear should be assessed urgently rather than through a routine appointment.

A detailed history, then a structured physical examination of the affected joint and usually the one alongside it for comparison. Existing scans and reports are reviewed if you bring them. Further imaging is requested only where it will genuinely change the decision. You should leave with a working diagnosis explained in plain language, the realistic options including non-surgical ones, and a clear next step.

No. A large proportion of orthopaedic problems are managed without an operation — through activity modification, targeted physiotherapy, medication, injections or simply time. Surgery is recommended when the diagnosis, the examination and the available evidence support it, and when the likely benefit outweighs the risk for you specifically. Where waiting is a reasonable option, it is presented as one.

The rehabilitation protocol is written alongside the surgical plan, in stages: protection, restoration of movement, progressive strengthening, then a graded return to activity or sport. Timelines vary considerably with the procedure, the tissue involved and the individual, so specific durations are discussed in your own consultation rather than quoted generally. No outcome or timeline can be guaranteed in advance.

Then we look at what else there is, because surgery is one answer among several. Sometimes the answer is no surgery at all. Sometimes it is physiotherapy. Sometimes observation, sometimes an injection, sometimes arthroscopy, sometimes reconstruction. Come when you have a knee or shoulder problem and want to understand what is actually wrong and what your options are — you do not have to arrive having decided.

Often, yes. Tell me what you want to get back to. Maybe it is competitive sport, maybe your morning run, maybe the gym. Maybe it is picking up your child without shoulder pain, or climbing a flight of stairs without thinking about your knee. Or maybe it is simply sleeping through the night. The treatment plan should begin with that goal — not with the operation.

Yes, and it is a sensible thing to do before any elective operation. Bring your imaging, reports and any surgical plan you have already been given. A second opinion may confirm the original recommendation, suggest a different approach, or suggest that nothing needs doing yet — all three are useful answers.