Arthroscopy (Keyhole) Surgery in Singapore

Joint pain and mobility issues can affect your daily activities and quality of life. If conservative treatments have not relieved your symptoms, arthroscopy surgery may be one of the options to manage certain joint conditions. This minimally invasive procedure, commonly known as keyhole surgery, allows orthopaedic surgeons to diagnose and treat various joint conditions through small incisions. At our clinic in Singapore, our Senior Consultant Orthopaedic Surgeon uses arthroscopy to help patients return to their active lifestyles with minimal disruption.

Dr Zackary Chua

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (Aus)MMed (SG)MRCS (Glasgow)FRCSEd (Orth)

Suitability Techniques Process Recovery Benefits Risks Cost FAQ Conclusion

What is Arthroscopy (Keyhole) Surgery?

Arthroscopy is a minimally invasive surgical procedure that enables orthopaedic surgeons to visualise, diagnose, and treat problems inside a joint. The term “arthroscopy” comes from two Greek words: “arthro” (joint) and “skopein” (to look). During this procedure, a small camera called an arthroscope is inserted through a tiny incision, typically less than 1cm, into the joint space.

The arthroscope transmits images to a video monitor, allowing the surgeon to see inside the joint in detail. Through additional small incisions, specialised instruments can be inserted to perform surgical treatment if required.

Arthroscopy is performed on various joints, with knee, shoulder, hip, ankle, elbow, and wrist. The procedure can be used to manage conditions such as torn cartilage, loose bone fragments, damaged ligaments, inflamed joint linings, and joint infections.

Ideal Candidates

Patients with persistent joint pain not responding to conservative treatments (e.g., physiotherapy, medications, injections)
Individuals with mechanical symptoms such as locking, catching, or giving way of the joint
Active individuals seeking to return to sports or physical activities
Patients with confirmed joint pathology on MRI or other imaging studies
Those experiencing significant functional limitations due to joint problems
Individuals with isolated joint injuries rather than widespread arthritis
Patients in good overall health who can safely undergo anaesthesia
Non-smokers or those willing to quit before surgery for optimal healing

Contraindications

Active joint infection or skin infection near the surgical site
Severe medical conditions that make anaesthesia high-risk
Significant osteoarthritis with substantial joint space narrowing
Blood clotting disorders or use of certain blood-thinning medications
Previous surgery resulting in significant scarring or altered anatomy
Inability to comply with post-operative rehabilitation requirements

Your orthopaedic surgeon will conduct a thorough evaluation, including physical examination and review of imaging studies, to determine if arthroscopy is appropriate for your specific condition. Age alone is not a determining factor, as suitability depends on overall health, joint condition, and medical assessment.

Treatment Techniques & Approaches

Standard Arthroscopy Technique

The standard arthroscopic approach typically involves creating around two to four small incisions around the affected joint. One portal is used for the arthroscope, while others accommodate surgical instruments. The joint is distended with sterile fluid to improve visualisation and create working space. This technique allows comprehensive joint examination and treatment of certain pathologies while reducing tissue trauma.

Single-Portal Arthroscopy

In select cases, single-portal or “needle arthroscopy” may be used. This minimally invasive technique involves inserting a smaller arthroscope through a single-entry point. While it has limitations on the range of procedures, it can be applied for diagnostic purposes and certain therapeutic interventions, such as joint lavage or biopsy.

Radiofrequency-Assisted Arthroscopy

Some arthroscopic procedures incorporate radiofrequency technology for tissue ablation or shrinkage. This approach is typically used for treating certain ligament laxities, removing inflamed synovial tissue, or smoothing irregular cartilage surfaces. The controlled application of radiofrequency energy provides an additional method for tissue treatment under direct visual guidance.

Technology & Equipment Used

Modern arthroscopy typically makes use of high-definition cameras with 30-degree or 70-degree angled lenses for joint visualisation. Specialised instruments include graspers, scissors, shavers, burrs, and suture-passing devices, all designed to work through small portals. Fluid management systems help maintain visibility while regulating joint pressure during the procedure.

Wondering which approach is suitable for you?

Our Senior Consultant Orthopaedic Surgeon will evaluate your specific needs and recommend a compatible technique.

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The Treatment Process

Pre-Treatment Preparation

Before your arthroscopy surgery, a pre-operative assessment is usually carried out. This may include blood tests and, depending on your age and medical history, investigations such as a chest X-ray or ECG. If general anaesthesia is planned, fasting for a period of 6–8 hours is typically required. Patients are generally advised to arrange for someone to accompany them home after the procedure, as driving may not be recommended immediately afterwards.

Your surgeon will review your medications, and you may be required to stop certain drugs like blood thinners several days before surgery. For smokers, cessation is strongly advised to optimise healing. On the day of surgery, wear loose, comfortable clothing that’s easy to put on after the procedure.

During the Procedure

Arthroscopy typically takes around 30-90 minutes, depending on the complexity of the treatment. After anaesthesia administration (general, regional, or local with sedation), the surgical site is thoroughly cleaned and draped. The surgeon then creates small incisions and inserts the arthroscope, examining the joint structures systematically.

Sterile fluid flows through the joint to maintain clear visualisation. Using the video monitor as a guide, the surgeon may carry out procedures such as removing loose bodies, trimming torn cartilage, repairing ligaments, or treating rough surfaces. Once the procedure is completed, the joint is irrigated, instruments removed, and incisions closed with sutures or adhesive strips.

Immediate Post-Treatment

After surgery, you’ll recover in the post-anaesthesia care unit where medical staff monitor your vital signs and pain levels. Ice packs are applied to reduce swelling, and your joint may be wrapped in a compression bandage. Many patients are discharged on the same day, depending on their condition and recovery from anaesthesia

You’ll receive specific instructions about weight-bearing restrictions, which vary depending on the joint treated and procedures performed. Pain medication prescriptions and wound care instructions are provided. A follow-up appointment is scheduled, typically within 1-2 weeks for wound check and suture removal if needed.

Recovery & Aftercare

First 24-48 Hours

Keep the surgical site clean and dry, following your surgeon’s specific wound care instructions. Apply ice packs for 20 minutes several times daily to minimise swelling. Elevate the operated limb when resting to reduce swelling. Take prescribed pain medications as directed, typically transitioning to over-the-counter options within a few days.

Watch for warning signs including excessive bleeding through dressings, severe pain uncontrolled by medication, fever above 38°C, increasing redness or warmth around incisions, or unusual discharge from wound sites. Contact your surgeon immediately if these occur.
First Week

Continue ice therapy and elevation as needed for comfort and swelling control. Begin gentle range-of-motion exercises as instructed by your surgeon or physiotherapist. Gradually increase activity levels while respecting weight-bearing restrictions. Keep follow-up appointments for wound assessment and to ensure proper healing progress.

Most patients can shower after 48-72 hours with waterproof dressings. Avoid soaking in baths, pools, or hot tubs until wounds are fully healed. Return to light activities varies between individuals and depends on the procedure performed.
Long-term Recovery

Full recovery from arthroscopy varies significantly based on the specific procedure performed. Some procedures may allow earlier return to daily activities, while others require longer rehabilitation periods. More complex repairs, such as ligament reconstruction, may require 3-6 months of rehabilitation.

Our Senior Consultant Orthopaedic Surgeon provides post-procedure support to ensure optimal recovery.

Schedule your consultation to learn more about what to expect.

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Benefits of Arthroscopy (Keyhole) Surgery

The minimally invasive approach of arthroscopy allows surgeons to access the joint through small incisions. Depending on the procedure, this may help limit soft tissue disruption and may be associated with a shorter recovery period. Smaller incisions can also reduce scarring and the risk of wound complications.

The arthroscope provides enhanced visualisation, allowing the surgeon to examine the joint structures and identify issues that may not be detected with imaging studies alone. In some cases, additional findings can be addressed during the same procedure.

Arthroscopy can sometimes be performed on an outpatient basis. After surgery, your surgeon may recommend rehabilitation exercises to support recovery and joint function.

Common Side Effects

Patients may experience some degree of swelling and discomfort after arthroscopy, which typically resolves within 1-2 weeks. Mild bruising around portal sites can occur and generally fades over time. Temporary stiffness may be observed; exercises or physiotherapy may be recommended to support joint movement.

Some fluid drainage from portal sites in the first 24-48 hours can occur and is typically managed with dressing changes. Minor bleeding that stains dressings may be noticed but usually decreases over time.

Rare Complications

While arthroscopy is generally considered safe, rare complications may occur in less than 1% of cases. These can include infection, which may require antibiotics or additional surgery. Blood clots (deep vein thrombosis) are uncommon but may develop in lower limb procedures.

In rare instances, nerve or blood vessel injury near portal sites can occur. Instrument breakage within the joint is very uncommon with modern equipment but may require retrieval. Some patients may experience persistent stiffness or synovitis (joint lining inflammation) that may need additional treatment.

Our Senior Consultant orthopaedic surgeon conducts these procedures following standard sterile protocols and modern surgical techniques to manage risks and support patient safety.

Cost Considerations

The cost of arthroscopy surgery varies based on several factors including the specific joint involved, complexity of the procedure, and whether additional treatments are required. Hospital facility fees, surgeon fees, anaesthetist charges, and specialised equipment usage all contribute to the total cost. Day surgery procedures are generally less expensive than those requiring overnight admission.

Your consultation will include a detailed discussion of anticipated costs based on your specific treatment needs. The quote typically encompasses pre-operative investigations, surgical fees, hospital charges, and initial follow-up visits. Additional costs may include medications or other necessary services, depending on individual requirements.

Arthroscopy (Keyhole) Surgery

Frequently Asked Questions

How long does arthroscopy surgery take to perform?

Arthroscopy typically takes 30-90 minutes, depending on the complexity of your condition and the specific treatments required. Simple diagnostic procedures may be completed in 30 minutes, while complex repairs such as ligament reconstruction can take up to 2 hours. Your surgeon will provide a more accurate time estimate during your consultation based on your specific needs.

When can I return to sports after arthroscopy?

Return to sports varies based on the procedure performed and the specific sport. Simple meniscus trimming may allow return to low-impact activities within 2-4 weeks and contact sports in 6-8 weeks. More complex procedures like ACL reconstruction typically require 6-9 months before returning to pivoting sports. Your surgeon will guide your progression based on objective criteria.

Is arthroscopy painful?

Most patients experience mild to moderate discomfort after arthroscopy. The minimally invasive nature of keyhole surgery generally results in less pain than open procedures. Pain is typically well-controlled with prescribed medications for the first few days, then managed with over-the-counter pain relievers. Ice therapy and elevation also help reduce discomfort.

Can arthroscopy be performed under local anaesthesia?

Yes, some arthroscopic procedures can be performed under local anaesthesia with sedation for knee and shoulder procedures. The choice of anaesthesia depends on the specific procedure, expected duration, patient preference, and medical factors. Your surgeon will discuss a suitable option during your pre-operative assessment.

How many incisions are made during arthroscopy?

Most arthroscopic procedures require 2-4 small incisions, each typically 5-10mm in length. The exact number depends on the joint being treated and the complexity of the procedure. One portal is used for the arthroscope camera, while the others accommodate surgical instruments. These small incisions in your joint typically heal over time, and scarring is usually limited.

What’s the success rate of arthroscopy surgery?

Success rates for arthroscopy vary depending on the specific condition being treated. Post-operative outcomes depend on factors including the underlying pathology, patient age, activity level, and adherence to rehabilitation. Your surgeon will discuss appropriate expectations based on your specific situation.

Can arthroscopy diagnose problems that MRI scans miss?

Yes, arthroscopy can help to identify certain conditions that may not be clearly visible on MRI scans. The direct visualisation allows detection of subtle cartilage changes, loose bodies, or synovial abnormalities that imaging might miss.

Conclusion

Arthroscopy (keyhole) surgery is a minimally invasive procedure used to examine and treat joint conditions. Depending on the condition and procedure performed, arthroscopy may help manage joint problems and support recovery. The use of small incisions and post-operative rehabilitation exercises can be part of the overall treatment plan recommended by your surgeon.

Ready to Take the Next Step?

If you are exploring arthroscopy surgery, you can discuss your condition and treatment options with our Senior Consultant Orthopaedic Surgeon. The consultation can provide more information about the procedure to help you make an informed decision.

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Dr Zackary Chua (蔡克祥医生)

Senior Consultant Orthopaedic Surgeon (Adult & Paeds)

MBBS (AUS)|MMed (Singapore)|MRCS (Glasgow)|FRCSEd (Orth)

A senior consultant orthopaedic surgeon with dual specialisations in Foot & Ankle Surgery and Paediatric Orthopaedics. Backed by his extensive years of training and experience, Dr Chua brings the necessary knowledge and skills to ensure a smooth recovery journey.

Rooted firmly by two fundamental philosophies: “When one’s feet hurt, one hurts all over” and “Children are not little adults”, Dr Chua’s approach to patient care reflects his compassionate care for adults and children.

Singhealth Quality Excellence Award – Silver (2011)
Service From the Heart Award (2021)
Singapore Health Quality Service Award – Gold (2023)
NUS Medicine Dean’s Award for Teaching Excellence (2023)

His active participation in the medical community extends to mentoring, research supervision, and contributions to key professional forums and symposiums, both locally and internationally.