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KNEE ARTHROSCOPY · DIAGNOSTIC & THERAPEUTIC · FRANKLIN, TN

Knee Arthroscopy Surgery
in Franklin, TN

Minimally Invasive Knee Surgery · Diagnostic & Therapeutic · Complete Knee Care
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Call today (615) 791-2630

Knee arthroscopy is a minimally invasive surgical procedure that allows Dr. Cory Calendine to access the knee joint through small incisions using fiber-optic cameras and specialized instruments. At the Bone and Joint Institute of Tennessee in Franklin, TN, arthroscopy serves two important roles: diagnosis and treatment mechanical knee conditions including meniscus tears, and it is used as a diagnostic and preparatory tool for patients on a pathway toward knee replacement. 

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ANDERSON ORTHOPAEDIC INSTITUTE

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JOINT REPLACEMENTS/YEAR

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KNEE CARE: ARTHROSCOPY TO ARTHROPLASTY

MINIMALLY INVASIVE DIAGNOSIS AND TREATMENT

What Is Knee Arthroscopy?

The Procedure — Camera & Instruments

Knee arthroscopy uses a small fiber-optic camera called an arthroscope — about the width of a pencil — inserted through a small incision in the knee. The camera transmits a live, high-resolution image of the joint interior to a monitor, allowing Dr. Calendine to examine the cartilage, menisci, ligaments, synovial lining, and bone surfaces with detail that imaging alone cannot provide. Through additional small incisions, specialized instruments can be inserted to perform surgical treatment at the same time. The minimally invasive nature of arthroscopy — three to four small incisions rather than a large surgical opening — means less disruption to surrounding tissue, less post-operative discomfort, and faster recovery than open knee surgery. Procedures performed arthroscopically include meniscus repair or removal, loose body removal, synovectomy, cartilage debridement, and ACL evaluation.

Diagnostic vs. Therapeutic Arthroscopy

Arthroscopy serves two distinct clinical functions. As a diagnostic tool, it provides definitive visualization of the joint interior that resolves ambiguities in MRI findings and provides information that changes the surgical or treatment plan. A patient whose MRI suggests possible meniscus pathology but whose symptoms don’t fully match may benefit from diagnostic arthroscopy to clarify the picture before proceeding to joint replacement planning. As a therapeutic tool, arthroscopy directly repairs or addresses identifiable structural problems — removing a torn meniscal flap that is causing locking and catching, extracting loose cartilage fragments that are causing pain with movement, or reducing synovial inflammation. In patients with specific mechanical symptoms, including complex meniscus tears, and good underlying joint structure, these targeted repairs can restore function for years.

Medical illustration of knee arthroscopy procedure showing arthroscope and instruments repairing a torn meniscus inside the knee joint.

Knee arthroscopy allows surgeons to diagnose and treat conditions like meniscus tears and cartilage damage

KNEE CONDITIONS TREATED WITH ARTHROSCOPY 

When Is Knee Arthroscopy Used? — Indications

ConditionHow Arthroscopy Helps
Meniscus TearRepair (suture) or partial removal (meniscectomy) of torn meniscal tissue causing pain, locking, or swelling
Loose BodiesRemoval of cartilage or bone fragments floating inside the joint and causing catching or mechanical symptoms
SynovitisSynovectomy: removal of inflamed synovial lining causing persistent swelling and pain
Cartilage DamageDebridement and smoothing of damaged cartilage surfaces; evaluation of cartilage status before joint replacement planning
ACL EvaluationDirect visualization of ligament integrity and associated meniscal or cartilage damage
Diagnostic AmbiguityDefinitive intra-articular assessment when MRI findings are uncertain or symptoms do not match imaging

Symptoms That Suggest Arthroscopy May Be Appropriate

Knee arthroscopy is most effective when symptoms suggest a repairable structural problem rather than diffuse degenerative joint disease. The symptoms that most commonly warrant arthroscopic evaluation include: sharp, catching, or locking sensations in the knee; episodes where the knee feels like it is giving way mechanically; persistent swelling that has not resolved with physical therapy and injections; and pain that began after a specific injury or mechanical event rather than gradually worsening over time.

These symptoms are distinct from the gradual, activity-related aching of advancing arthritis, which is better addressed through the joint replacement pathway. When the clinical picture is mixed — some mechanical symptoms combined with background arthritis — arthroscopic assessment helps clarify whether the mechanical component is causing disproportionate symptoms and can be addressed without replacement.

When Arthroscopy Is Not the Right Answer

Knee arthroscopy does not reverse or repair cartilage loss from osteoarthritis. For patients with bone-on-bone arthritis affecting the primary compartments of the knee, joint replacement provides significantly better and more durable relief than arthroscopic debridement. The evidence against arthroscopic debridement as a treatment for established osteoarthritis is well-documented in the orthopedic literature. When a patient’s symptoms reflect advanced joint-space narrowing on imaging and global arthritic change rather than a discrete repairable lesion, the appropriate next step is a joint replacement consultation.

Total Knee Replacement — When Joint Replacement Is the Right Next Step

WHY SEE A JOINT REPLACEMENT SPECIALIST FOR KNEE ARTHROSCOPY?

Arthroscopy in Dr. Calendine's Knee Replacement Practice

One Practice, Full Spectrum of Knee Care

Most orthopedic practices divide their work by subspecialty. Sports medicine surgeons perform arthroscopy. Joint replacement surgeons perform replacements. The two patient populations rarely overlap in the same surgeon’s hands. Dr. Calendine’s practice at the Bone and Joint Institute of Tennessee is structured differently: he manages knee care across the full continuum, from arthroscopic diagnosis and treatment through partial knee replacement, total knee replacement with the Mako® robotic system, and the muscle-sparing subvastus approach.

For patients, this matters in a specific and practical way. A knee that starts with a meniscus tear does not always stay there. Arthritis develops. Symptoms progress. Treatment decisions made at the arthroscopy stage influence what options are available later. When the surgeon who performs your arthroscopy is also the surgeon who would perform your knee replacement — if it becomes necessary — the clinical decisions at each stage are made with full awareness of the whole picture.

Operating room photograph of knee arthroscopy performed using an arthroscope and specialized instruments through small incisions — minimally invasive knee surgery, Dr. Cory Calendine, MD, Bone and Joint Institute of Tennessee, Franklin, TN

Arthroscopy | Joint Replacement Intelligence

When Dr. Calendine performs arthroscopy on a patient with knee arthritis who is being evaluated for joint replacement, the procedure provides information that no imaging study can match: direct visualization of cartilage condition, subchondral bone quality, synovial status, and compartment-by-compartment assessment. This information shapes the replacement planning — confirming whether a partial knee replacement is appropriate, determining whether the subvastus approach is feasible, and documenting the specific intra-articular environment that the replacement will need to address.

The same applies in reverse. When arthroscopy reveals that a patient’s knee arthritis is more advanced than imaging suggested, and that the repairable lesion driving symptoms is not the primary problem, Dr. Calendine can initiate the joint replacement evaluation pathway without requiring a new consultation with a different surgeon. The transition from arthroscopic care to replacement planning happens within the same practice, with continuity of clinical knowledge.

Knee arthroscopy procedure in an orthopedic operating room — minimally invasive surgery using arthroscope and specialized instruments — Dr. Cory Calendine, MD, Bone and Joint Institute of Tennessee, Franklin, TN
Total Knee Replacement
Partial Knee Replacement
Subvastus Knee Replacement

WHAT HAPPENS DURING KNEE ARTHROSCOPY

The Knee Arthroscopy Procedure — What to Expect

The Procedure

Knee arthroscopy is performed under general or regional anesthesia (including spinal or nerve block), based on patient health and preference. The procedure typically takes 30 minutes to one hour, depending on what is found and treated. The knee is positioned and secured, the surgical field is prepared, and two to three small incisions (portals) are made around the joint. Saline solution is used to expand the joint space and provide clear visualization as the arthroscope is introduced.

Using the live camera image on a monitor, Dr. Calendine examines the joint systematically — cartilage surfaces, menisci, ligaments, and synovial lining. When a treatable finding is identified, specialized instruments are introduced through the additional portals to perform the repair, debridement, or removal. After completing the necessary work and confirming the result, the saline is drained, instruments withdrawn, and incisions closed with dissolvable sutures or adhesive strips.

Safety, Anesthesia, and Risks

Arthroscopic knee surgery has a well-established safety profile. Potential complications include infection, blood clots, temporary stiffness, or fluid accumulation in the joint — all uncommon with proper technique and post-operative management. Dr. Calendine uses prophylactic protocols for infection and clot prevention, and provides detailed post-operative instructions for wound care and activity. Pre-operative evaluation identifies and addresses individual risk factors before surgery. As with any surgical procedure, all risks are reviewed in detail at the consultation and documented in the consent process.

IS ARTHROSCOPY OR JOINT REPLACEMENT RIGHT FOR MY KNEE?

Arthroscopy vs. Joint Replacement — The Right Timing

FactorKnee ArthroscopyKnee Replacement
Arthritis severityMinimal to moderate: good residual joint spaceModerate to severe: significant joint-space narrowing
Symptom characterMechanical: catching, locking, sharp localized painDiffuse, constant aching; stiffness; activity limitation
OnsetOften after specific injury or mechanical eventGradual worsening over months or years
ImagingSpecific lesion visible (meniscus, loose body)Global joint-space narrowing; bone-on-bone changes
Response to conservative carePT and injections have partially helped; residual mechanical symptomsPT and injections no longer providing meaningful relief
Patient age / activityTypically younger / more active; healthy surrounding cartilageAny age; activity limited by arthritis regardless of fitness

When the Picture Is Mixed: Both May Be Appropriate in Sequence

Many patients present with a combination: background arthritis plus a discrete mechanical problem (a meniscal tear, for example) that is causing a disproportionate amount of their current symptoms. In these cases, arthroscopy to address the mechanical problem first may provide significant symptomatic relief and delay the need for joint replacement. The decision requires detailed evaluation of imaging, symptom character, and overall joint health. Dr. Calendine’s experience with both procedures means this decision is made with full awareness of the alternatives and their likely outcomes.

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WHAT RECOVERY LOOKS LIKE AFTER KNEE ARTHROSCOPY

Recovery Timeline — Knee Arthroscopy

Recovery Varies by Procedure Type

Recovery from knee arthroscopy is highly dependent on what was performed during the procedure. Diagnostic arthroscopy with minimal intervention has the fastest recovery. Meniscus repair — where torn tissue is sutured back in place rather than removed — requires longer protected weight-bearing to allow healing. More complex work (cartilage procedures, synovectomy) falls between these extremes. Dr. Calendine will advise on your specific recovery expectations before and immediately after your procedure.

Div
Day of Surgery

Home the same day in most cases. Ice and elevation as directed. Soft bandage in place. Some patients weight-bearing immediately; others use crutches — depends on procedure performed.

Div
Days 1–3

Wound care per discharge instructions. Ice and elevation to control swelling. Activity as tolerated for meniscectomy or diagnostic cases. Protected weight-bearing for meniscus repair.

Div
Week 1–2

Sutures or adhesive strips in place. Follow-up visit with Dr. Calendine to review surgical findings and begin planning rehabilitation. Most patients off crutches for simpler procedures.

Div
Weeks 3–6

Physical therapy begins — range of motion, swelling management, quad strengthening. Return to light activity and walking without assistance for most patients. Meniscus repair patients progress more gradually.

Div
1–3 Months

Full return to activity for most arthroscopic cases. Meniscus repair patients approach full clearance. Return to sport guided by PT assessment and Dr. Calendine's evaluation.

Div
4–6 Months

Full recovery for more complex procedures. Assessment of whether arthroscopic treatment has achieved adequate symptom relief or whether joint replacement consultation is the next step.

Knee Procedures at the Bone and Joint Institute of Tennessee

FREQUENTLY ASKED QUESTIONS

Frequently Asked Questions — Knee Arthroscopy

Is knee arthroscopy the same as knee replacement?

No. Knee arthroscopy and knee replacement are fundamentally different procedures. Arthroscopy is minimally invasive — it uses small incisions and a camera to examine and treat the inside of the knee joint without replacing any of the joint surfaces. Knee replacement removes and resurfaces the damaged joint surfaces with metal and plastic components.

 

Arthroscopy is typically appropriate for mechanical problems (meniscus tears, loose bodies, synovitis) in patients with healthy or mildly arthritic joints. Knee replacement is appropriate when arthritis has progressed to the point where the joint surfaces are too damaged for repair. In some patients, arthroscopy is a step on the pathway toward joint replacement, not an alternative to it.

Recovery from knee arthroscopy depends significantly on what was performed. For diagnostic arthroscopy or simple procedures like meniscectomy (partial removal of a torn meniscus), most patients are walking without assistance within a few days and return to most activities within two to six weeks. Meniscus repair — where the torn tissue is sutured rather than removed — requires a longer protected recovery (six weeks or more with restricted weight-bearing) to allow the repair to heal. More complex procedures fall between these benchmarks. Dr. Calendine reviews your specific expected recovery before surgery. 

Not necessarily. For patients with mechanical knee symptoms and healthy or mildly arthritic underlying joints, arthroscopy can provide significant, long-lasting relief without ever requiring joint replacement. However, knee arthroscopy does not repair underlying cartilage loss from osteoarthritis. Patients whose primary problem is advancing arthritis — rather than a discrete repairable lesion — are likely to continue progressing toward joint replacement regardless of arthroscopic treatment. One of the benefits of seeing Dr. Calendine, who manages the full spectrum of knee care, is that the arthroscopy findings directly inform the replacement planning if and when that step becomes appropriate. 

Knee arthroscopy is used to diagnose and treat: meniscus tears (repair or removal of the torn portion); loose bodies (cartilage or bone fragments causing catching or mechanical pain); synovitis (removal of inflamed joint lining); cartilage damage (debridement and smoothing); ACL and ligament assessment; and diagnostic ambiguity when MRI findings are unclear or do not match symptoms. Arthroscopy is most effective when a specific, identifiable, repairable problem is present. It is not effective as a treatment for widespread bone-on-bone osteoarthritis.

Knee arthroscopy is typically performed under general anesthesia, spinal anesthesia, or a regional nerve block — most commonly a femoral or adductor canal nerve block that numbs the knee area without requiring full general anesthesia. The specific anesthesia choice depends on your overall health, personal preference, and the expected length and complexity of the procedure. Dr. Calendine’s anesthesia team reviews your options and makes a recommendation based on your specific situation before surgery. For most arthroscopic procedures, patients are discharged home the same day. 

For patients in the early stages of knee arthritis who have mechanical symptoms alongside background joint disease, seeing a surgeon who performs both arthroscopy and joint replacement offers a specific advantage: continuity of care across the full treatment pathway. A sports medicine surgeon may perform excellent arthroscopy but is not the surgeon you would see for knee replacement. When the surgeon who performs your arthroscopy is the same surgeon who would perform your joint replacement — if it becomes necessary — the arthroscopic findings inform the replacement planning, and the transition from one treatment phase to the next happens without starting over with a new surgeon and a new consultation. 

 

For younger patients with isolated sports injuries and no arthritis, a sports medicine specialist is entirely appropriate. For patients in the middle range — some arthritis, some mechanical symptoms, uncertain trajectory — Dr. Calendine’s comprehensive approach offers the most complete picture.

FRANKLIN, TN · SERVING ALL OF MIDDLE TENNESSEE

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