DR. ONG KEE LEONG
Knee Arthroscopy
Knee arthroscopy is a minimally invasive surgical procedure that examines and treats knee joint problems. During this procedure, a surgeon inserts a small camera (arthroscope) through tiny incisions to view the knee joint on a screen. This technique allows for the diagnosis and treatment of various knee conditions with smaller incisions than traditional open surgery.
Book AppointmentPotential Risks and Complications
Knee arthroscopy, while generally well-tolerated, carries some risks. These include infection at incision sites, internal bleeding, blood clots, and possible injury to surrounding nerves or vessels. Some patients may experience ongoing pain, stiffness, or swelling. Rare complications include instrument breakage during surgery and anaesthesia-related issues.
Indications for Knee Arthroscopy
The following conditions may warrant consideration for knee arthroscopy when non-surgical treatments have not provided adequate relief.
- Meniscus Tears: These are soft tissue structures that cushion the knee joint. Arthroscopy allows for repair or removal of damaged meniscal tissue that causes pain or mechanical symptoms.
- Ligament Injuries: Tears in the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), or collateral ligaments can be reconstructed or repaired through arthroscopic techniques.
- Cartilage Damage: Injured or worn out cartilage surfaces can be addressed through débridement (cleaning) or microfracture techniques to stimulate new cartilage growth. Advanced techniques for cartilage repair can also be performed.
- Loose Bodies: Fragments of bone or cartilage that float in the joint space can be removed, eliminating the catching or locking sensations they cause.
- Synovitis: Inflammation of the synovial membrane (joint lining) can be treated by removing inflamed tissue to reduce pain and swelling.
- Patella Misalignment: The kneecap’s tracking path can be evaluated and sometimes corrected through arthroscopic procedures.
Benefits of Knee Arthroscopy
- Minimal Scarring: The procedure typically requires only 2-3 small incisions of about 1 cm each, resulting in less noticeable scarring than open surgery.
- Reduced Pain: Smaller incisions and less tissue disruption generally lead to decreased post-operative pain compared to open surgical procedures.
- Faster Recovery: Most patients can return home the same day and often resume normal activities within weeks rather than months.
- Lower Infection Risk: Smaller incisions and shorter operating times can contribute to reduced infection rates compared to open procedures.
- Improved Diagnostic Accuracy: Direct visualisation of joint structures allows for precise diagnosis of conditions that may not be apparent on imaging studies.
- Outpatient Procedure: Many knee arthroscopies can be performed as day surgery, eliminating the need for overnight hospital stays.
Surgical Techniques
Debridement
This technique involves removing damaged tissue and loose fragments, and smoothing irregular surfaces within the joint. The surgeon uses specialised instruments to trim and clean up frayed meniscus edges, remove loose cartilage pieces, and smoothen roughened surfaces, restoring a more functional joint environment.
Meniscectomy
This procedure removes damaged portions of the meniscus that cannot be repaired. The surgeon carefully trims away torn or unstable sections while preserving as much healthy meniscal tissue as possible. Selective removal targets only the damaged tissue, maintaining the knee’s cushioning and stability functions to the greatest extent possible.
Meniscus Repair
When appropriate, torn meniscal tissue can be sutured back together rather than removed. Special arthroscopic instruments allow the surgeon to place stitches through the meniscus, securing torn edges together. This technique is typically reserved for certain tear patterns in patients with good healing potential.
Chondroplasty
This technique addresses damaged articular cartilage on the joint surfaces. Using specialised instruments, the surgeon can smooth irregular cartilage, remove loose flaps, and stabilise the cartilage surface. In some cases, microfracture techniques create small holes in the bone beneath damaged cartilage areas to promote new cartilage-like tissue formation.
Synovectomy
This procedure removes inflamed synovial tissue lining the joint capsule. Using specialised shavers and cutting tools, the surgeon can selectively remove thickened, inflamed synovium that contributes to pain and swelling. The procedure targets only abnormal tissue while preserving normal synovium.
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Preparing for Surgery
- Medical Evaluation: A comprehensive assessment determines surgical suitability and identifies risk factors. This typically includes physical examination, medical history review, and imaging studies such as MRI to confirm the diagnosis. Blood tests may be ordered to check overall health status and identify any conditions that may affect surgery or recovery.
- Medication Adjustments: Certain medications may need to be modified before surgery to reduce complication risks. Blood thinners such as aspirin, warfarin, or clopidogrel may need to be temporarily discontinued several days before surgery to reduce bleeding risk. Anti-inflammatory medications may also need to be stopped.
- Pre-operative Fasting: Patients must refrain from eating and drinking for a specified period before anaesthesia. Typically, no food should be consumed for 6-8 hours before surgery, though clear liquids might be permitted up to 2 hours before the procedure.
Post-Surgical Care and Recovery
- Initial Recovery Phase: Focuses on pain management with prescribed medication, swelling control using ice packs, and keeping surgical dressings clean and dry according to medical instructions.
- Early Mobility & Rehabilitation: Begins with gentle weight-bearing and range-of-motion exercises within days of surgery, progressing to structured physical therapy that gradually increases in intensity as healing occurs.
- Gradual Return to Activities: Most patients can resume sedentary work within 2-3 weeks and driving once off narcotic pain medication, with full recovery taking 4-6 weeks for simple procedures and 6-12 months for complex cases.
Step-by-Step Procedure
Anaesthesia Administration
The procedure begins with appropriate anaesthesia based on patient factors and surgeon preference. Regional anaesthesia (spinal or epidural) numbs the lower body while allowing the patient to remain conscious. Alternatively, general anaesthesia may be used, particularly for longer or more complex cases.
Surgical Site Preparation
The knee area is cleaned with antiseptic solution and draped to create a sterile field. The skin is thoroughly cleansed with an antimicrobial solution extending from mid-thigh to mid-calf.
Portal Placement
Small incisions (portals) are strategically created for instrument insertion. Typically, two to three portals measuring about 1 cm each are made around the knee. These carefully placed portals allow access to different compartments of the knee while minimising tissue damage.
Joint Examination
The arthroscope is inserted to inspect all knee structures. Saline solution is pumped into the joint to expand the space and improve visibility. The surgeon examines the entire joint, including the medial and lateral compartments, the patellofemoral space, and all ligamentous structures. This assessment confirms the diagnosis and identifies any additional issues not apparent on imaging studies.
Therapeutic Intervention
Specific surgical techniques address the identified pathology according to the pre-operative plan. Specialised instruments are inserted through the accessory portals to perform necessary procedures such as meniscus repair, debridement, or loose body removal. Real-time images from the arthroscope guide the execution of these interventions.
Closure
Upon completion, instruments are removed, and the joint is irrigated and closed. The small incisions are typically closed with sutures or surgical tape. Sterile dressings are applied to the wound sites, and the knee may be wrapped with a compressive bandage to minimise swelling and bleeding.
Why Do Patients Choose Dr Ong Kee Leong?
- Dr. Ong Is Passionate In Sports, Giving Him A Deep Understanding Of Sports-Related Injuries And How They Can Be Treated
- Personalised And Professional Approach To Deliver High-Quality Orthopaedic Care Based On The Most Up-To-Date Literature
- Detailed Aftercare Plan To Ensure Smooth, Long-Term Recovery
- Fellowship Trained Surgeon With 15 Years Of Experience In Orthopaedic Conditions
- Problem-Oriented, Well-Organised and Individualized Treatment Plans Catered To Your Specific Needs
- Specialist In The Management Of Sports Injuries And Degenerative Conditions Of The Shoulder And Knee Joints
- Knowledgeable And Pleasant Clinical Staff To Assist You With Your Every Need Detailed Aftercare Plan To Ensure
- Our Care Is Conveniently Accessible At Mount Elizabeth Novena and Farrer Park Hospital
- Minimal Waiting Time For Initial Consultation
- Assistance With Medical Claims (e.g. Medisave & Integrated Shield Plans)
About Dr. Ong Kee Leong
Senior Consultant, MBBS (Singapore), MMed (Ortho), FRCSEd (Ortho)
Dr. Ong Kee Leong is a fellowship-trained orthopaedic surgeon. He subspecializes in shoulder and knee, foot and ankle, hand wrist and elbow surgeries, arthroscopic sports surgery, and the management of sports-related injuries.
He has been registered with the Singapore Medical Council as a specialist in Orthopaedic Surgery since 2011.
- MBBS, National University of Singapore (NUS) Faculty of Medicine 2001
- Member of the Royal College of Surgeons of Edinburgh 2007
- Master of Medicine in Orthopaedic Surgery (NUS) 2007
- Fellow of the Royal College of Surgeons of Edinburgh in Orthopaedic Surgery 2011
- Health Manpower Development Plan (HMDP) Scholarship, Ministry of Health 2012-2013:
- Sports Surgery and Arthroscopy in Germany (Hannover)
- Adjunct Assistant Professor, Lee Kong Chian School Of Medicine, Nanyang Technological University
- Senior Clinical Lecturer, Yong Loo Lin School of Medicine, NUS
Awards & Teaching
- Dr. Ong had received numerous awards such as Best Service and Eastern Health Alliance Caring (Gold) Awards.
- He also has an interest in clinical research and has written papers in multiple peer-review journals. As a Core Faculty of Singhealth Orthopaedic Surgery Residency Program, he oversees the training of junior orthopaedic surgeons.
- Regularly invited to teach local and regional surgeons in Shoulder and Knee Surgery Courses.
- He is a recipient of multiple teaching awards including the Singhealth Residency Outstanding Faculty Awards from 2014-2016 and Changi General Hospital Outstanding Educator Awards 2015-2016.
Frequently Asked Questions
How long does knee arthroscopy take?
The procedure typically lasts 30-60 minutes, depending on the complexity of the condition and treatments performed. More extensive repairs, such as complex meniscus suturing or ligament reconstruction, may take longer, while diagnostic arthroscopy or simple debridement procedures may be completed more quickly.
Can arthroscopy prevent knee arthritis?
Arthroscopy treats specific mechanical problems but does not prevent the natural progression of arthritis. Removing unstable meniscal tears or loose bodies may improve symptoms and function, but the procedure does not restore damaged cartilage to its original state.
How does knee arthroscopy affect athletic performance in competitive athletes?
Return to pre-injury performance levels varies by sport and procedure. After meniscectomy, most athletes return to previous performance levels. Meniscus repair shows moderate success rates, with about two-thirds of athletes regaining their previous abilities. Individual results depend significantly on rehabilitation commitment, pre-injury fitness, and sport-specific demands.
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Mt Elizabeth Novena
- 38 Irrawaddy Road #06-59/60/61 Mt Elizabeth Novena Specialist Centre Singapore 329563
- klong@sog.sg
- (65) 6884 6788
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- (65) 9652 5022
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Mon – Fri : 9:00 am – 5:00 pm
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other practice locations
Farrer Park Hospital
- 1 Farrer Park Station Road #14-06 Connexion Singapore 217562
- klong@sog.sg
- (65) 6884 6788
- (Ask for Dr Ong)
- (65) 9652 5022
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Mon – Fri : 9:00 am – 5:00 pm
Sat : 9:00 am – 1:00 pm
Mt Alvernia Medical Centre
- 820 Thomson Road #07-53 Mt Alvernia Medical Centre D Singapore 574623
- klong@sog.sg
- (65) 6884 6788
- (Ask for Dr Ong)
- (65) 9652 5022
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Mon – Fri : 9:00 am – 5:00 pm
Sat : 9:00 am – 1:00 pm
"Moving your body the way nature intended is a freedom not well appreciated until it is lost. We are passionate about getting you back in the game, and staying in the game. Our team is fully committed to returning you to the life and activities you love."
Billing & Payment
Consultation fees are charged based on length of consultation, and start from SGD$200 (within 30 minutes).
Modes of Payment
We accept the following modes of payment:
- Cash
- PayNow & PayLah
- All major Credit Cards
If you are insured and would like to use a Letter of Guarantee (LOG) from the major insurers in Singapore, please contact us and our friendly clinic staff will assist you and provide more information if required.
Can I Claim Through My Medisave Account? (For Singaporeans and PR)
Yes, you can. Our Clinic is an accredited day surgery clinic by the Ministry of Health. Singaporeans and Permanent Residents may use their Medisave for eligible orthopaedic inpatient procedures and hospitalizations.
The exact amount would depend on the complexity of the procedure. If you have any enquiries, feel free to speak to our friendly clinic staff about using your Medisave account.
Integrated Shield Plans (Singaporeans and PRs)
Yes, patients who have purchased Integrated Shield plans with riders for co-insurance and deductibles will be able to use them in our clinic for eligible procedures. For more information, contact us to find out if your procedure is claimable.
The 5 Approved Integrated Shield Insurers are:
- NTUC Income’s IncomeShield and Enhanced IncomeShield
- American International Assurance International Co’s (AIA) HealthShield Gold
- Great Eastern Life Assurance Co’s SupremeHealth and SupremeHealth Plus
- Prudential Assurance Co’s PRUShield
- AXA Shield