When I first injured my knee (1990) and arthroscopy was an inevitability, my OS had me sit in his desk office and the nurse set up a videotape for me to watch. It provided an introduction to arthroscopic surgery. Then my OS came in and answered any questions I had. 3 weeks later, I had my surgery. I had an epidural and was able to watch the video screen which was hooked up to an arthroscopic video probe. This arthroscopic surgery was for a cartilage tear but my partial ACL tear was discovered during the operation.When I severed my ACL in 1998, I also had an epidural but that time I dozed off, did not see the operation and woke up in the recovery room.
We oftentimes think of arthroscopy as the way that repairs are done to knee deficiencies. But years ago, arthroscopy was the way that an OS did his primary inspection of the internal knee deficiencies and even though MRIs now-a-days give a fairly accurate picture of what to expect during surgery, arthroscopy is still the most direct way of identifying and determining the extent of knee deficiencies.
In order to perform arthroscopy, small pencil diameter sized holes are needed inorder to slide an arthroscopic tool into your knee. Most times, the OS will use 3 or 4 incisions located outside the circumference of the kneecap inorder to utilize the various arthroscopic tools and to get a good look at all knee internals. One incision hole maybe used for a video probe, another for an arthroscopic tool such as a mini-cutting tool, a hook, a mini-vacuum, etc.
As with anything in life, there are risks but you should never become a worry wort over them. When I originally saw the short video in my OS's office (which explained arthroscopic surgery), there was a part that I questioned my OS about and that was where the video indicated that sometimes an arthroscopic tool can fall off into your knee. The video indicated that in those cases, full knee surgery may be required to get the tool out. My OS explained that it was true and although it can happen, it was an extremely rare occurrence. But his experience was that indeed he had a tool that did come off the end once or twice in all the years that he had done arthroscopy. But he was able to use other arthroscopy tools to fish it out and therefore it was not a big deal.
What I noticed during my own arthroscopy was that the video probe is remarkable in providing a crystal clear view of what's going on inside the knee. The fluid is clear. Any floating blood masses or whatever they are (clots), the OS sucks them out with his handy dandy mini-vacuum tool. He uses a hook to see how stretched a partially torn ligament is or to move around whatever he sees to make a better assessment. He then has a cutting tool and I think I remember him having a whirring tool that could kind of shave off or smooth out surfaces (not sure if I really saw that or not - it's been such a long time !). I'm sure there are other attachments for repairing cartilage, etc but the above is what I remember.
Of course, when one goes for a reconstruction and an incision is made of say 2-3 inches down from the kneecap as was the case for my patella autograft, I would not consider that part, the getting of the graft, as arthroscopy. But the pencil diameter shaped holes is characteristic of arthroscopy and those holes require perhaps a stitch or two to close them. My arthroscopic holes faded with time and are non-existent. I would think that only on fair skinned individuals would you be able to see those holes in the future. It's only a graft type incision, one that is 2-3 inches long that is visible (although not that much at all on me, 22 mos post-op).
The arthroscopy procedure itself is very easy on the knee and helps for fast recovery. Years ago, all this was done thru full knee surgery. While arthroscopy itself is easy on the knee and recovery, the internal deficiencies have their own timeline as to recovery and functionality. Obviously, if someone has significant cartilage removed or has arthritis, then recovery to 100% may not be realized. But the arthroscopic procedure itself is basically poking a hole into the skin. The attending to the deficiencies is what varies with each patient.