Arthroscopy

Definition

Arthroscopy is a surgery done to examine a joint visually. Most of the time, it is done on large joints like the knee or shoulder. A special tool called an arthroscope is used. It is an instrument that looks like a long tube with a miniature camera on the end. Repairs or corrections to the joint may be done by using the arthroscope and other tools.

Diagnostic Arthroscopy of the Right Knee

Arthroscopy can be done to diagnose an injury or a condition.

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Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

• Infection
• Blood clots
• Swelling or bleeding
• Damage to blood vessels, nerves, or other tissue
• The need to have another surgery or more extensive surgery

Factors that may increase the risk of complications include:

• Pre-existing heart or lung condition
• Obesity
• Smoking
• Recent or chronic illness
• Diabetes
• Bleeding disorders

Reasons for Procedure

The procedure is most often performed for the following reasons:

• Diagnose an injury or disease inside a joint
• Remove bone or cartilage
• Repair tendons or ligaments

What to Expect

Prior to Procedure

• Your doctor will likely do the following to evaluate the joint:
  • Physical exam
  • X-rays
  • MRI scan
• Arrange for a ride to and from the procedure.
• Do not eat or drink anything after midnight the night before the procedure.
• You may be asked to use a special soap the morning of the procedure.

Anesthesia

The type of anesthesia will depend on the joint your doctor is looking at. You may receive one of the following:

• General anesthesia —you will be asleep during the procedure
• Local anesthesia—the area will be numbed
• Spinal anesthetic —your lower body will be numbed by putting a numbing medication in your back

Description of the Procedure

Tiny incisions will be made in the skin along the joint. Special tools will be inserted through the incisions. The tools include the arthroscope. The picture from the arthroscope will show up on a screen so that the inside of your joint can be viewed. The images may be used to move around other tools that can cut and repair tissue in your joint.

For example:

• Some meniscal tears in the knee will be repaired by cutting and removing some of the cartilage.
• Carpal tunnel syndrome in the wrist may be treated by loosening the ligament that puts pressure on the nerves.
• Torn anterior and posterior cruciate ligaments may also be repaired by arthroscopy.

When the examination or surgery is done, the tools will be removed. The skin may be closed with stitches or clips. The incisions will be covered with a dressing. The fluid or tissue that was removed may be sent to a lab for examination.

How Long Will It Take?

Usually less than 1 hour, but this may be longer if repairs are being done.

Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Post-procedure Care

The dressings can sometimes be removed as early as the next morning. When you return home after the procedure, do the following to help ensure a smooth recovery:

It may take 4-6 weeks for the joint to recover in a repair was done. A specific activity and rehabilitation program may be suggested. This will help speed your recovery and protect future joint function.

Athletes often return to athletic competition within a few weeks.

Note: Repair of the anterior cruciate ligament (ACL) by arthroscope may require a recovery time of 4-6 months and a more specialized rehabilitation program.

Call Your Doctor

Call your doctor if any of these occur:

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
• Persistent nausea or vomiting
• Pain that you cannot control with the medications you were given
• Cough, shortness of breath, or chest pain
• Joint pain, fatigue, stiffness, rash, or other new symptoms
• Swelling, tingling, pain, or numbness in your toes that is not relieved by elevating your knee above heart level for 1 hour

If you think you have an emergency, call for emergency medical services right away.