Arthroscopy Procedure
Overview
Arthroscopy is a medical technique that lets doctors look inside joints and treat different joint conditions. Surgeons use a thin tube with a fiber-optic camera, placing it through a small cut in the skin.
The camera sends clear images of the joint to a monitor, helping doctors see problems without large incisions. Surgeons also use very thin tools during this procedure to fix certain joint issues through extra-small incisions.
Key Features:
- Minimally invasive procedure.
- Small cuts about the size of a buttonhole.
- A direct visual examination of joint structures.
Reasons for Performing Arthroscopy
Doctors choose arthroscopy to see inside joints when other tests like X-rays are not helpful. Using a small tool called an arthroscope, they check for problems in the knee, shoulder, elbow, ankle, hip, or wrist. This approach helps spot injuries, inflammation, or damage in cartilage or the synovium.
Surgeons use arthroscopic surgery as a minimally invasive option to fix problems such as torn cartilage, ligament injuries, or inflamed joint linings. They also remove loose bone fragments or scar tissue. Techniques exist for knee arthroscopy, shoulder arthroscopy, and other joints like the ankle, hip, and wrist. Common joint treatments through arthroscopy:
| Condition | Treated Joint Areas |
|---|---|
| Torn cartilage | Knee, shoulder, ankle |
| Ligament tears | Knee, elbow, wrist |
| Joint inflammation | Any major joint |
Possible Issues
Surgeons use arthroscopic procedures for conditions like osteoarthritis, rheumatoid arthritis, chondromalacia, and rotator cuff tendon tears, which are generally safe, but patients should consider some risks. The chance of complications is low, but they include:
- Infection: Infection can occur anytime the skin is broken, though the risk is lower than with open surgery.
- Damage to Tissues or Nerves: Surgical tools might harm nearby nerves or tissues.
- Blood Clots: Blood clots can form, especially if the surgery takes longer than usual.
- Joint Stiffness or Swelling: Some people notice stiffness or swelling in the area after surgery.
| Condition | Possible Risk Factors |
|---|---|
| Osteoarthritis | Tissue damage, blood clots |
| Rheumatoid arthritis | Infection, nerve injury |
| Chondromalacia | Swelling, joint stiffness |
| Rotator cuff injury | Nerve damage, infection |
| Impingement syndrome | Tissue damage, swelling |
| Carpal tunnel syndrome | Nerve injury, infection |
How You Prepare
Patients prepare for joint arthroscopy by following several important steps. Doctors often advise them to stop taking certain medicines or supplements that might raise the chance of bleeding. The table below highlights some main steps to follow:
| Step | What to Do |
|---|---|
| Medicines | Do not use blood-thinning drugs or supplements. |
| Fasting | Avoid solid foods for about 8 hours before surgery. |
| Transportation | Arrange for someone to pick you up afterward. |
| Clothing | Wear loose clothes, such as gym shorts. |
Patients should check with the healthcare team if any medicines need to be stopped or started before the procedure. A friend or family member should be available to help after surgery, especially for those who live alone. Wearing comfortable clothing makes it easier when leaving the hospital or clinic.
What You Can Expect
What Happens During the Procedure
Before the procedure, staff ask patients to remove personal items like street clothes and jewelry. Patients wear a hospital gown or shorts. Medical staff place an intravenous (IV) line into the hand or forearm to deliver medication that helps the patient relax.
Anesthesia Options
| Type of Anesthesia | Area Affected | Consciousness |
|---|---|---|
| Local | Target joint (e.g., knee, shoulder, wrist, elbow, ankle) | Awake |
| Regional | Lower half of body | Awake |
| General | Whole body | Asleep |
For procedures involving the knee, ankle, elbow, shoulder, or wrist, the anesthesia choice depends on the complexity and joint involved. Medical staff position the patient to best access the joint. Sometimes a device supports the limb for stability.
The team may apply a tourniquet to reduce bleeding, making it easier for the surgeon to see inside. Medical staff introduce sterile fluid into the joint to expand the area and give the surgeon a better view. The surgeon creates a small incision for a tiny camera called an arthroscope. The surgeon inserts other thin instruments through additional incisions.
These tools let the surgeon inspect, repair, or remove damaged tissues. The incisions for arthroscopy are minimal—usually just large enough for the instruments. Most patients need only one or two stitches per incision, or small adhesive strips.
What Happens After the Procedure
Once the procedure ends, staff monitor patients in a recovery area for a few hours. The medical team checks that the patient wakes up safely from anesthesia and assesses pain levels.
Post-Procedure Care
- Medications: Staff give pain relievers and medicine to reduce swelling.
- R.I.C.E.: Patients rest, use ice packs, apply compression bandages, and elevate the affected limb to decrease discomfort and swelling.
- Temporary Supports: Staff provide splints, slings, or crutches for comfort and safety, especially for the knee, shoulder, ankle, or wrist.
- Exercise and Therapy: Physical therapists recommend exercises to help patients regain strength and movement. Gentle stretching or strengthening exercises can help with recovery. Early movement under guidance can promote rapid recovery.
Important Warning Signs
Seek medical advice if any of these occur after arthroscopy:
- Fever
- Severe pain not eased by medication
- Fluid or pus leaking from incision sites
- Ongoing swelling
- Changes in the color of the skin around the joint
- New sensations of numbness or tingling
Post-Arthroscopy Recovery and Care
Most people can return to light activities and desk tasks a few days after the procedure. Driving is usually possible in 1 to 4 weeks, based on individual recovery speed. Strenuous actions and sports may be allowed after a few more weeks, but some may need a longer period before resuming these.
Recovery is different for everyone. Some may need extra time or physical therapy to get back to normal. The surgical team reviews the results of the procedure with the patient quickly and schedules follow-ups to monitor healing and answer questions.
| Activity | Estimated Time to Resume |
|---|---|
| Desk Work | Few days |
| Driving | 1–4 weeks |
| Strenuous Tasks | Several weeks |
