ARTHROSCOPIC SURGERY
Arthroscopy is the examination of a joint, specifically, the inside structures. The term literally
means "to look within the joint."
Arthroscopy has modernized the treatment of joint injuries. In the past, many orthopedic injuries
involved extensive surgery, including large skin incisions, several days in the hospital, and a
prolonged recovery period. Today for many orthopedic injuries arthroscopic surgery improves our
ability to more easily examine, diagnose, and treat problems in the joints and perform less
invasive surgery reducing recovery time and improving return to function.
Description
The arthroscope is a small fiber-optic viewing instrument used to look directly into the joint
The surgeon inserts the arthroscope into the joint through a tiny incision (about 1/4 of an inch).
Other incisions are made for the insertion of surgical instruments. The surgical instruments used
in arthroscopic surgery are small, most about the size of a pencil.
The arthroscope is made up of a tiny lens, light source and video camera. Light is sent through a
fiber optic cable to the end of the arthroscope that is inserted into the joint. By attaching the
arthroscope to a miniature video camera, the surgeon is able to see the interior of the joint
through this very small incision rather than a large incision needed for surgery. The video camera
attached to the arthroscope displays the camera image on a television screen. The surgeon can
then determine the amount or type of injury, then repair or correct the problem if necessary.
Purpose
Arthroscopy is a technique commonly used by orthopedic surgeons for the treatment of patients
of all ages. Diagnosing joint injuries and disease begins with a thorough medical history, physical
examination, and X-rays. Less frequently additional tests such as an MRI, or CT scan may be
needed
Looking inside the joint allows the doctors to see exactly which structures are damaged.
The knee, shoulder, elbow, ankle, hip, and wrist are most frequently examined joints.
Conditions often diagnosed and treated with arthroscopy include disease and injuries that
damage bones, cartilage, ligaments, muscles, and tendons.
Some of the most frequent conditions include:
 Synovitis or the inflamed lining (synovium) in knee, shoulder, elbow, wrist, or ankle.
 Shoulder: rotator cuff tendon tears, impingement syndrome, and recurrent dislocations
 Knee: meniscus tears, chondromalacia (wearing or injury of cartilage surface), and
anterior cruciate ligament (ACL) tears.
 Loose bodies of bone and/or cartilage of the joints listed above.
What if the damage is too severe?
If the surgeon decides after the arthroscopic examination that a conventional approach to
surgically expose or "open" the joint must be used, a good photographic record will be useful
when the surgeon opens the joint to complete the final surgical plan.
ARTHROSCOPIC SURGERY
Surgical overview
During a visit prior to surgery you will have a pre-operative examination to be sure your heart,
lungs and body are well enough for anesthesia and surgery. On the day of surgery you will be
asked to arrive several hours prior to your surgery having no food or drink from the previous
midnight. Morning medications prescribed by your doctor are taken as usual with a small sip of
water. Ask about this during your pre-op exam. Most patients have their arthroscopic surgery as
outpatients and are able to go home several hours after the surgery. Arthroscopic surgery
although easier in terms of recovery than "open" surgery, still requires the use of anesthetics and
the special equipment in a hospital operating room. You will be given a general, spinal or a local
anesthetic, depending on your problem and medical status.
Aftercare
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You will need someone to drive you home. Most patients spend one or two hours in the
recovery room then go home.
Pain medication may be prescribed. Do not drive a vehicle or drink alcohol while taking
pain medicines.
The incisions are closed by small tape strips or stitches and covered with dressings and a
bandage. Dressings generally stay on 1-3 days, ask your doctor. Showers, NOT baths
are permitted after dressings are removed. If your dressing needs to stay on longer you
can use a plastic bag while showering.
During your recovery at home, the patient needs to be aware of the signs of infection,
which include redness, warmth, excessive pain not relieved by medication, and swelling
despite frequent elevation. The risk of infection increases if the incisions become wet too
early following surgery.
The use of crutches is commonplace after knee arthroscopy. Depending on your surgery
you may progress to independent walking on an "as tolerated" basis or need to remain
“non-weight bearing “ on the operated leg. Discuss this with your surgeon.
Shoulder arthroscopy patients usually wear a sling or other immobilizer. Continue to wear
this until directed otherwise. Do not drive following shoulder surgery.
Swelling can cause pain and delay recovery. Keep operated extremity above the level of
you heart to lessen swelling and discomfort. Use ice packs as needed for 15 minutes of
every hour.
Depending on your surgery a rehabilitation program, supervised by a physical therapist is
begun to help the patient regain mobility and strength of the affected joint and limb.
Risks
The incidence of complications is low compared to the high number of arthroscopic procedures
performed every year. Possible complications include infection, swelling, damage to the tissues in
the joint, blood clots, blood into the joint or nerve injury.
Overall complication rate is far less than one percent for all arthroscopic procedures.