Your Health - Arthroscopy

Arthroscopy

(Fiberoptic Joint Examination)

Click here to view an animated version of this procedure.

Definition

Arthroscopy is a surgery done to visually examine a joint. Most of the time it is done on larger joints like the knee or shoulder. A special tool called an arthroscope is used. It is an instrument that looks like a long tube that has 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

Reasons for Procedure

It is done to see, diagnose, and treat problems inside your joint. The procedure is most often performed for the following reasons:

Diagnosis of an injury or disease inside a joint
Remove bone or cartilage
Repair tendons or ligaments

Possible Complications

Complications are rare but no procedure is completely free of risk. If you are planning to have an arthroscopy, your doctor will review a list of possible complications which may include:

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
Recent or chronic illness
Diabetes
Bleeding disorders
Smoking

What to Expect

Prior to Procedure

Your doctor will likely do the following:
- Physical exam
- X-rays —a test that uses radiation to take pictures of the joint
- MRI scan —a test that uses a magnetic field to make pictures of the inside of a joint
Arrange for a ride to and from the procedure
The night before, do not eat or drink anything after midnight
You may be asked to use a special soap the morning of the procedure

Anesthesia

The type will depend on the joint. You may receive one of the following:

General anesthesia —you will be asleep
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

The surgeon will make tiny incisions 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 the doctor can see the inside of your joint. The doctor will use the images to move around other tools the can cut and repair tissue in your joint.

For example:

Some meniscal (cartilage) tears in the knee will be repaired by cutting out some of the cartilage
Carpal tunnel syndrome in the wrist may be treated by loosening the ligament that puts pressure on the nerves

Once the examination 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 one hour but this may be longer if repairs are being done

Will It Hurt?

Most patients report no pain during the procedure. After the procedure, pain medications are used to treat the pain.

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:

You may apply ice for the first 24 to 48 hours after surgery to help with swelling and pain.
Elevate the part of you body that you had surgery on while resting in bed.
Keep the incision area dry for the first 24 hours. After a day, it is usually fine to shower or rinse the area, but soaking the area in water is not recommended.
You may be instructed to use crutches or a cane for the first few days if the surgery was done on a joint in you legs.
Take only non-aspirin containing medications for minor pain.
If you have stitches or staples your doctor will remove them in 7-10 days.
Be sure to follow your doctor’s instructions .

It takes 4-6 weeks for the joint to recover. You can probably go back to work or resume daily activities within a few days as long your doctor approves. 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

After arriving home, contact your doctor if any of the following occurs:

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
Nausea and/or vomiting that you can't control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital
Pain that you can't control with the medications you've been 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 one hour
Drainage

In case of an emergency, CALL 911.

RESOURCES:

American Academy of Orthopedic Surgeons
http://www.aaos.org/

Arthritis Foundation
http://www.arthritis.org/

CANADIAN RESOURCES:

The Arthritis Society
http://www.arthritis.ca/

Canadian Orthopaedic Association
http://www.coa-aco.org/

References:

Arthroscopy Association of North America website. Available at: http://www.aana.org/ . Accessed July 10, 2009.

Lindström D, Azodi O, Wladis A, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial. Annals of Surgery Issue. 2008;248:739-745.

What is arthroscopy? American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00109 . Updated October 2007. Accessed July 10, 2009.

Yacub J, Rice B, Dillingham T. Nerve injury in patients after hip and knee arthroplasties and knee arthroscopy. American Journal of Physical Medicine & Rehabilitation. 2009;88:635-641.

Last reviewed November 2009 by John C. Keel, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.