Arthroscopy is a medical procedure used for the diagnostic and therapeutic procedure of joint problems. It is a surgical procedure that is performed on the joint for the examination of the damage in the joints. It involves making a small incision on the affected joint and using an endoscope through the incision to examine the inside of the joint. An endoscope is just a tube that contains a camera and lighting for taking images of inside the joints
When is arthroscopy used?
Arthroscopic procedures can be performed on a joint with problems on the cartilages and ligaments. These may include:
- Removal of fragments of loose bone or cartilage
- Repair of damaged cartilage
- Draining excess fluid away from the joint
- Repair of broken meniscus and ligaments
- Treating arthritis, carpal tunnel syndrome, and frozen shoulder
If typical medications and home remedies fail to treat these problems, arthroscopy is usually preferred over open surgery where the joint is opened fully. Sometimes, when the problem is minor or unseen on X-rays and other scans, and this is when arthroscopy is done.
How is the procedure performed?
First, an incision is made on the side of the affected joint. The arthroscopic tube is quite narrow, about 7mm, so the incision will usually be quite small. The procedure can be done under general anesthesia or regional anesthesia. The tube will then be inserted into the joint through this incision and into the gap of the joint where it can take images. This is usually enough for general observation of the joint, but tiny surgical instruments may also be inserted in case the doctor needs to treat the problem.
Once complete, the wound is patched up and bandaged. Given that it’s not a serious procedure, you may even be released on the same day of the surgery or the day after. You will also be able to resume regular activities soon afterward, although you should ease yourself into some activities.
Why is arthroscopy advantageous?
Arthroscopy will often be recommended for most minor orthopedic problems because:
- The patient experiences less pain after the procedure requiring fewer pain relievers.
- Healing time and recovery is faster, and often times the patient is released on the same day as a day case.
- There may be no need for rehabilitation and you can resume activities soon afterward.
- The smaller incision reduces the risk of infection.
Are there any risks?
All surgical procedures will carry some risk to the individual, and so does arthroscopy. Most of them are minor such as bruising, swelling and discomfort, but these will go away after a few days. More serious complications are rare, but they do happen, for example:
Infection in the joint: referred to as septic arthritis, this leads to pain and swelling in the joint, associated with fever
Bleeding in the joint: this will also cause pain and swelling
Clotting of blood: bleeding is often followed by formation of clots, exacerbating the pain and swelling
Damage to the superficial nerves: there could be some loss of sensation around the incision site that could either be temporary or permanent.
What to expect?
Arthroscopy is performed under General or regional anesthesia. A tourniquet is sometimes used in order to decrease the blood loss which makes it easier to see inside of the joint. Another option to increase the visualization of the inside of the joint is to fill it with sterile fluid. Sterile fluid helps distend the area, providing more room and better visualization of the joint.
Incisions made while having an arthroscopy are usually very small and closed with one or two stitches. Sometimes, they are also closed with narrow stripes of sterile adhesive tape. Arthroscopy procedure lasts about 30 minutes to 2 hours. It all depends on the procedure and the reason why you are having it.
Arthroscopy aftercare includes: medications to relieve pain and inflammation. Bed rest, ice packs and compression as well as keeping your joint elevated for a few days which can help reduce the pain and swelling. Temporary splints or crutches used for a couple of days may also reduce the pressure on the affected joint, relieving comfort and protection. Physical therapy and rehabilitation are also recommended to help strengthen the muscles and to improve the function and the range of movement of the affected joint.
You should consult your doctor in cases when:
- Have a high fever, higher than 38 degrees
- Severe pain that can’t be managed with painkillers
- Redness or swelling in the affected joint
- Numbness and tingling of the affected joint
- Drainage from the incision.
Once the procedure is done, your doctor will review the results as soon as possible. The healing period after an arthroscopy surgery if needed for the treatment of diseases or injuries of the joints may take a couple of weeks. The progression of your condition will be closely monitored in the follow-up visits.
Like any other medical procedure, arthroscopy has complications as well. Possible complications include:
- Damage to the blood vessels
- Damage of the nerves
- Blood clot formation
If you are experiencing joint pain (eg: knee pain) for whatever reason, you should seek the help of our experienced orthopedic surgeons.