Your Health - Arthroscopy

Arthroscopy

(Fiberoptic Joint Examination)

Click here to view an animated version of this procedure.

Definition

Visual examination of a joint with an arthroscope, which is a fiberoptic instrument with a lighted tip. Arthroscopy is also used to perform some corrective surgeries.

Diagnostic Arthroscopy of the Right Knee

Parts of the Body Involved

Any joint: shoulder, elbow, wrist, hip, knee, or ankle

Reasons for Procedure

Arthroscopy is done to visualize, diagnose, and treat problems inside a joint. The procedure is most often performed for the following reasons:

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

Risk Factors for Complications During the Procedure

Pre-existing heart or lung condition
Obesity
Recent or chronic illness
Diabetes
Bleeding disorders
Certain medications such as blood thinners

What to Expect

Prior to Procedure

Your doctor will likely do the following:

Physical Exam
X-rays of joint
MRI Scan—a test that uses a strong magnetic field to make pictures of the inside of a joint

In the days leading up to your procedure:

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 pre-surgical scrubs to the affected joint

During Procedure

IV fluids, anesthesia, possibly a sedative

Anesthesia

General, local, or spinal anesthetic, depending on the joint.

Description of the Procedure

The surgeon makes tiny skin incision(s) along the joint and inserts pencil-sized instruments that contain a small lens and lighting system to magnify and illuminate the structures inside the joint. By attaching the arthroscope to a miniature television camera, the surgeon is able to see the inside of the joint.

In some cases, surgical repair can also be done via arthroscopy. For example, many meniscal (cartilage) tears of the knee can be treated with arthroscopic surgery, as can carpal tunnel syndrome in a procedure called carpal tunnel release .

After the arthroscope is removed, the incisions will be covered with a dressing, and the skin may be closed with stitches or clips. These are usually removed 7 to 10 days after the procedure.

After Procedure

Laboratory examination of the removed fluid or tissue.

How Long Will It Take?

Usually less than one hour

Will It Hurt?

Most patients report no pain during the procedure.

Possible Complications

Infection
Blood clots in a vein ( phlebitis )
Excessive swelling or bleeding
Damage to blood vessels or nerves

Average Hospital Stay

None

Postoperative Care

The operative dressing can usually be removed the morning after surgery and replaced with small adhesive strips
Apply ice for the first 24 to 48 hours after surgery
Move and elevate legs while resting in bed
Keep the incision area dry; shower with a plastic bag securely taped above and below the area
You may be instructed to use crutches or a cane for the first few days
Take only non-aspirin containing medications for minor pain

Outcome

It takes 4 to 6 weeks for the affected joint to recover, but you can probably go back to work or resume daily activities within a few days. A specific activity and rehabilitation program may be suggested by your surgeon or physiatrist, in order to speed your recovery and protect future joint function.

Athletes and others in good physical condition prior to arthroscopy 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 to 6 months, and a more specialized rehabilitation program.

Call Your Doctor If Any of the Following Occurs

Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision sites
Nausea or vomiting
Swelling, tingling, pain, or numbness in your toes that is not relieved by elevating your knee above heart level for one hour
Drainage

RESOURCES:

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

Arthritis Foundation
http://www.arthritis.org

CANADIAN RESOURCES:

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

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

References:

American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org . Accessed October 14, 2005.

Arthroscopy Association of North America website. Available at: http://www.aana.org/ . Accessed October 14, 2005.

Last reviewed December 2007 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.