An arthroscopy is a surgical procedure in which a surgeon inspects a joint through a tiny camera. Arthroscopies can be helpful to diagnose joint conditions, or treat an already diagnosed problem. It is considered a minimally invasive surgery. Minimally invasive surgeries use only small incisions to gain access to the surgical site. It is an outpatient procedure, meaning that the patient will go home after the surgery and not have to stay in the hospital to recover.
Arthroscopies are done by orthopedic surgeons and can be performed on many parts of the body, including the:
The most commonly performed arthroscopies are on the shoulder and knee.
An arthroscopy can be performed in a hospital or surgery center. The patient isn't allowed to eat or drink anything after midnight the night before surgery. Patients typically arrive one to two hours before their scheduled surgery start time. This allows for the patient to be evaluated by the surgical team (nurse, surgeon, and anesthesiologist) before the surgery begins. The patient and anesthesiologist will decide what type of anesthesia will be best for the patient. The patient could be under general anesthesia, where the patient is completely asleep. The patient could also ask for aregional block, which means that they are awake during the surgery but cannot feel anything past the point where medication was injected. Once the patient is in the room, the anesthesiologist will begin to administer anesthetics, and the nurse begins to position the patient and clean the area being operated on. A surgical drape is placed over the affected joint, and then the surgery will begin.
Steps In an Arthroscopy
1. Surgeon makes several small incisions with a sterile knife
2. Small plastic or metal trocars are placed into the incisions
3. Sterile fluid is pumped into the area to distend the joint to create space and rinse away debris
4. A small camera is placed through one of the incisions, and the surgeon inspects the joint
5. Depending on what the surgeon sees, he/she can use surgical instruments to fix defect(s)
6. Once the defect(s) are fixed, the surgeon removes the trocar(s)
7. A small size suture is used to close the skin where the incisions were made
8. Dressing is applied to the affected joint
Why it's used
An arthroscopy might be recommended if you have problems such as persistent joint pain, swelling or stiffness, and scans have not been able to identify the cause.
An arthroscopy can also be used to treat a range of joint problems and conditions. For example, it can be used to:
• repair damaged cartilage
• remove fragments of loose bone or cartilage
• drain away any excess fluid
• treat conditions such as arthritis, frozen shoulder or carpal tunnel syndrome
An arthroscopy can be carried out to help diagnose and treat a number of joint problems and conditions.
Diagnosing joint problems
An arthroscopy can be used to help investigate:
• joint pain
• joint stiffness
• swelling of the joint
• the joint giving way or "popping" out of position
These problems are usually first investigated using X-rays,computerised tomography (CT) scans or magnetic resonance imaging (MRI) scans. If these scans don't find anything, it may be necessary to take a direct look at the inside of the joint. An arthroscopy can also be used to assess the level of joint damage resulting from an injury, such as a sports injury, or from underlying conditions that can cause joint damage, such as osteoarthritis.
Treating joint problems and conditions
Fine surgical instruments can be used along with an arthroscope to allow a surgeon to treat a range of joint problems and conditions. For example, an arthroscopy can be used to:
• repair damaged cartilage, tendons and ligaments (for example, inknee ligament surgery)
• remove inflamed tissue
• remove small sections of bone and cartilage that have broken off and are loose within the joint
• drain away an excess build-up of synovial fluid (which lubricates the joint)
Conditions that can be treated with arthroscopy include:
• arthritis – a common condition that causes pain and inflammation within a joint
• Baker's cyst – a build-up of synovial fluid inside a joint, leading to stiffness and swelling
• frozen shoulder – pain and stiffness in the shoulder that tends to get gradually worse
• carpal tunnel syndrome – a tingling sensation, numbness and sometimes pain in the hand and fingers
• arthrofibrosis – excess scar tissue caused by a previous injury that disrupts the normal workings of the joint
• bone spurs – abnormal bone growths that can cause persistent pain
• synovitis – inflammation of the joint
Knee Problems and Repairs
Knee problems can be caused by disease or by injury. Symptoms can include pain, swelling, instability, and difficulty walking. The most common knee problems are:
• a torn ligament
• a torn meniscus
• a loose body inside the knee joint