Arthroscopy

Arthroscopy is a surgical procedure to diagnose and treat structural problems in your joints, which may cause pain, instability or other dysfunction. It uses a tool called an arthroscope, which is a long, thin tube that transmits light and video. The arthroscope allows a surgeon to look inside your joint through a very small opening. Surgeons perform minimally invasive surgery guided by the arthroscope.

Arthroscopy is a type of endoscopy — a procedure that uses a special type of scope to look inside a particular part of your body. All endoscopes are thin tubes that go through small holes. Some go into existing openings in your body, while others, like arthroscopes, go through a small incision. Surgeons make other small incisions — about the size of a dime — to operate through, using long, narrow tools.

Types of arthroscopy

Orthopaedic surgeons use arthroscopy to diagnose and treat a variety of common joint injuries and conditions. It’s quickly become the standard of care for most routine procedures on major joints.

Types of arthroscopy you might have include:

• Ankle arthroscopy
• Elbow arthroscopy
• Hip arthroscopy
• Knee arthroscopy
• Shoulder arthroscopy
• Wrist arthroscopy

Common conditions arthroscopy treats include:

• Cartilage tears (like labral or meniscus tears)
• Joint impingement (like ankle, shoulder or hip impingement)
• Joint instability (like ankle or knee instability)
• Ligament tears (ankle sprains, wrist sprains and knee ligament tears)
• Nerve compression syndromes (like carpal tunnel syndrome)
• Synovitis (often an early stage of rheumatoid arthritis)

How should I prepare for arthroscopic surgery?

Most arthroscopic surgeries are outpatient procedures, meaning you can expect to go home the same day. But as you’ll likely be under anesthesia for the operation, you’ll need to arrange for a ride home.

You may also need to:

• Take some standard health screening tests.
• Discuss what type of anesthesia you want to have.
• Stop taking certain medications before your procedure.
• Avoid eating solid foods the day before your procedure.

What happens during arthroscopic surgery?

You’ll have anesthesia for the procedure. You may have a local type of anesthesia that numbs your joint area while you stay awake. Or you may have general anesthesia and sleep through the procedure.

During arthroscopy surgery, your surgeon will:

1. Position you for surgery. They might use a holding device to keep your joint in position.
2. Make a tiny incision (a half inch or less). They’ll use this to insert the arthroscope.
3. Expand the joint space. Filling the space with saline creates more room to operate in.
4. Examine your joint. The arthroscope will project magnified images of your joint to a screen.
5. Operate. They’ll make one or more small incisions to place ports for their surgical tools.
6. Complete the surgery. When they’re done, they’ll close your incisions with stitches or tape.

What your surgeon does when they operate will depend on your condition. They might need to:

• Release a compressed or pinched nerve.
• Remove damaged tissues or loose fragments.
• Repair or reinforce torn tissues or broken bones.
• Reshape or adjust misaligned bones in your joint.

Most arthroscopy operations take one to two hours. Afterward, you’ll spend another one to two hours in a recovery room as you come out of the anesthesia. Healthcare providers will monitor your recovery.

What are the risks and benefits of this surgery?

The benefit of arthroscopy over open joint surgery is that it’s minimally invasive. This means:

• Faster return to activities
• Less postoperative pain
• Minimal blood loss and scarring
• Less risk of complications

Even minimally invasive surgery carries a small risk of surgical complications, like:

• Blood clots
• Excessive bleeding
• Damage to nearby tissues
• Infection
• Nerve injury (usually temporary)
• Stiffness after surgery

Surgical complications are rare. If they do occur, your healthcare team will know what to do.

What happens after arthroscopy?

You’ll go home to recover from surgery. Depending on the procedure you had, you might need to wear a brace or splint to keep your joint in position while it heals. If you had surgery on a leg, you might need to use crutches to keep weight off the joint. You can use the RICE method and over-the-counter pain relievers to reduce pain and swelling after surgery. Your incisions should heal within a week or two.

As soon as you’re able, your healthcare team will encourage you to start moving your joint in specific ways. They might give you exercises to practice at home, or they might refer you to a physical therapist, who’ll practice exercises with you. Physical therapy is an important part of your recovery from surgery. It helps rebuild weakened tissues and prevent them from stiffening and scarring.

How long is the recovery from arthroscopy?

Recovery from arthroscopy is generally easier and faster than recovery from open surgery. The small incisions cause less pain and heal sooner than a large incision. Being able to start moving your joint sooner after surgery also helps speed up your recovery. But the physical therapy part of your recovery can still last several weeks to months. It depends on your condition and the type of repairs you have.