Definition & Overview
Arthroscopy is a surgical procedure that examines the joints with the aim to minimize the amount of blood loss. Unlike traditional surgical methods used to perform such examinations, arthroscopy is less costly, less painful, and requires considerably less recovery time. In fact, the procedure is usually performed on an outpatient basis; therefore, the patient does not need to spend a night at the hospital.
The purpose of the procedure is to examine the joint surface, ligaments, and cartilage to identify any problems. In some cases, a doctor will perform an arthroscopy to look for foreign bodies that may have penetrated the joint, or to examine a certain disease that has affected the joint.
During an arthroscopy, the doctor will use an arthroscope, a surgical device with a light and camera attached to a thin tube. The doctor will insert the tube through a small incision on either side of the joint. The arthroscope produces a video recording of the joint, which the doctor will examine to find any abnormalities.
Most arthroscopy procedures are performed on the shoulders, knee, and ankles, as these are the joints that usually have problems. However, the procedure can also be performed on the wrist, knees, and elbow if required.
Conditions that require an arthroscopy
Arthroscopy is helpful when diagnosing different forms of arthritis, diseases that affect the joints, and determining the extent of a joint-related injury. For example, a doctor can see the damage caused by osteoarthritis using an arthroscope. When diagnosing rheumatoid arthritis, the doctor can use an arthroscope to remove the tissue lining to be examined for various infections.
When diagnosing injuries, it's easier to determine the extent of the damage to the ligaments and cartilage during an arthroscopy. In some cases, a foreign object that is lodged in the joint can be removed through arthroscopic surgery.
How an arthroscopy is performed
Although considered as an outpatient procedure, arthroscopy is essentially a surgical procedure so a preoperative evaluation of patient's health will need to be performed prior to the surgery. This can include blood tests, a urinalysis, and a complete physical examination. The patient's heart, lung, and kidneys should be able to function adequately. If there is any concern about the function of the heart and lungs, an EKG or a chest x-ray will need to be performed to determine the exact condition. If the patient is displaying any signs of infection, other than an infection to the joints, the procedure will have to be postponed until such time the infection is under control.
Once the results of the preoperative evaluation reveal that the patient is ready for the procedure, an IV line is connected to the patient and anesthesia is administered. The results of the preoperative examination will determine the type of anesthetic.
The surgeon will then create a small incision, usually around a quarter of an inch long on the side of the joint being examined. The surgeon will insert the arthroscope tube through this incision. If other instruments are required to perform surgical repairs or a biopsy, the surgeon will create another incision.
Once the surgeon has completed the diagnosis or treatment of the joint, the instruments are removed and the incision is closed using sutures. After the wound has been addressed adequately, the surgeon may need to support the joint using a brace or an ACE wrap.
The patient may need to stay at the hospital for several hours after the procedure, especially if it was performed using general anesthesia. Medications to control the pain will be given before the patient leaves the hospital.
During the first couple of days after the surgery, the patient will need to keep the wound dry. If there is excessive pain in the joint or if swelling develops, the patient will need to inform the doctor immediately.
Other than pain medications, the patient can use ice packs to reduce the pain and control the swelling. Once the wound has fully healed, the patient is usually asked to start an exercise program in order to strengthen the joint and eventually gain normal joint functions.
Like any other surgical procedure, there are risks associated with an arthroscopy. There is a risk of damaging surrounding tissues during the placement and movement of surgical instruments. Infections can also develop after the procedure, which will need to be treated immediately in order to prevent these from spreading. Although rare, there is also a risk of developing blood clots in the legs or lungs.