Arthroscopy: Less invasive surgery for knees and other joints

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Arthroscopy

Arthroscopy is a minimally invasive way to diagnose and treat joint problems.

Definition

Arthroscopy (ahr-THROS-skuh-pe) is a procedure for diagnosing and treating joint problems. During arthroscopy, a surgeon examines and, in many cases, repairs your injured or diseased joint with the help of an optical instrument called an arthroscope. An arthroscope consists of a light source, a lens system and bundled glass or plastic fibers (fiberoptics) to carry light to the area being examined. These parts are encased in a tube, usually about one-eighth of an inch (4 mm) in diameter. A video camera attached to the arthroscope relays the view from within your joint to a video monitor. Because the arthroscope is so narrow, your surgeon needs only a small incision to place it in your joint.

Risks

Arthroscopy is a low-risk procedure. Complications occur in 1 percent to 2 percent of arthroscopies. The risks include:

  • Bone, cartilage or ligament damage from placing and movement of instruments within the tight space of the joint
  • Blood vessel or nerve damage in the area around the joint
  • Tendon or ligament damage
  • Bleeding within the joint
  • A blood clot in a leg vein, mainly a risk in procedures lasting over an hour
  • Infection

What you can expect

Although the experience varies depending on why you're having the procedure and on which joint is involved, some aspects of arthroscopy are fairly standard.

  • You'll remove your street clothes and jewelry and put on a hospital gown or shorts.
  • A nurse will place an intravenous catheter in your hand or arm and inject a mild sedative.

You'll receive general, regional or local anesthesia.

  • General anesthesia is sometimes the best option for repairing acute injuries, or for procedures in which the surgeon has to reposition the arthroscope repeatedly. You receive general anesthesia by an intravenous injection. If you have general anesthesia, you'll be unconscious throughout the procedure.
  • Regional anesthesia leaves you awake while blocking sensation in a large part of your body. The most common form of regional anesthesia is delivered through a small tube placed between two of your vertebrae, or spine bones. Another type — sometimes referred to as a nerve block — is injected in the vicinity of a nerve or group of nerves.
  • Local anesthesia involves injecting numbing agents below the skin to block sensation in a limited area, such as your knee. With local anesthesia, you'll be awake during your arthroscopy, but the most you'll feel is pressure or a sensation of movement within the joint.

After the procedure

  • Arthroscopic surgery usually takes between 30 minutes and 2 hours, depending on the procedure performed. After that, you'll be taken to a separate room to recover for a few hours before going home.
  • Your doctor may give you medication to relieve pain and inflammation.
  • At home, you'll need to wrap, rest, ice and elevate the joint for several days to reduce swelling and pain.
  • You may need to temporarily use splints, slings or crutches for comfort and protection.
  • Your doctor may prescribe physical therapy and rehabilitation to help strengthen your muscles and improve the function of your joint.
  • In general, you should be able to resume desk work and light activity in a week, and more strenuous activity in two weeks. Remember, however, that your situation may dictate a longer recovery period, along with rehabilitation.

Ice compress

Illustration of ice compress

Relieve pain and swelling after arthroscopy by elevating the affected joint and applying a pressure bandage and an ice pack.

Last Updated: 04/16/2008
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