What is Arthroscopy?

Arthroscopy is a surgical procedure used by orthopedic surgeons to visualize, diagnose and treat problems inside a joint. Derived from two Greek words, "arthro" (joint) and "skopein" (to look), the term literally means "to look within the joint."

In an arthroscopic examination, the surgeon makes a small incision and inserts instruments the size of a pencil that contain a small lens and lighting system that magnifies and illuminates the structures inside the joint. The arthroscope is attached to a miniature television camera that allows the surgeon to see the interior of the joint. The surgeon can explore throughout the joint, examining the cartilage, ligaments, and under the bones for damage or deterioration. Once the diagnosis is complete, the surgeon can repair or correct the problem as necessary.

Most Frequent Diagnosis

A diagnosis of joint injuries and disease begin with a thorough medical history, physical examination, and usually X-rays. An MRI or CT scan may also be needed. A final diagnosis is made through the arthroscope, the most accurate way to "look inside" the joint.

Injuries and disease can damage bones, cartilage, ligaments, muscles and tendons. Some of the most frequent conditions found during an arthroscopic examination include:

While the inside of nearly every joint can be viewed with an arthroscope, the joints most frequently examined are the knee, shoulder, elbow, ankle, hip and wrist.

Originally, arthroscopy was simply a diagnostic tool for planning standard open surgery. Advances in instrumentation and surgical techniques make it possible to treat many conditions arthroscopically. For example, it is effective in treating most meniscal tears in the knee. Some problems associated with arthritis can also be treated with a combination of arthroscopy and standard surgery.

What Happens During Arthroscopy?

Most arthroscopic surgery is done outpatient. Arthroscopic surgery, while far less invasive than "open" surgery, still involves the use of anesthetics and other special surgical equipment. You will be given a general, spinal or local anesthetic, depending on the joint and problem under investigation.

The arthroscope, a fiberoptic telescope about the size of a pencil, is inserted into the joint through a small incision (approximately 1/8 of an inch long). Fluid is then injected to distend the joint and allow for visualization of the structures within the joint. Several other small incisions may be made to provide access to other parts of the joint or insert other instruments as small as 1/10 of an inch. When indicated, corrective surgery is performed as part of the same procedure.

Following surgery, you will be moved to a recovery room, and it's likely you will need little or no pain medication. Upon discharge, you will be given instructions about what activities to avoid, and which exercises you should do to aid your recovery. At the follow-up visit, your doctor will initiate a rehabilitation program designed to rebuild muscle strength and relieve further stress around the treated joint.

Occasionally, during arthroscopy, the surgeon may discover that the injury or disease cannot be treated adequately with arthroscopy alone. At such times, extensive "open" surgery may be performed while you are still anesthetized, or delayed to a later date after you have discussed the findings with your surgeon.

Recovery And Beyond

The amount of surgery required and recovery time will depend on the nature and complexity of your problem. Patients are generally on some type of activity restriction for approximately six weeks following surgery, or until rehabilitation is completed.

While uncommon, complications can occur during or following arthroscopy. The most common complications are infection, phlebitis (blood clots of the vein), excessive swelling or bleeding, and damage to blood vessels or nerves. However, these complications occur in far less than one percent of all arthroscopic procedures.

It is not unusual for patients to resume daily activities within a few days of surgery. Athletes and others who are in good physical condition may return to athletic activities within a few weeks, depending on the particulars of each person's overall condition. In some rare cases, certain activities may be permanently restricted. Your doctor, in evaluating your particular diagnosis and preexisting conditions, is best qualified to make this decision.

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