Arthroscopy

What is an arthroscopy?

Arthroscopy is a surgery that allows your doctor to see the inside of your joints and treat joint conditions and diseases. Arthroscopy is performed using very small surgical tools and an arthroscope. An arthroscope is a long, thin camera. It is inserted into the joint through an incision over or near the joint. The camera transmits pictures of the inside of your joint to a video screen viewed by your doctor as he or she performs your surgery. Common surgeries performed with arthroscopy include the repair of torn cartilage or ligaments.

Arthroscopy is a type of minimally invasive surgery. This involves making small incisions instead of the larger one needed for open joint surgery. In arthroscopy, surgical tools are threaded through the smaller incisions and around tissues instead of cutting through them. This generally results in a quicker recovery and less pain than open surgery.

Other surgical procedures that may be performed

Your doctor may also perform a biopsy. A biopsy is the removal of a sample of cells or tissue that is tested for cancer and other diseases. In some cases, an open surgery may be needed if your doctor finds a problem during arthroscopy that cannot be treated without open surgery. Open surgery is performed by making a longer incision that allows your doctor to directly view and treat the joint.

Why is an arthroscopy performed?

An arthroscopy is a procedure that may be recommended to diagnose and possibly treat a variety of joint and orthopedic conditions, most commonly of the knee, shoulder, elbow, hip, wrist and ankle. These include:

• Acute and chronic joint painfrom such conditions as a torn ligament or arthritis
• Arthritis, or inflammation of the joint. Both osteoarthritis and rheumatoid arthritis can lead to pain, swelling and destruction of the joint.
• Carpal tunnel syndrome, which is compression of the median nerve in the wrist
• Cartilage conditions, such as loose or torn cartilage, meniscal tears in the knee and shoulder, and wearing down or injury of cartilage
• Frozen shoulder(adhesive capsulitis), which is inflammation of the shoulder joint, or shoulder impingement, which is pinching of a shoulder tendon or bursa, a fluid-filled sac that helps cushion joints
• Joint infection, which is also called septic arthritis
• Joint inflammation, most commonly of the knee, shoulder, elbow, wrist or ankle. Inflammation can be caused by a variety of conditions, such as rheumatoid arthritis, bursitis, and lupus.
• Joint scarring, which can be due to an injury, previous surgery, or chronic inflammation
• Ligament injuries and conditions, such as anterior cruciate ligament (ACL) tear in the knee and recurrent shoulder dislocations
• Loose bone and bone spurs, which are abnormal bony growths found most often in the joints. Loose bone and bone spurs are most commonly caused by osteoarthritis.
• Tendon injuries and conditions, such as a tear of the rotator cuff tendon in the shoulder and patellar tendon rupture in the knee
• Tissue biopsy, which involves removing samples of tissues to be examined for disease or malignancy (cancer)

How is an arthroscopy performed?            

Your arthroscopy will be performed in a hospital or outpatient setting by a surgical team led by an orthopedic surgeon. An orthopedic surgeon is a physician who specializes in diseases and conditions of the bones and joints.

In general, your surgeon will perform the arthroscopy by inserting an arthroscope through a small incision. The camera attached to the arthroscope allows the surgeon to view the surgical area on a video screen as he or she performs the surgery. In some cases, more than one small incision may be necessary to completely examine the joint and allow insertion of special instruments to treat your condition.

Types of anesthesia that may be used

An arthroscopy may be performed using a nerve block or general anesthesia:

• General anesthesia is a combination of intravenous (IV) medications and gases that put you in a special type of deep sleep. During general anesthesia, you are unaware of the procedure and will not feel any pain. In some cases, you may also receive a peripheral nerve block infusion in addition to general anesthesia. This type of anesthesia involves an injection or continuous drip of a liquid anesthetic, which flows through a tiny tube inserted near your surgical site to control pain during and/or after surgery.
• A nerve block is also known as regional or local anesthesia. For regional anesthesia, your anesthesiologist or nurse anesthetist will inject an anesthetic medication around certain nerves in the spine to numb a large are of the body. To numb a smaller area, your doctor will inject the anesthetic in the skin and tissues around the procedure area (local anesthesia). You will be awake, but kept as comfortable as possible during the procedure. You will also be given a sedative through your IV to keep you sleeping lightly.