Arthroscopy is a procedure that orthopaedic surgeons use to inspect, diagnose, and repair problems inside a joint.
The word arthroscopy comes from two Greek words, "arthro" (joint) and "skopein" (to look). The term literally means "to look within the joint." During arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your joint. The camera displays pictures on a television screen, and your surgeon uses these images to guide miniature surgical instruments.
Because the arthroscope and surgical instruments are thin, your surgeon can use very small incisions (cuts), rather than the larger incision needed for standard, open surgery. This results in less pain for patients, and shortens the time it takes to recover and return to favorite activities.
Knee arthroscopy is a surgical technique that can diagnose and treat problems in the knee joint.
Arthroscopy diagnoses several knee problems, such as a torn meniscus or a misaligned patella (kneecap). It can also repair the ligaments of the joint. There are limited risks to the procedure and the outlook is good for most patients. Your recovery time and prognosis will depend on the severity of the knee problem and the complexity of the required procedure.
Your doctor may recommend that you undergo a knee arthroscopy if you’re experiencing knee pain. Your doctor might have already diagnosed the condition causing your pain, or they may order the arthroscopy to help find a diagnosis. In either case, an arthroscopy is a useful way for doctors to confirm the source of knee pain and treat the problem.
Arthroscopic surgery can diagnose and treat knee injuries, including:
Your doctor or surgeon will advise you how to prepare for your surgery. Be sure to tell them about any prescriptions, over-the-counter medications, or supplements that you’re currently taking. You may need to stop taking certain medicines, such as aspirin or ibuprofen, for weeks or days before the procedure.
You must also refrain from eating or drinking for six to 12 hours before the surgery. In some cases, your doctor may prescribe you a pain medication for any discomfort you experience after the surgery. You should fill this prescription ahead of time so that you have it ready after the procedure.
Your doctor will give you an anesthetic before your knee arthroscopy. This may be:
If you’re awake, you may be able to watch the procedure on a monitor. The surgeon will begin by making a few small incisions, or cuts, in your knee. Sterile salt water, or saline, will then pump in to expand your knee. This makes it easier for the surgeon to see inside the joint. The arthroscope enters one of the cuts and the surgeon will look around in your joint using the attached camera. The surgeon can see the images produced by the camera on the monitor in the operating room. When the surgeon locates the problem in your knee, they may then insert small tools into the incisions to correct the issue. After the surgery, the surgeon drains the saline from your joint and closes your cuts with stitches.
There are risks associated with any type of surgery, though they are rare. Every surgery has the following risks:
There are also risks specific to a knee arthroscopy, such as:
This surgery isn’t very invasive. For most people, the procedure takes less than an hour depending on the specific procedure. You will likely go home on the same day for recovery. You should use an ice pack on your knee and a dressing. The ice will help reduce swelling and minimize your pain.
At home, you should have someone look after you, at least for the first day. Try to keep your leg elevated and put ice on it for a day or two to reduce swelling and pain. You’ll also need to change your dressing. Your doctor or surgeon will tell you when to do these things and for how long. You will probably need to see your surgeon for a follow-up appointment a few days after the procedure.
Your doctor will give you an exercise regimen to follow at home to help your knee recover, or will recommend a physical therapist to see until you’re able to use your knee normally. The exercises are necessary to help restore your full range of motion and to strengthen your muscles. With the proper care, your outlook after having this procedure is excellent.
Your shoulder is a complex joint that is capable of more motion than any other joint in your body. It is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
Normal anatomy of the shoulder
Your orthopaedic surgeon may ask you to see your primary doctor to make sure that you do not have any medical problems that need to be addressed before your surgery. Blood tests, an electrocardiogram, or chest x-ray may be needed to safely perform your surgery.
If you have certain health risks, a more extensive evaluation may be necessary before your surgery. Be sure to inform your orthopaedic surgeon of any medications or supplements that you take. You may need to stop taking some of these prior to surgery.
If you are generally healthy, your arthroscopy will most likely be performed as an outpatient. This means you will not need to stay overnight at the hospital. The hospital or surgery center will contact you ahead of time to provide specific details about your procedure. Make sure to follow the instructions on when to arrive and especially on when to stop eating or drinking prior to your surgery.
Before the operation, a member of the anesthesia staff will talk with you about anesthesia options. Shoulder arthroscopy is most commonly performed using regional nerve blocks which numb your shoulder and arm. This numbing medicine is injected in the base of your neck or high on your shoulder. This is where the nerves that control feeling in your shoulder and arm are located. In addition to its use as an anesthetic during surgery, a nerve block will help control pain for a few hours after the surgery is completed. Many surgeons combine nerve blocks with sedation or a light general anesthetic because patients can become uncomfortable staying in one position for the length of time needed to complete the surgery.
Most arthroscopic procedures take less than an hour, however, the length of your surgery will depend on what your surgeon finds and what repairs are required.
Postoperative - After surgery, you will stay in the recovery room for 1 to 2 hours before being discharged home. Nurses will monitor your responsiveness and provide pain medication, if needed. You will need someone to drive you home and stay with you for at least the first night.
Although recovery from arthroscopy is often faster than recovery from open surgery, it may still take weeks for your shoulder joint to completely recover.
You can expect some pain and discomfort for at least a week after surgery. If you have had a more extensive surgery, however, it may take several weeks before your pain subsides. Ice will help relieve pain and swelling. Your doctor may prescribe pain medicine, if needed.
Many types of pain medication are available to help control pain, including opioids, nonsteroidal anti-inflammatory drugs (NSAIDs) and local anesthetics. Treating pain with medications can help you feel more comfortable, which will help your body heal faster and recover from surgery faster.
Opioids can provide excellent pain relief, however, they are a narcotic and can be addictive. It is important to use opioids only as directed by your doctor. You should stop taking these medications as soon as your pain starts to improve.
Although it does not affect how your shoulder heals, lying flat may pull on your shoulder and cause discomfort. Some patients are more comfortable sleeping in a reclining chair or propped up in bed during the first days after surgery.
A few days after surgery, you should be able to replace your large bandage with simple Band-Aids. You may shower once your wounds are no longer draining, but try not to soak or scrub your incisions.
You will most likely need a sling or special immobilizer to protect your shoulder. Your surgeon will discuss with you how long the sling will be needed.