Arthroscopy

(Fiberoptic Joint Examination)

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Definition | Body Parts Involved | Reasons for Procedure | Complications | What to Expect | Outcome | Call Doctor If

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Definition

Visual examination of a joint with an arthroscope, which is a fiberoptic instrument with a lighted tip. Arthroscopy is also used to perform some corrective surgeries.

Parts of the Body Involved

Any joint: shoulder, elbow, wrist, hip, knee, or ankle

Reasons for Procedure

Arthroscopy is done to visualize, diagnose, and treat problems inside a joint. The procedure is most often performed for the following reasons:

• Diagnosis of an injury or disease inside a joint
• Removal of bone or cartilage
• Repair of tendons or ligaments

Risk Factors for Complications during the Procedure

• Pre-existing heart or lung condition
• Obesity
• Recent or chronic illness
• Diabetes

What to Expect

Prior to Procedure

Your doctor will likely do the following:

• Physical exam
• X-rays of joint
• MRI scan – a test that uses magnetic waves to make pictures of the inside of a joint

In the days leading up to your procedure:

• Arrange for a ride to and from the procedure
• The night before, do not eat or drink anything after midnight
• You may be asked to use pre-surgical scrubs to the affected joint

During Procedure - IV fluids, anesthesia, possibly a sedative

Anesthesia - General, local, or spinal anesthetic, depending on the joint

Description of the Procedure - The surgeon makes tiny skin incision(s) along the joint and inserts pencil-sized instruments that contain a small lens and lighting system to magnify and illuminate the structures inside the joint. By attaching the arthroscope to a miniature television camera, the surgeon is able to see the inside of the joint.

In some cases, surgical repair can also be done via arthroscopy. For example, many meniscal (cartilage) tears of the knee can be treated with arthroscopic surgery, as can carpal tunnel release.

After the arthroscope is removed, the incisions will be covered with a dressing, and the skin may be closed with stitches or clips. These are usually removed 7-10 days after the procedure.

After Procedure - Laboratory examination of the removed fluid or tissue

How Long Will It Take? Usually less than one hour

Will It Hurt? Most patients report no pain during the procedure

Possible Complications:

• Infection
• Blood clots in a vein (phlebitis)
• Excessive swelling or bleeding
• Damage to blood vessels or nerves

Average Hospital Stay - None

Postoperative Care:

• The operative dressing can usually be removed the morning after surgery and replaced with small adhesive strips
• Apply ice for the first 24-48 hours after surgery
• Move and elevate legs while resting in bed
• Keep the incision area dry; shower with a plastic bag securely taped above and below the area
• You may be instructed to use crutches or a cane for the first few days
• Take only non-aspirin containing medications for minor pain

Outcome

It takes 4-6 weeks for the affected joint to recover, but you can probably go back to work or resume daily activities within a few days. A specific activity and rehabilitation program may be suggested to speed your recovery and protect future joint function.

Athletes and others in good physical condition prior to arthroscopy often return to athletic competition within a few weeks. NOTE: Repair of the anterior cruciate ligament (ACL) by arthroscope may require a recovery time of 4-6 months.

Call Your Doctor If Any of the Following Occurs

• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision sites
• Nausea or vomiting
• Swelling, tingling, pain, or numbness in your toes that is not relieved by elevating your knee above heart level for one hour
• Drainage

SOURCE:

American Academy of Orthopaedic Surgeons

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Last reviewed January 2001 by Medical Review Board