An arthroscopy is a minimally invasive surgical procedure that allows a surgeon to look inside a joint to diagnose and treat problems. The term arthroscopy comes from two Greek words: arthro (meaning joint) and skopien (meaning to look).
This article on arthroscopy is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.
Joint problems can often be diagnosed using magnetic resonance imaging (MRI) or X-ray. However, sometimes these are not clear enough to provide a full diagnosis, particularly when the damage involves soft tissues around a bone. Therefore, an arthroscopy may eventually be used to investigate the following complaints in a joint:
- pain, swelling, or inflammation
- a tear in the joint
- a tear in the ligament
- a loose piece of bone
- unsteadiness or instability (knee ‘giving way’)
As well as evaluation, an arthroscopy can also be used to treat a range of orthopaedic conditions in place of traditional surgery. These include inflammation and acute or chronic injuries such as:
Shoulder – rotator cuff tendon tears, impingement syndrome, and recurrent dislocations
Knee – cartilage tears, and wearing or injury of cartilage cushion (chondromalacia)
Wrist – carpal tunnel syndrome
Any joint – loose bodies of bone or cartilage in the knee, shoulder, elbow, wrist, fingers, ankle, and hip.
Arthroscopic (also known as endoscopic) spinal procedures also enable surgeons to treat a range of spinal conditions, such as bulging discs, deformities, and tumours – with minimal damage to the surrounding tissues. This averts the need to access mid-spine conditions through the rib cage.
An arthroscopy can be conducted under local or general anaesthetic, and may take over an hour if there is a lot of work to be done. An anti-bacterial fluid is used to first clean the skin over the affected joint. The surgeon then makes a small incision and inserts a narrow tube with a tiny fibre-optic camera attached, known as an arthroscope. A small light and a lens on the end illuminates and magnifies the joint so the surgeon has a clear view of any problems or damage.
If treatment is also being given, a second incision is made to insert the surgical instruments. Damaged areas are repaired and unwanted tissue, bone, or cartilage is removed. Sometimes a fluid is used to wash out the joint, particularly in cases of arthritis - which can relieve painful symptoms for several months.
Once the arthroscopy procedure is complete, all fluid is drained from the joint and the incisions are closed with stitches or tape. A sterile dressing and bandage may also be applied. If there is likely to be much bleeding or fluid weeping, drains may be attached for a few hours to make sure all extra fluids leave the knee.
Since an arthroscopy is a keyhole procedure, the recovery time is dramatically shorter compared to traditional surgery. Keyhole surgery also causes less trauma to the connective tissues and significantly reduces the risk of infection, so complications are less likely.
Most patients can return home the same day after arthroscopy. The surgical incisions should be pain-free, but the joint itself may swell, causing discomfort for a few weeks. If the surgery was performed on a knee joint, the patient may be given crutches to help relieve stress when walking.
After a month, the patient should be able to fully load the affected joint as normal, and after a few more weeks the function of the joint should be fully recovered. This process is often faster in athletes in peak physical condition. Conversely, older patients or those with more complicated injuries may demand longer recovery times and extended physiotherapy.
An arthroscopy is generally a safe procedure and brings fewer risks than traditional surgery. In rare events, however, the following complications can occur:
- accidental damage to the joint
- damage to blood vessels or nerves
- instrument breakage
- infection of the joint
- blood clots of a vein (phlebitis)
- excessive bleeding into the joint
- reaction to anaesthetic
- loss of sensation in the skin around the joint
You should see your doctor urgently if you have any of the following symptoms during recovery:
- progressively worse pain, swelling or tenderness
- a high temperature
- fluid, pus, or blood coming from the incisions
- numbness or tingling around the joint