Description

This procedure is typically done on the knee, hip, ankle, shoulder, elbow, or wrist.

Three different types of anesthesia (pain management) may be used for arthroscopy surgery:

• General anesthesia. You will be unconscious and unable to feel pain.
• Painkilling medicine. Your joint may be numbed, and you may be given medicines that relax you. You will stay awake.
• Spinal anesthesia. This is also called regional anesthesia. The painkilling medicine is injected into a space in your spine. You will be awake but will not be able to feel anything below your waist.

The area is cleaned and a pressure band (tourniquet) may be applied to restrict blood flow. The health care provider will then make a surgical cut into the joint. Sterile fluid is passed through the joint space to expand the joint and provide a better view.

Next, a tool called an arthroscope is inserted into the area. An arthroscope consists of a tiny tube, a lens, and a light source. It allows the surgeon to look for joint damage or disease.

Images of the inside of the joint are displayed on a monitor. One or two other surgical cuts may be needed so the doctor can use other instruments to remove bits of cartilage or bone, take a tissue biopsy, or perform other minor surgery. In addition, ligament repairs can be done using the arthroscope.

Why the Procedure is Performed

A number of different injuries and diseases may cause joint pain or problems.

Arthroscopy may be needed to:

• Diagnose the cause of joint pain after an injury
• Perform carpal tunnel surgery
• Remove loose bone or cartilage fragments in the joint
• Remove the lining of the joint. This lining is called the synovium, and it may become swollen or inflamed from arthritis.
• Repair a torn ligament or tendon
• Repair damaged cartilage or meniscus (the piece of cartilage that cushions the knee joint area)

Risks

The risks from surgery are:

• Allergic reactions to medications
• Breathing problems

Other risks from this surgery include:

• Bleeding into the joint
• Blood clot
• Damage to the cartilage, meniscus, or ligaments in the knee
• Infection in the joint
• Injury to a blood vessel or nerve
• Joint stiffness

Outlook (Prognosis)

After the procedure, the joint will probably be stiff and sore for a few days. Ice is commonly recommended after arthroscopy to help relieve swelling and pain.

You can resume gentle activities, such as walking, immediately. However, using the joint too much may cause swelling and pain, and may increase the chance of injury. Do not restart normal activity for several days or longer.

You may need to make arrangements for work and other responsibilities. Your doctor may also recommend physical therapy.

Depending on your diagnosis, you may have other resrictions or need to do certain exercises.

Before the Procedure

You will usually have an MRI scan of the joint done before surgery is planned.

Always tell yoru doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

You will be asked to stop taking drugs that make it harder for your blood to clot beginning 2 - 3 weeks before surgery. These drugs include aspirin, ibuprofen (Advil, Motrin), and naproxen (Naprosyn, Aleve).

Ask your doctor which drugs you should still take on the day of your surgery.

You will usually be asked not to eat or drink anything for 6 - 12 hours before the procedure. Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery.

You must sign a consent form. Make arrangements for transportation from the hospital after the procedure.

Alternative Names

Arthroscopy - hip; Arthroscopy - wrist; Arthroscopy - ankle

References

Azar FM. General principles of arthroscopy. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 47.

Miller MD, Hart J. Surgical principles. In: DeLee JC, Drez D Jr., Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2009:chap 2.

Update Date: 4/28/2012

Reviewed by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, Unviersity of Washington School of Medicine; and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.