Arthroscopy is a surgical procedure used to diagnose and treat various problems inside joints. Through a small incision the pencil-sized arthroscope is placed into the joint. Via a fiberoptic light source and small lens, a micro TV camera transmits the image to a monitor where it can be observed as well as recorded. Other instruments can be placed through another small incision to allow the performance of various surgical procedures. The arthroscope magnifies the structures within the joint giving an in depth and detailed view of the joint and the pathology.
An operating room is necessary, though an overnight hospital stay is not. Before the procedure the patient will be given an anesthetic – either a light general or regional. The skin surrounding the joint is sterilized, and through a small incision, sterile fluid is placed into the joint. The incisions are buttonhole or smaller in size and usually 3 are necessary. The arthroscope is used to systematically evaluate the entire joint, and as it is evaluated, a surgical plan is formed. Specially designed instruments are then used to perform whatever surgery is necessary.
After the procedure is completed, the incisions are closed and a sterile dressing is applied. The patient is taken to the recovery room until he/she is awake and ready to return home. The nurse will give instructions concerning care of the wounds and when follow-up will be done.
In general, all arthroscopy wounds should be kept clean and dry for 5 days from the time of surgery. If there is any drainage still occuring at 5 days, the patient should wait until it stops before getting the wound wet.
Elevation and ice packs will help decrease the pain and swelling for the first 24 hours after surgery. Physical therapy is usually started on the day after surgery and certainly within the first few days. A follow-up appointment with your physician will be made for approximately three weeks from the time of surgery. If there is a problem or a special concern prior to this that the therapist cannot resolve, the physician’s assistant should be contacted for an earlier appointment.
Recovery time is very dependent on exactly what arthroscopic procedure is performed. For simple procedures such as the removal of loose cartilage or a torn meniscus, many patients are back working and active within several days. If more extensive rehabilitation is necessary, for example after a rotator cuff repair of the shoulder or a ligament repair of the knee, the patient may be off work for a couple of weeks. Many of the rehabilitation exercises can be done at home, and this will decrease the recovery time.
What are the possible complications and risks? Complications from arthroscopy are rare, and even the minor ones occur less than 5% of the time. The major ones are very rare. They include but are not limited to death, infection, bleeding, phlebitis, blood clots, damage to nerves or blood vessels, pain, failure of tendon or ligament repair, failure to alleviate pain, and instrument breakage. In addition, there are risks posed by anesthesia. It is important to understand both the potential benefits as well as the potential risks of arthroscopy before making a decision for or against it. There are many precautions taken to avoid any complications, but despite this, arthroscopy, like any other surgical procedure, does have risks.