Arthroscopy

Introduction

Arthroscopy is a surgical procedure doctors use to look at, diagnose, and treat problems inside a joint. Your doctor may recommend it if you have inflammation in a joint, have injured a joint, or have damaged a joint over time. You can have arthroscopy on any joint. Most often, it’s done on the knee, shoulder, elbow, ankle, hip, or wrist. The internal structure of a joint is examined for diagnosis and/or treatment using a tube-like viewing instrument called an arthroscope. Arthroscopy was popularized in the 1960s with the advent of fiberoptic technologies and is now commonplace throughout the world. Typically, it is performed by orthopaedic surgeons in an outpatient setting. When performed in the outpatient setting, patients can usually return home on the same day the procedure is completed. 

Arthroscopy can be helpful in the diagnosis and treatment of many noninflammatory, inflammatory, and infectious types of arthritis as well as various injuries within the joint.

Preparing for Arthroscopy:

Arthroscopy is essentially a procedure during which no blood loss is expected and generally has few complications. Before having an arthroscopy or any other procedure, be sure to tell your doctor about any medications or vitamins you are taking. Depending on the type of anaesthesia you’ll have, your doctor may want you to avoid eating solid foods eight hours before your procedure. 

The night before arthroscopy, do not drink or eat anything unless your doctor tells you otherwise. Wear loose, comfortable clothing — baggy gym shorts, for example, if you’re having knee arthroscopy — so you can dress easily after the procedure.

You won’t be allowed to drive yourself home after the procedure, so make sure. someone will be available to pick you up. If you live alone, ask someone to check on you that evening or, ideally, stay with you the rest of the day.

Procedure:

The type of anaesthesia used varies depending on the joint being examined and the medical health of the patient. Arthroscopy can be performed under a general anaesthetic, a spinal or epidural anaesthetic, a regional block (where only the extremity being examined is numbed), or even a local anaesthetic. If a general anaesthetic is not used, the patient is often sedated. After adequate anaesthesia is achieved, the procedure can begin. An incision is made on the side of the joint to be examined and the arthroscope is inserted into the incision.  In arthroscopic surgery, additional instruments for surgical repairs are inserted into the joint through additional small incisions in the joint. These instruments can be used to cut, remove, and suture (sew) damaged tissues. Once the procedure is completed, the arthroscope is removed and the incisions are sutured closed. A sterile dressing is placed over the incision and a brace or ACE wrap may be placed around the joint. 

Immediately after arthroscopic surgery, patients may be sleepy, especially if a general anaesthetic or sedation has been used. Medications are administered to control pain. The surgical incisions from arthroscopy are small. They usually consist of one or more 5 mm (1/4 inch) incisions on either side of the joint, which are bandaged after surgery. The bandage may absorb some of the tissue drainages from these wound sites. The bandage should only be removed under the advice of the treating surgeon or nurse. It should otherwise be kept as dry as possible during the first few days after surgery. Patients should notify their physician’s office immediately if they develop unusual joint pain, swelling, redness or warmth, or if they injure the involved joint.

Complications:

Complications are rare. Potential complications of arthroscopy are rare and include bleeding into the joint and infection of the joint, as well as side effects from anaesthesia.

Call your doctor right away if you have any of these symptoms:

• Fever
• Pain that gets worse
• Severe swelling
• Numbness or tingling
• Discoloured or smelly fluid seeping from the wound