Arthroscopy is a surgical procedure that is used to diagnose and treat joint problems, especially of knee, shoulder, elbow, ankle, hip or wrist. An arthroscopy is recommended for cases where the patient experiences swelling or inflammation in a joint, has injured a joint, or the joint is damaged over time. Arthroscopy enables the doctor to see inside the joint by only making a small incision. Through the small incision, the surgeon inserts a thin tube with a fibre-optic video camera (known as arthroscope), to investigate the inside of the joint by high-quality images produced by the arthroscope. In some cases, arthroscopy may also be used to correct the issue using pencil-thin surgical instruments.
Purpose of Arthroscopy
Essentially, an arthroscopy is used to diagnose and treat joint conditions, especially of the knee, shoulder, elbow, ankle, hip and wrist. It is a preferred mode of diagnosis when other mediums such as X-rays, etc. have not provided complete clarity on the problem. Moreover, arthroscopy is also used to treat various joint conditions such as:
- Loose bone fragments
- Injured, torn or damaged cartilage
- Inflammation in joint linings
- Torn or stressed ligaments
- Joint scarring
Risks of Arthroscopy
Arthroscopy is a very safe and minimally-invasive surgical procedure with minimum risks. Complications occur in as rare as one in a 100 cases. However, some rare problems that may arise include:
- Damage to the tissue, nerve, blood vessels, ligaments, etc.
- Bleeding at the incision site
- Bleeding inside the joint
- Blood clots in legs or lungs
- Breathing difficulty due to anaesthesia
- Allergic reaction to anaesthesia or any other medication used during surgery
- Stiffness in the joint
Procedure of Arthroscopy
The doctor will help the patient prepare before the procedure, depending on the joint concerned. In general cases, the doctor will advise the patient to do the following:
- Avoid certain medications or supplements that might increase chances of bleeding
- Avoid eating at least 8 hours before the procedure
- Do not drive back after the procedure; hence, be sure to be accompanied by someone
- Wear comfortable, lose clothing
To make the patient ready for the procedure, an intravenous catheter is placed in the hand or the forearm through which a mild sedative is inserted. Depending on the type of procedure and the joint concerned, the doctor places the patient under local, regional or general anaesthesia. Then the patient will be either asked to lay on the back or side, depending on the target joint. The limb in focus will be directed in a positioning device and then in some cases, a tourniquet is used to reduce the blood loss and improve the visibility inside the joint concerned. In other cases, to improve visibility, the surgeon might use a sterile fluid which expands the area around the target joint.
Post this, a small incision – about the size of a buttonhole – is made to allow the surgeon to insert the arthroscope to view the inside of the joint in-depth and diagnose problems. Moreover, in other cases, several small incisions are made around the joint, allowing the surgeon to insert surgical tools to repair the joint problem. An arthroscopy is a very short procedure that takes about an hour. Post the procedure, the surgeon will make one or two stitches, or use sterile adhesive tape to close the incisions.
Once the procedure is done, the patient is kept in the hospital for a few hours to ensure recovery and no complications. When discharged, the doctor will advise the patient on aftercare which can include:
- Medications to ease pain and swelling
- Rest, ice, compress and elevate the joint to reduce pain and swelling
- Mobility aids – crutches or slings – for comfort, if required
- Exercises including physical therapy to improve strengthen and joint functionality
Recovery after Arthroscopy
The patient is discharged on the same day of the procedure. Post the procedure, the patient might experience some pain in the target area which can be eased with the medications suggested by the doctor. In general cases, the pain and stiffness after an arthroscopy are lesser than an open procedure. It is also important to keep the target as dry as possible; patients can also use plastic cover to protect the area while bathing.
Also, depending on the joint, specific recovery measures will be directed by the doctor; such as in a knee arthroscopy – the patient will be asked to apply ice pack on the knee or dressing that will help reduce pain and swelling. Moreover, the leg would be needed to be kept at an elevation. Moreover, depending on the case, the doctor will schedule follow-up appointments, if needed.
Generally, the patient will be able to resume light normal activity within a few days; such as patients would be able to drive in one to three weeks. Heavy and more strenuous activities can be resumed in a longer time, also post consultation with a doctor. That said, not all patients have the same recovery process. Some might take longer than others, while some could heal faster than average.
In case, the patient experiences – fever, worsening pain, severe swelling, numbness or tingling, bleeding or drainage from the wound – the doctor must be immediately informed.