Arthroscopy

Overview

Arthroscopy is a minimally invasive surgical technique utilized for both diagnosing and treating joint issues that cause pain, instability, or dysfunction. A surgeon introduces a slender tube connected to a fiber-optic video camera through a small incision, roughly akin to the dimensions of a buttonhole. The camera transmits real-time footage of the joint’s interior onto a monitor.

Arthroscopy allows surgeons to gain a clear view inside the joint without the need for large incisions. Surgeons can also repair certain forms of joint damage through arthroscopy, utilizing pencil-thin surgical instruments introduced via additional small incisions. This approach minimizes tissue disruption and promotes faster recovery compared to traditional open surgery.

Types of operation

Arthroscopy allows surgeons to view into joints without the need to make a large incision. An example of an arthroscopy are as follows:

• Shoulder arthroscopy.
• Elbow arthroscopy.
• Hand and wrist arthroscopy.
• Hip arthroscopy.
• Knee arthroscopy.
• Foot and ankle arthroscopy.

Reasons for undergoing the procedure

In order to diagnose and treat several kinds of joint, tendon, and ligament issues, the healthcare provider use arthroscopy for the following conditions:

• Knee pain, instability, and other injuries, such as tears in the anterior cruciate ligament (ACL) and meniscus.
• Damaged ligaments, cartilage, and tendons.
• Injuries like tears in the rotator cuff, dislocated shoulder, frozen shoulder, and shoulder impingement.
• Arthritis, which can affect the feet and ankles.
• Wrist pain, including conditions like carpal tunnel syndrome, ganglion cysts, and wrist arthritis.

Risk

Arthroscopy is typically considered a safe medical procedure with infrequent complications. Possible concerns may include:

• Tissue or nerve damage: The positioning and maneuvering of the instruments inside the joint have the potential to harm the joint’s structures.
• Infection: An infection can happen after any kind of invasive surgery.
• Blood clots: Procedures that last longer than an hour may, in rare cases, increase the risk of blood clots developing in the lungs or legs.
• Allergic reaction: Reaction to anesthesia.

Procedure

A healthcare professional might recommend arthroscopic surgery to a patient facing issues like meniscus, cartilage, tendon, or ligament damage, especially when conventional non-surgical treatments have proven ineffective. Arthroscopy, a minimally invasive technique conducted through small incisions, presents several advantages over open surgery, including quicker recovery, diminished pain, minimal blood loss, and reduced scarring.

Before the procedure

The specific preparations vary depending on the joint that the surgeon is inspecting or repairing. As a general guideline, you should:

• Avoid certain medications: The healthcare provider will instruct the patient to refrain in consuming any medication or dietary supplement that might increase the risk of bleeding.
  Patients should inform their healthcare provider about any blood thinners or nonsteroidal anti-inflammatory drugs (NSAIDs) they are taking prior to the procedure.
• Fasting: The patient may be instructed to refrain from solid food eight hours prior to the treatment.
• Avoid driving: After the treatment, patients won’t be allowed to drive themselves home, it is important to make sure transportation will be available. Requesting someone to check on the patient that evening or, ideally, stay with them for the rest of the day is advised if they live alone.
• Loose clothing: If an individual is having a knee arthroscopy, they are advised to wear baggy gym shorts to ensure ease of dressing following the treatment.

During the procedure

Patients usually return home on the same day following arthroscopy since it is typically an outpatient procedure. It’s crucial that someone accompanies the patient after surgery and remains with them for the remainder of the day due to the administration of anesthesia during the procedure.

Depending on the procedure, a different form of anesthesia, such as local, regional, or general anesthetic, may be used.

• Local anesthesia: Healthcare providers inject numbing agents beneath the skin to inhibit sensation in a specific area, like the knee. Patients remain conscious during the arthroscopy, with the primary sensations being pressure or a sensation of movement inside the joint.
• Regional anesthesia: A tiny needle is inserted between two lumbar vertebrae in the spine, which is the most common method of administering regional anesthetic. The person’s lower body becomes numb while they are still awake.
• General anesthesia: It might be preferable for the patient to be unconscious throughout the surgery, depending on how long it takes. Through an intravenous (IV) route, usually a vein, general anesthesia is delivered.

You will be positioned in the optimal posture for the upcoming procedure, which may involve lying on your back or on your side. To facilitate the surgery, the limb undergoing the procedure will be securely held in place using a positioning device. A tourniquet may be employed to reduce blood loss and improve visibility within the joint. An alternative method to enhance the visibility within your joint entails injecting a sterile fluid into the joint, which enlarges the space surrounding it.

This procedure involves making a single small incision to accommodate the viewing device. Additionally, several tiny incisions are made around the joint at various locations to facilitate the insertion of surgical instruments as needed for tasks such as grasping, cutting, grinding, and suctioning. The healthcare provider utilizes the images captured by the arthroscope to either diagnose the issue or perform surgical interventions as required. The incisions will be of a size that allows them to be sealed with either one or two stitches or with thin strips of sterile adhesive tape.

After the procedure

Arthroscopic surgery typically has a relatively short duration. For instance, knee arthroscopy usually lasts approximately an hour. Following the procedure, the individual will be transferred to a recovery area where they will spend a few hours recuperating before being discharged to go home.

Patient may need to do the following after the procedure:

• Refrain from placing weight or pressure on the treated area for a specified duration. If the arthroscopy was performed on the hip or leg, patient may require crutches or another supportive device.
• Apply ice and elevate the affected area.
• Maintain the cleanliness of the incision site and keep it covered.
• Consider taking nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief.
• Only take showers rather than baths until the incision has healed.
• If necessary, wear a sling or brace for support.
• Healthcare provider will recommend that the patient do physical therapy or rehabilitation to strengthen the muscles and enhance the function of the joints.

Outcome

It’s essential to understand that the recovery process can vary from one individual to another, and some may require an extended period for rehabilitation based on their specific circumstances. The surgeon will discuss the findings with the patient, and in certain cases, a written medical report may be provided. Subsequent follow-up appointments will allow for monitoring progress and addressing any issues that may arise.

Patients should anticipate the ability to return to desk jobs and engage in light activities within a few days of the procedure. Typically, resuming driving can occur within one to three weeks, while participation in more physically demanding activities may become possible a few weeks later.

Patients should promptly reach out to their healthcare provider if they experience any concerning symptoms, such as severe pain or excessive bleeding at the incision site, as well as symptoms like nausea, vomiting, or signs of infection such as fever or redness at the incision site.