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Arthroscopy

(Fiberoptic Joint Examination)

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Definition

Arthroscopy is a surgery done to examine a joint visually. Most of the time, it is done on larger joints, like the knee or shoulder. A special tool called an arthroscope is used. It is an instrument that looks like a long tube with a miniature camera on the end. Repairs or corrections to the joint may be done by using the arthroscope and other tools.
Diagnostic Arthroscopy of the Right Knee
IMAGE
Arthroscopy can be done to diagnose an injury or a condition.
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

It is used to see, diagnose, and treat problems inside your joint. The procedure is most often performed for the following reasons:
  • Diagnose an injury or disease inside a joint
  • Remove bone or cartilage
  • Repair tendons or ligaments

Possible Complications

Complications are rare, but no procedure is completely risk free. If you are planning to have an arthroscopy, your doctor will review a list of possible complications, which may include:
  • Infection
  • Blood clots
  • Swelling or bleeding
  • Damage to blood vessels, nerves, or other tissue
  • The need to have another surgery or more extensive surgery
Factors that may increase the risk of complications include:

What to Expect

Prior to Procedure

  • Your doctor will likely do the following:
    • Physical exam
    • X-rays—a test that uses radiation to take pictures of the joint
    • MRI—a test that uses a magnetic field to make pictures of the inside of a joint
  • Arrange for a ride to and from the procedure.
  • The night before, do not eat or drink anything after midnight.
  • You may be asked to use a special soap the morning of the procedure.

Anesthesia

The type of anesthesia will depend on the joint your doctor is looking at. You may receive one of the following:
  • General anesthesia—you will be asleep
  • Local anesthesia—the area will be numbed
  • Spinal anesthetic—your lower body will be numbed by putting a numbing medicine in your back

Description of the Procedure

The doctor will make tiny incisions in the skin along the joint. Special tools will be inserted through the incisions. The tools include the arthroscope. The picture from the arthroscope will show up on a screen so that the doctor can see the inside of your joint. The doctor will use the images to move around other tools that can cut and repair tissue in your joint.
For example:
Once the examination is done, the tools will be removed. The skin may be closed with stitches or clips. The incisions will be covered with a dressing. The fluid or tissue that was removed may be sent to a lab for examination.

How Long Will It Take?

Usually less than one hour, but this may be longer if repairs are being done.

Will It Hurt?

Most patients report no pain during the procedure. After the procedure, pain medicines are used to treat pain.

Post-procedure Care

The dressings can sometimes be removed as early as the next morning. When you return home after the procedure, do the following to help ensure a smooth recovery:
  • Apply ice for the first 24-48 hours after surgery to help with swelling and pain.
  • While resting in bed, elevate the part of your body that you had surgery on.
  • Keep the incision area dry. Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • You may be instructed to use crutches or a cane for the first few days if the surgery was done on a joint in your legs.
  • Take only non-aspirin containing medicines for minor pain.
  • If you have stitches or staples, your doctor will remove them in 7-10 days.
  • Be sure to follow your doctor’s instructions.
It takes 4-6 weeks for the joint to recover. You can probably go back to work or resume daily activities within a few days, as long your doctor approves. A specific activity and rehabilitation program may be suggested. This will help speed your recovery and protect future joint function.
Athletes often return to athletic competition within a few weeks.
Note: Repair of the anterior cruciate ligament (ACL) by arthroscope may require a recovery time of 4-6 months and a more specialized rehabilitation program.

Call Your Doctor

After arriving home, contact your doctor if any of the following occurs:
  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which persist for more than two days after discharge from the hospital
  • Pain that you cannot control with the medicines you have been given
  • Cough, shortness of breath, or chest pain
  • Joint pain, fatigue, stiffness, rash, or other new symptoms
  • Swelling, tingling, pain, or numbness in your toes that is not relieved by elevating your knee above heart level for one hour
  • Drainage
In case of an emergency, call for medical help right away.

RESOURCES

American Academy of Orthopedic Surgeons http://www.aaos.org

Arthritis Foundation http://www.arthritis.org

CANADIAN RESOURCES

The Arthritis Society http://www.arthritis.ca

Canadian Orthopaedic Association http://www.coa-aco.org

References

Arthroscopy Association of North America website. Available at: http://www.aana.org . Accessed July 10, 2009.

Lindström D, Azodi O, Wladis A, et al. Effects of a perioperative smoking cessation intervention on postoperative complications: a randomized trial. Ann Surg . 2008;248:739-745.

What is arthroscopy? American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00109 . Updated October 2007. Accessed July 10, 2009.

Yacub J, Rice B, Dillingham T. Nerve injury in patients after hip and knee arthroplasties and knee arthroscopy. Am J PhysMed Rehabil . 2009;88:635-641.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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