What is Arthroscopy?

Arthroscopy is a minimally invasive orthopedic surgery performed for the diagnosis and treatment of joint issues. It is generally performed when the surgeon wants to inspect the insides of a joint without damaging the tissues surrounding it.

The procedure is generally performed by inserting a scope and surgical instruments through tiny incisions. The scope is a narrow tube with a fiber-optic video camera attached to it. The video captured through the camera is transmitted to a high-definition monitor for diagnosis and treatment.

It is usually performed for weight-bearing joints like knee, shoulder, elbow, ankle, hip, and the wrist joint. For diagnosis, it is usually reserved as the last option if the imaging tests are not clear and the surgeon is not able to determine the cause even after thorough conservative examination. On the other hand, it is the most preferred surgical approach as it provides quicker recovery with minimal complications.

What happens during arthroscopy?

Before arthroscopy, the orthopedist performs a thorough diagnosis for the patient to find the exact cause of the issue and determine what the best treatment option would be. Generally, before the surgery imaging tests are performed. Common imaging tests performed before arthroscopic orthopedic surgery are X-rays, CT scan, MRI scan, ultrasonography, etc.

Once the diagnosis has been confirmed, the orthopedic surgeon discusses various treatment options with the patient. Arthroscopic surgery can be performed under either general anesthesia or regional anesthesia – based on the joint being operated on and the type of surgery.

Once the anesthesia has taken effect, the surgeon makes a tiny (3-4 mm – the size of a buttonhole) incision to insert the scope and surgical instruments. The surgery is generally completed with minimal injury to the surrounding tissues. Once the surgery has been completed, the incisions are sutured and bandaged for recovery.

How to prepare for arthroscopic orthopedic surgery?

If you are undergoing arthroscopic surgery, you should undergo the following preparatory steps before the surgery:

• Inform your surgeon about your entire medical history and allergies, so that they can prepare accordingly. If you are taking medications like blood thinners, clotters, etc., that may interfere with healing ability or cause complications during the surgery, you may need to stop them.

• Leave all your valuables like watches, jewelry, etc., at home.

• You may need to fast 8-12 hours before the surgery, depending on the kind of anesthesia your surgery is being performed under.

• You may not be able to drive yourself home after the surgery, so arrange for someone to drive you home after the surgery. In case of arthroscopic joint replacement surgery, you may also need an attendant to help you during the first few days after the surgery.

• Wear loose-fitting and comfortable clothing in the days after the surgery so you will be able to recover more easily.

What to expect after an orthopedic surgery?

Generally, every patient’s experience is different after the surgery, depending on the type of surgery being performed, the patient’s general health condition, the joint being operated on, etc. Most arthroscopic surgeries are completed within 60-90 minutes, after which the patient is taken to the recovery room for overnight observation.

Generally after care after arthroscopic surgery includes medications, rest (RICE method), assistive devices (like crutches, slings, walkers, etc.), and physical therapy. The amount and duration of physical therapy depends on the type of surgery, the amount of joint function the patient wants, the patient’s age and health condition, etc.

Most patients are able to resume everyday activities and desk work within a few days, and start driving within 1-3 weeks of the surgery. However in case of a complication, recovery can be delayed. You should consult your surgeon if you have any signs of complications like fever, severe unmanageable pain, infectious drainage from the surgical site, inflammation of the incision, numbness or tingling sensation, etc.

When is arthroscopic surgery required?

Arthroscopic orthopedic surgery is usually a minor surgery that can be performed on an outpatient basis, in case of minor procedures. If you have a severely damaged or degenerated joint, you should consult an orthopedic surgeon for arthroscopic surgery.

Arthroscopy is generally performed for:

• • Loose bone fragments

• • Damaged or torn cartilage, tendons, and ligaments

• • Inflamed joint linings

• • Scarring within joints

• • Knee joint pain and instability due to ACL or meniscus tears

• • Shoulder impingement, tendinitis, frozen shoulder, dislocated shoulder, rotator cuff tears, etc.

• • Arthritic degeneration of the joints

• • Wrist pain due to carpal tunnel syndrome, ganglion cyst, etc.

It is generally advised if the patient has severe pain and immobility, and his symptoms do not improve even with medical management and physiotherapy.

What are the risk factors associated with arthroscopy?

Though arthroscopic surgeries are by-and-large very safe, occasionally, they can result in post-surgical complications like:

• • Tissue or nerve damage due to placement and movement of surgical instruments

• • Allergy to anesthesia and other anesthesia-related complications

• • Infection and drainage in the surgical site

• • Uncontrolled bleeding and swelling

• • Instrument breaking while operating

• • Formation of blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism)

How does arthroscopy benefit you?

The most common benefits of arthroscopy over traditional open surgery are:

• • Smaller incisions

• • More accurate diagnosis

• • Shorter surgery time

• • Less postoperative pain and inflammation

• • Minimal trauma to the soft tissues surrounding the surgical site

• • Less postoperative pain

• • Quicker recovery time

• • Minimal scarring

• • Fewer chances of postoperative complications