Arthroscopy

Arthroscopy is a minimally invasive surgical procedure that allows doctors to see inside your joints through tiny incisions, helping diagnose and treat various joint problems without the need for large cuts.

Table of contents

• What Is Arthroscopy?
• Joints That Can Be Treated
• Conditions Treated with Arthroscopy
• How the Procedure Works
• Preparing for Arthroscopy
• Benefits of Arthroscopy
• Possible Risks and Complications
• Recovery and Aftercare

What Is Arthroscopy?

Arthroscopy is a surgical procedure that orthopedic surgeons (doctors who specialize in bones and joints) use to look inside a joint and treat problems. The word comes from two Greek words: “arthro” meaning joint and “skopein” meaning to look^[1].

During the procedure, a surgeon inserts a narrow tube called an arthroscope through a small incision in your skin—about the size of a buttonhole. This tube contains a tiny fiber-optic camera and light that allows the surgeon to see inside your joint on a high-definition video monitor^[1]. The arthroscope is thin, usually pencil-sized, and transmits magnified images of the inside of your joint to help guide treatment^[2].

The camera attached to the arthroscope displays detailed images of your joint on a screen, allowing the surgeon to examine the cartilage (the smooth tissue that cushions your joints), ligaments (strong bands that connect bones), and other structures without making a large incision^[1]. If the surgeon needs to repair damage, they can insert pencil-thin surgical instruments through additional small incisions—usually about the size of a dime—to perform the necessary work^[2].

Joints That Can Be Treated

Orthopedic surgeons use arthroscopy to diagnose and treat problems in various joints throughout your body. The most commonly treated joints include^[1]:

• Knee
• Shoulder
• Elbow
• Ankle
• Hip
• Wrist

The knee is the most common joint for arthroscopy procedures, though the procedure has quickly become the standard of care for most routine operations on major joints^[2].

Conditions Treated with Arthroscopy

Doctors recommend arthroscopy to diagnose and treat a wide range of joint conditions. Your doctor may suggest this procedure if X-rays and other imaging studies like MRI scans (magnetic resonance imaging) or CT scans (computed tomography) have not provided clear answers about what’s causing your joint problems^[1].

Common conditions that can be treated with arthroscopy include^[1][2]:

• Loose bone fragments floating in the joint
• Damaged or torn cartilage, including meniscus tears in the knee
• Inflamed joint linings, a condition called synovitis
• Torn ligaments, such as ACL (anterior cruciate ligament) tears in the knee
• Scarring within joints
• Cartilage tears, including labral tears in the shoulder or hip
• Joint impingement in the ankle, shoulder, or hip
• Joint instability in the ankle or knee
• Nerve compression syndromes like carpal tunnel syndrome in the wrist
• Rotator cuff tendon tears in the shoulder
• Shoulder impingement and recurrent dislocations

Arthroscopy can help find what’s causing pain, swelling, and stiffness in your joints^[4]. In many cases, the surgeon can diagnose a problem and repair it during the same procedure.

How the Procedure Works

Most arthroscopic surgeries are outpatient procedures, meaning you can expect to go home the same day^[2]. You will have anesthesia for the procedure—either a local type that numbs just your joint area while you stay awake, or general anesthesia where you sleep through the procedure^[2].

During the surgery, your surgeon will follow these steps^[2]:

1. Position you for surgery, sometimes using a holding device to keep your joint steady
2. Make a tiny incision (a half inch or less) to insert the arthroscope
3. Expand the joint space by filling it with saline solution, which creates more room to work
4. Examine your joint using the magnified images projected to a screen
5. Make one or more small incisions to place surgical tools if repair work is needed
6. Close the incisions with stitches or tape when finished

What your surgeon does during the operation depends on your specific condition. They might need to remove damaged tissues or loose fragments, repair or reinforce torn tissues or broken bones, release a compressed nerve, or reshape misaligned bones in your joint^[2].

Most arthroscopy operations take one to two hours. Afterward, you’ll spend another one to two hours in a recovery room as you wake up from the anesthesia, and healthcare providers will monitor your recovery^[2].

Preparing for Arthroscopy

Before your arthroscopy, your doctor will examine your joint and may order blood tests and other standard health screening tests^[2]. You’ll also discuss what type of anesthesia you’ll have.

Important preparation steps include^[2]:

• Stopping certain medications before your procedure, especially blood-thinning medications like aspirin and certain herbal supplements, which typically must be stopped several days before surgery
• Avoiding eating solid foods the day before your procedure—usually nothing to eat or drink after midnight
• Arranging for someone to drive you home after surgery, since anesthesia can remain in your body for about 24 hours
• Planning to have someone stay with you for the first 24 hours to ensure your safety

Before the surgery, you should also prepare your home for recovery. Remove tripping hazards like loose rugs and electrical cords, create a comfortable recovery space, and prepare easy-to-access meals^[2]. If you smoke, your doctor will strongly encourage you to quit at least two weeks before your procedure, as smoking impairs healing^[2].

Benefits of Arthroscopy

The main benefit of arthroscopy compared to traditional open joint surgery is that it’s minimally invasive. This means the procedure offers several advantages^[2]:

• Faster return to activities and normal routine
• Less postoperative pain
• Minimal blood loss and scarring
• Less risk of complications
• Faster recovery overall

Because the incisions are very small, you’ll have less pain and joint stiffness after the procedure. This often shortens the time it takes to recover and return to your favorite activities compared to traditional surgery with larger incisions^[1].

If you have a desk job, you may be able to return to work within a few days after surgery. However, if your work involves physical labor, lifting, or standing for long periods, it may take a few weeks to a few months before you can return^[2].

Possible Risks and Complications

Arthroscopy is a very safe procedure, and complications are not common^[1]. However, as with any surgery, even minimally invasive procedures carry a small risk of problems.

Possible complications include^[1][2]:

• Tissue or nerve damage: The placement and movement of instruments within the joint can sometimes damage the joint’s structures
• Infection: Any invasive surgery carries a risk of infection, though the risk from arthroscopy is lower than from open surgery with larger incisions
• Blood clots: Rarely, procedures lasting longer than an hour can increase the risk of blood clots developing

It’s important to note that the risk of infection from arthroscopy is lower than the infection risk from open incision surgery^[1].

Recovery and Aftercare

Recovery from arthroscopic surgery is usually faster than open surgery^[5]. You will probably need about 6 weeks to recover fully, though if your doctor repaired damaged tissue, recovery may take longer^[5].

After surgery, you may have some pain, swelling, bruising, and stiffness. You’ll feel tired for several days, and your skin may appear discolored near the incisions^[5]. This swelling is normal and will start to go away in a few days.

To help with recovery at home^[5]:

• Rest when you feel tired and get enough sleep
• Use pillows to raise your ankle and leg above the level of your heart to reduce swelling
• Apply ice packs to reduce swelling—keep ice on for at least 20 minutes, 3-4 times a day
• Take pain-relief medicines as directed by your doctor
• Keep the affected joint raised when possible
• Walk each day after your doctor says you can, gradually increasing the amount

You can typically take a shower 48 to 72 hours after surgery and clean the incisions with regular soap and water. However, do not take a bath or soak the joint until your doctor says it’s okay^[5]. If you have a dressing over your incisions, keep it clean and dry, and you may remove it 48 to 72 hours after surgery.

Physical therapy is a crucial part of recovery after arthroscopy. Your doctor or physical therapist will give you exercises to do, starting with gentle movements like flexing and extending the joint. A physical therapist will create a customized plan to meet your individual needs, gradually increasing the intensity of exercises over time^[2]. Consistency with these exercises is essential for the best outcome.

You should avoid performing daily activities like lifting, driving, cleaning, or gardening for the first 2-3 weeks after surgery. Consider getting help with these activities, as they can disrupt the surgical site and cause additional damage^[2]. If an activity causes pain or discomfort, stop immediately and consult your healthcare provider.

Your doctor will provide specific guidelines for your recovery, including when you can drive again and when you can resume normal activities. Most people can return to their regular routines within a few weeks to a few months, depending on the type of work they do and the complexity of the surgery performed^[5].