Comprehensive Guide to Arthroscopy

What Is Arthroscopy?

Arthroscopy is a surgical technique that allows doctors to visualise, diagnose, and treat joint problems using a small camera, called an arthroscope, inserted into the joint through a small incision. This camera transmits images of the joint to a monitor, allowing the surgeon to guide their instruments and perform repairs inside the joint.

Arthroscopy is commonly performed on major joints such as:

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

Why Arthroscopy Is Performed

Arthroscopy is used to both diagnose and treat various joint conditions. It’s often recommended when non-invasive methods like physiotherapy or medication fail to provide relief. Common issues that can be diagnosed or treated using arthroscopy include:

• Torn cartilage or ligaments (such as a torn meniscus or ACL)
• Shoulder impingement or rotator cuff tears
• Loose bone fragments or cartilage within the joint
• Joint inflammation (such as synovitis)
• Joint infections
• Arthritis-related damage (though arthroscopy does not cure arthritis, it can help manage symptoms)

How Arthroscopy Works

Arthroscopy typically involves three main steps: preparation, the procedure itself, and recovery. Below is a breakdown of what you can expect during each stage.

1. Preparation for Arthroscopy

Before the procedure, your orthopaedic doctor will provide specific instructions depending on the joint being examined and your overall health. Preparation usually involves:

• Medical Evaluation: A physical examination, blood tests, and possibly imaging tests (X-rays, MRI) are done to understand the full extent of the joint problem.
• Fasting: As with many surgeries, you’ll be asked to fast for 6-12 hours before the procedure, especially if general anesthesia will be used.
• Medication Adjustments: If you’re taking certain medications (like blood thinners), your doctor may recommend adjusting or pausing them before the surgery.

2. The Arthroscopy Procedure

Arthroscopy is usually performed under general, regional, or local anesthesia, depending on the joint being treated and the complexity of the procedure.

• Incisions: Small incisions (about the size of a buttonhole) are made near the joint.
• Inserting the Arthroscope: The surgeon inserts the arthroscope through one of the incisions, which transmits real-time images of the joint’s interior to a screen.
• Performing the Procedure: The surgeon may make additional small incisions to insert tiny surgical instruments for tasks such as removing damaged tissue, repairing torn cartilage, or smoothing bone surfaces.
• Duration: The length of the procedure varies depending on the complexity of the condition but generally lasts between 30 minutes to 2 hours.

3. Recovery After Arthroscopy

Since arthroscopy is minimally invasive, recovery is typically faster compared to open surgery. However, recovery timelines can vary depending on the joint treated and the extent of the surgery.

• Immediate Recovery: Most patients can go home the same day after the procedure. You’ll likely have small bandages over the incisions, and your joint may feel swollen or uncomfortable for a few days.
• Physiotherapy: In most cases, your doctor will prescribe a course of physical therapy to help regain strength and mobility in the joint. Exercises are crucial for speeding up recovery and improving the outcome of the surgery.
• Full Recovery: The timeline for complete recovery can range from a few weeks to several months. For instance, minor repairs on the knee might heal in a few weeks, while more extensive shoulder procedures could take several months for full recovery.
• Follow-up Appointments: You’ll need to see your doctor for follow-up visits to monitor your progress and remove stitches if necessary.

Benefits of Arthroscopy

Arthroscopy has several advantages over traditional open surgery, including:

• Minimally Invasive: Smaller incisions lead to less tissue damage.
• Faster Recovery: Reduced trauma to the joint and surrounding tissues typically means a quicker recovery time compared to open surgery.
• Reduced Pain: Arthroscopy often results in less post-operative pain, which can help minimise the need for pain medications.
• Lower Risk of Infection: The smaller incisions reduce the risk of infections and complications associated with surgery.
• Accurate Diagnosis: It allows surgeons to get a clear, real-time view of the joint, which improves diagnostic accuracy.
• Outpatient Procedure: In many cases, arthroscopy is done on an outpatient basis, meaning you can go home the same day.

Common Types of Arthroscopy

Arthroscopy can be used to address a variety of conditions across multiple joints. Here are some of the most common applications:

1. Knee Arthroscopy

• Used for meniscus tears, ACL injuries, removal of loose cartilage, and treating patella (kneecap) misalignment.
• Recovery can take anywhere from 4-8 weeks, depending on the procedure.

2. Shoulder Arthroscopy

• Used to repair rotator cuff tears, remove bone spurs, or treat shoulder impingement and frozen shoulder.
• Shoulder arthroscopy recovery can take several months, especially for rotator cuff repairs.

3. Hip Arthroscopy

• Often performed to remove damaged cartilage, treat femoroacetabular impingement (FAI), or correct labral tears.
• Hip arthroscopy recovery can take 2-6 months.

4. Ankle Arthroscopy

• This is used to remove bone spurs, repair ligament damage, or treat ankle arthritis.
• Recovery time typically ranges from 4-8 weeks.

5. Wrist Arthroscopy

• Commonly used for treating carpal tunnel syndrome, removing cysts, or repairing ligament injuries.
• Wrist arthroscopy recovery usually takes 6-8 weeks.

6. Elbow Arthroscopy

• Used to remove loose bodies (like bone fragments) or treat elbow arthritis.
• Full recovery may take several months.

Risks and Complications of Arthroscopy

Although arthroscopy is a low-risk procedure, as with any surgery, there are potential complications, including:

• Infection: While rare, there is always a risk of infection, particularly if the wound is not cared for properly post-surgery.
• Blood Clots: There is a small risk of developing a blood clot, especially after procedures on weight-bearing joints like the knee.
• Stiffness: Some patients may experience joint stiffness after the procedure, which can be managed with physical therapy.
• Nerve or Blood Vessel Damage: In rare cases, nerves or blood vessels near the joint may be damaged during surgery.
• Prolonged Pain: Some patients may continue to experience pain or discomfort in the joint, even after successful surgery.

It’s important to discuss these risks with your surgeon before undergoing the procedure.

Preparing for Arthroscopy: Key Tips

To ensure the best outcome, it’s important to prepare for your arthroscopy surgery:

• Discuss Medication: Talk to your doctor about any medications or supplements you are taking. Some may need to be paused before the procedure.
• Arrange Transportation: Since you may be sedated or under general anesthesia, you’ll need someone to drive you home after the procedure.
• Follow Fasting Instructions: If general anesthesia is used, you’ll need to fast the night before the surgery.
• Comfort at Home: Set up a recovery area at home with easy access to necessities, and arrange for assistance if needed during the initial recovery phase.

Arthroscopy has improved joint surgery by offering a minimally invasive way to diagnose and treat joint problems. Whether it’s for a torn meniscus, rotator cuff repair, or arthritis management, this procedure offers numerous benefits, including faster recovery, less pain, and a lower risk of complications compared to traditional surgery.

If you are dealing with persistent joint pain or a mobility issue, consult your orthopaedic doctor to see if arthroscopy is the right option for you.