Introduction
Arthroscopic surgery, also known as arthroscopy, is a minimally invasive procedure that allows surgeons to visualize, diagnose, and treat joint problems using small incisions and a tiny camera or scope. Before this technique, surgeons had to make large incisions to open the joint, which affected surrounding tissues and carried a higher risk of infection with longer recovery times. In contrast, arthroscopy reduces infection risk and shortens recovery. Today, it is one of the most common orthopedic procedures.
Treatment Overview
Arthroscopic surgery utilizes an arthroscope, a small surgical instrument roughly the size of a pencil. The arthroscope has a lens and lighting system that enables the surgeon to see inside the joint without fully opening it. It can be connected to a camera, allowing the surgeon to view enlarged images on a video monitor or record footage. Initially used for diagnosing joint conditions, arthroscopy has evolved to treat various joint problems. Specialized instruments inserted through small incisions alongside the arthroscope now allow for surgical repairs as well. In some cases, a combination of arthroscopy and traditional surgery is required.
Conditions Treated with Arthroscopy
While arthroscopy can be used to examine nearly any joint, it is most commonly performed on the knee, shoulder, elbow, ankle, hip, and wrist. It is particularly effective for treating issues involving bones, cartilage, ligaments, tendons, and muscles.
Bones, the body's hardest tissues, support our structure and connect at joints. Cartilage, a smooth tissue, covers the ends of many bones, facilitating easy movement. Conditions such as chondromalacia, which softens and deteriorates cartilage, can disrupt joint function. Arthroscopy is used to treat these conditions by smoothing or shaving damaged cartilage and removing abnormal growths like bone spurs or calcium deposits.
Tendons, which connect muscles to bones, are prone to tearing under stress. Similarly, ligaments, which connect bones and provide joint stability, can become injured. The synovium, a lining of the joint, produces synovial fluid to lubricate and cushion movements. Injury or overuse can lead to inflammation of tendons, ligaments, and the synovium. Arthroscopy is frequently used to repair tendons, treat ligament tears, and remove inflamed synovium (synovitis). It can also be used to take tissue samples for further examination through a synovial biopsy.
What to Expect During Arthroscopy
Arthroscopic surgery is generally an outpatient procedure, although an overnight hospital stay may be required in some cases. Depending on the joint and the condition being treated, patients may receive sedation, local, or regional anesthesia. The surgeon elevates the limb and applies a tourniquet to reduce blood flow to the joint. Small incisions, approximately ¼” to ½” in size, are made near the joint, and sterile saline is injected to expand the joint space for better visibility. The surgeon inserts the arthroscope and any additional instruments needed for the procedure. After the surgery, the surgeon may inject medication into the joint to manage pain and inflammation. Due to the small incisions, only a few stitches are necessary.
Recovery times vary based on the complexity of the procedure. Most patients return to work or daily activities within a few days. In some cases, rehabilitation may be needed to help restore joint mobility and strength. Full recovery usually takes several weeks.
Benefits of Arthroscopy
Arthroscopy is often a short procedure, sometimes lasting only minutes. Because it is minimally invasive, it requires less anesthesia and shorter sedation times than open joint surgeries. Most patients return home the same day. Arthroscopy generally involves less pain, a reduced risk of infection, and a faster recovery due to smaller incisions and less disruption of surrounding tissues compared to traditional open surgery.
