Arthroscopy is a type of minimally invasive surgery that allows an orthopedic surgeon to visualize and treat some problems within the joint. The surgeon will insert an arthroscope, a small instrument that is equipped with a camera, into the joint through a small incision. Once the problem is visualized, the surgeon can often treat the issue through other small incisions using specially designed tools. Arthroscopy is generally performed as an outpatient procedure, allowing patients to return home on the same day. The benefits of an arthroscopic procedure are smaller incisions, faster healing, less scarring, fewer complications, and rapid recovery time.
Is it Necessary?
Damage to bones, ligaments, cartilage, tendons, and muscles can all be caused by injuries or disease. Many steps have to be taken to properly diagnose an issue. Diagnosing begins with a careful study of one’s medical history, a physical exam, and often an x-ray. Sometimes a magnetic resonance image (MRI) or a computed tomography (CT) scan are necessary. Doctors can use arthroscopy as a diagnostic tool if x-rays and other imaging have left some questions unanswered.
Conditions Treated with Arthroscopic Surgery
Synovitis is an inflammation of the synovial lining in the knee, shoulder, elbow, wrist, or ankle. A synovectomy can be completed using arthroscopy to remove the inflamed synovium and relieve some pain.
Acute or Chronic Problems
- Shoulder: Rotator cuff tears, impingement syndrome, and recurrent dislocations
- Knee: Meniscal tears, anterior cruciate ligament tears (ACL), and kneecap dislocation
- Arthritis: Knee, shoulder
Recovery from an arthroscopic procedure is fairly simple. Small incisions will take several weeks to heal, as all incisions do. Although pain is minimal, it will take several weeks to get to full recovery. You will be given post-operative instructions based on your physician’s preferences before you are discharged from the hospital that discuss dressing removal, bathing/showering instructions, and when a follow up appointment should be scheduled with your doctor. An exercise program may be issued as well that will help you recover strength and range of motion of the joint. Rehabilitation is often recommended by your surgeon to help decrease the time it takes to recover and to help protect joint function in the future. Recovery time will be different for everyone. Most of the time patients will resume work, school, or other daily activities within a few weeks. Patients who are in good physical condition can resume some athletic activities as well. However, please remember all cases are different and patients have different medical backgrounds. Recovery times are as unique as the individual going through the surgery.
Anterior Cruciate Ligament
Anterior cruciate ligament injuries, also known as ACL injuries, occur most often during a sporting event. The ACL provides stability to the joint (prevents hyperextension). Once ruptured, the ACL does not heal on its own, and most often requires reconstruction. Arthroscopy is used to assist this surgical procedure when an autograft (harvesting tissue from the patient) or an allograft (harvesting tissue from another donor) is used.
The meniscus is piece a ligament that takes on a C-shape and acts as a cushion and a shock-absorber for the knee joint. Meniscal tears typically occur with a twisting motion of the knee, but they can also happen in a squatting motion. The meniscal ligament can become brittle from aging, and then it is more likely to tear. The characteristic symptoms of a meniscus tear are pain, decreased joint motion, swelling, and “locking” of the joint. Arthroscopic surgery can be used to remove the torn portion of the ligament.
The surgeon can make an assessment of joint degeneration during an arthroscopic procedure conducted for arthritis treatment. The surgeon will perform a knee debridement and lavage, which includes the following process: removing loose pieces of cartilage suspected of causing irritation, trimming and smoothing cartilage that has become irregular and bumpy from wear, removing inflamed synovial tissue, and flushing out the joint with a saline solution to clean out materials known to cause irritation and swelling.
Knee Cap Dislocation/Patella Instability
Patella (knee cap) instability causes poor patellar tracking. This can cause abnormal wear and tear on the undersurface of the patella. Arthroscopic surgery can be used to visualize and smooth the articular cartilage surfaces of the patella and the patella femoral groove (chondroplasty). Patella tracking can be assessed as well during arthroscopy to assist in decisions regarding additional procedures such as a lateral release or repair of the medial patellofemoral ligament.
Osteochondritis Dissecans (OCD) is a condition that develops in joints, most often in children and adolescents. It occurs when a small segment of bone begins to separate from its surrounding region due to a lack of blood supply. As a result, the small piece of bone and the cartilage covering it begin to crack and loosen. In older children and young adults, the OCD lesions have a greater chance of separating from the bone and cartilage, and can even detach and float around inside the joint. Arthroscopy can be used to visualize the lesions and determine a course of action.
There are many different shoulder procedures that can be performed arthroscopically, including rotator cuff tear repair, labral tears, impingement syndrome, and recurrent dislocation repair. For a more detailed explanation of possible shoulder injuries, please go to our shoulder section.
There are many different ankle procedures that can be performed arthroscopically, including treatment of arthritis, inflammation (synovitis), damaged cartilage (OCD), instability, and fractures. For a more detailed explanation of possible ankle injuries, please go to our foot & ankle section.