(Arthroscopic Surgery, Arthroscopic Examination, Joint Endoscopy, Knee Arthroscopy, Shoulder Arthroscopy, Fiberoptic Joint Examination)
What is arthroscopy?
Arthroscopy is a minimally-invasive procedure used for the diagnosis and treatment of conditions affecting joints. The doctor can directly view the internal structures of a joint using an instrument called an arthroscope.
Orthopedic surgeons use arthroscopy to diagnose and treat joint problems. An arthroscope is a small, tube shaped instrument that is used to look inside a joint.
It consists of a system of lenses, a small video camera, and a light for viewing. The camera is connected to a monitoring system that allows the doctor to view a joint through a very small incision. The arthroscope is often used in conjunction with other tools that are inserted through another incision.
The joint most frequently examined using arthroscopy is the knee. However, arthroscopy can be used to examine other joints, including the following:
Anatomy of the knee
Joints are formed where bones meet. Most joints are mobile, allowing the bones to move. Basically, the knee is two long leg bones held together by muscles, ligaments, and tendons. Each bone end is covered with a layer of cartilage that absorbs shock and protects the knee.
There are two groups of muscles involved in the knee, including the quadriceps muscles (located on the front of the thighs), which straighten the legs, and the hamstring muscles (located on the back of the thighs), which bend the leg at the knee.
Tendons are tough cords of tissue that connect muscles to bones. Ligaments are elastic bands of tissue that connect bone to bone. Some ligaments of the knee provide stability and protection of the joints, while other ligaments limit forward and backward movement of the tibia (shin bone).
The knee consists of the following:
Tibia. This is the shin bone or larger bone of the lower leg.
Femur. This is the thighbone or upper leg bone.
Patella. This is the kneecap.
Cartilage. A type of tissue that covers the surface of a bone at a joint. Cartilage helps reduce the friction of movement within a joint.
Synovial membrane. A tissue that lines the joint and seals it into a joint capsule. The synovial membrane secretes synovial fluid (a clear, sticky fluid) around the joint to lubricate it.
Ligament. A type of tough, elastic connective tissue that surrounds the joint to give support and limits the joint's movement.
Tendon. A type of tough connective tissue that connects muscles to bones and helps to control movement of the joint.
Meniscus. A curved part of cartilage in the knees and other joints that acts as a shock absorber.
Reasons for the procedure
An arthroscopic procedure may be used to diagnose and assist in the treatment of the following conditions:
Inflammation in the knee, shoulder, elbow, wrist, or ankle
Injuries, such as shoulder rotator cuff tendon tears or impingement syndrome (pinching of tendons in the shoulder caused by the excessive squeezing or rubbing of the rotator cuff and shoulder blade)
Cartilage damage, such as tears, injury, or wear
Ligament tears with instability in the knee
Carpal tunnel syndrome in the wrist
Loose bone and/or cartilage, particularly in the knee, shoulder, elbow, ankle, wrist, or hip
Corrective surgery or a biopsy may be performed using arthroscopy. For example, torn ligaments can be repaired or reconstructed. Arthroscopic surgery may eliminate the need for an open surgical procedure.
There may be other reasons for your doctor to recommend an arthroscopy.
Risks of the procedure
As with any surgical procedure, complications can occur. Some possible complications may include, but are not limited to, the following:
Blood clots in the legs or lungs
There may be other risks depending on your specific medical condition. Be sure to discuss any concerns with your doctor prior to the procedure.
Before the procedure
Your doctor will explain the procedure to you and offer you the opportunity to ask any questions that you might have about the procedure.
You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
In addition to a complete medical history, your doctor may perform a complete physical examination to ensure you are in good health before undergoing the procedure. You may undergo blood tests or other diagnostic tests.
Notify your doctor if you are sensitive to or are allergic to any medications, latex, tape, and anesthetic agents (local and general).
Notify your doctor of all medications (prescribed and over-the-counter) and herbal supplements that you are taking.
Notify your doctor if you have a history of bleeding disorders or if you are taking any anticoagulant (blood-thinning) medications, aspirin, or other medications that affect blood clotting. It may be necessary for you to stop these medications prior to the procedure.
If you are pregnant or suspect that you are pregnant, you should notify your doctor.
You will be asked to fast for eight hours before the procedure, generally after midnight.
You may receive a sedative prior to the procedure to help you relax. Because the sedative may make you drowsy, you will need to arrange for someone to drive you home.
The area around the surgical site may be shaved.
Based on your medical condition, your doctor may request other specific preparation.