Arthroscopy

• How the test is performed

  This procedure is typically performed on the knee, shoulder, elbow, or wrist. The type of anesthesia depends on the particular joint and other factors. A regional anesthetic numbs the affected area, but the patient may remain awake, depending on whether other medications are used. For more extensive surgery, general anesthesia may be used. In this case the patient is asleep and pain-free.

  The area is cleaned and a pressure band (tourniquet) may be applied to restrict blood flow. The health care provider then makes a surgical cut into the joint. Sterile fluid is passed through the joint space to provide a better view.

  Next, a tool called an arthroscope is inserted into the area. An arthroscope consists of a tiny tube, a lens, and a light source. It allows a surgeon to look for joint damage or disease. The device also allows the surgeon to perform reconstructive procedures on the joint, if needed.

  Images of the inside of the joint are displayed on a monitor.

  One or two small additional surgical cuts may be needed in order to use other instruments. These instruments can be used to remove bits of cartilage or bone, take a tissue biopsy, or perform other minor surgery. In addition, ligament reconstruction can be performed using the arthroscope in many cases.

• How to prepare for the test

  You should not eat or drink anything for 12 hours before the procedure. You may be told to shave your joint area. You may be given a sedative before leaving for the hospital.

  You will be asked to wear a hospital gown during the procedure so the body part for surgery is accessible.

  You must sign a consent form. Make arrangements for transportation from the hospital after the procedure.

• How the test will feel

  You may feel a slight sting when the local anesthetic is injected. After this medicine starts to work, you should feel no pain.

  The joint may need to be manipulated to provide a better view, so there may be some tugging on the leg (or arm, if done on the shoulder).

  After the test, the joint will probably be stiff and sore for a few days. Ice is commonly recommended after arthroscopy to help relieve swelling and pain.

  Slight activity such as walking can be resumed immediately, however excessive use of the joint may cause swelling and pain and may increase the chance of injury. Normal activity should not be resumed for several days or longer. Special preparations may need to be made concerning work and other responsibilities. Physical therapy may also be recommended.

  Depending on your diagnosis, there may be other exercises or restrictions.

• Why the test is performed

  Your doctor may order this test if you have:

  • A need for joint surgery
  • Damaged meniscus (the piece of cartilage that cushions the knee joint area)
  • Joint pain from an injury
  • Joint disease
  • Lesions or other problems detected by x-rays
  • Signs of bone fragments from a fracture
  • Signs of a torn ligament
  • Unexplainable joint pain

  Arthroscopy can also help see if a disease is getting better or worse (this is called monitoring the disease), or to determine whether a treatment is working.

• What abnormal results mean

  Abnormal results may be due to:

  • Bleeding
  • Bone fragments
  • Damaged meniscus cartilage
  • Dislocation
  • Lesions
  • Rotator cuff tendinitis
  • Torn ligaments
• What the risks are
  • Joint stiffness
  • Increased pain
  • Infection (fever)
  • Inflammation
  • Swelling
• Special considerations

  The diagnostic accuracy of an arthroscopy is about 98%, although x-rays and sometimes MRI scans are taken first because they are noninvasive.

Review Date: 7/29/2008

Reviewed By: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.