Arthroscopy is a surgical procedure orthopaedic surgeons
use to visualize, diagnose and treat problems inside a
joint. The word arthroscopy comes from two Greek words
“arthro” and “ skopein”. The
term literally means “to look within a joint”.
In an arthroscopic examination, an orthopaedic surgeon
makes a small incision in the patient’s skin and then
inserts pencil sized instruments(telescope) that contain a small
lens and lighting system to magnify and illuminate the
structures inside the joint. Light is transmitted through
fiber optics to the end of the arthroscope that is inserted
into the joint. By attaching, the arthroscopy to a miniature
television, camera, and the surgeon is able to see the
interior of the joint through this very small incision
rather than a large incision needed for surgery.
The television camera attached to the arthroscopy displays
the images of inside of the joint on a television screen, allowing
the surgeon to look, for example, throughout the knee
at cartilage and ligaments, and under the kneecap. The
surgeon can determine the amount or type of injury, and
then repair or correct the problem, if it is necessary.
Why is Arthroscopy necessary?
Diagnosing joint injuries and disease begins with a thorough
medical history, physical examination, and usually x-rays.
Additional tests such as an MRI, or CT scan also may be
needed. Through the arthroscopy, a final diagnosis is
made which may be more accurate than through “open” surgery
or from x-rays studies.
Disease and injuries can damage bones, cartilage, ligaments,
muscles, and tendons. Some of the most frequent conditions
found by arthroscopic examination of joints are: -
INFLAMMATION: Synovitis – inflamed lining
in the knee, shoulder, elbow, wrist, or ankle
INJURY(acute and chronic )Shoulder : rotator cuff
tendon tears, impingement syndrome, and recurrent dislocations.
Knee – meniscal tears, chondromalacia and anterior cruciate
ligament tears with instability. Wrist – carpal tunnel
LOOSE BODIES OF BONE AND/ OR CARTILAGE : knee,
shoulder, elbow, ankle, or wrist
Although the inside of nearly all joints can be viewed
with an arthroscopy, six joints are most frequently examined
with this instrument. These include the knee, shoulder,
elbow, ankle, hip, and wrist. As advances are made by
engineers in electronic technology and new techniques
are developed by orthopaedic surgeons, other joints may
be treated more frequently in the future.
How is Arthroscopy performed?
Arthroscopic surgery, although much easier in terms
of recovery than “open” surgery, requires the
use of anesthetics and the special equipment in a hospital
operating room or outpatient surgical suite. You will
be given a general, spinal or a local anesthetic, depending
on the joint or suspected problem. A small incision
will be made to insert the arthroscopy several other
incisions may be made to see other parts of the joint
or insert other instruments. When indicated corrective
surgery is performed with specially designed instruments
that are inserted into the joint through accessory incisions.
Initially, arthroscopy was simply a diagnostic tool
for planning standard open surgery. With development
of better instrumentation and surgical techniques, many
conditions can be treated arthroscopically. For instance,
most meniscal tears in the knee can be treated successfully
with arthroscopic surgery. Some problems associated
with arthritis can also be treated. Several disorders
are treated with a combination of arthroscopic and standard
- Rotator cuff procedure
- Repair or resection of torn cartilage from knee
- Reconstruction of anterior cruciate ligament in
- Removal of inflamed lining in knee, shoulder, elbow,
- Release of carpal tunnel
- Repair of torn ligaments
- Removal of loose bone or cartilage in knee, shoulder,
elbow, ankle, wrist
After arthroscopic surgery, the small incisions will
be covered with a dressing. You will be moved from the
operating room to a recovery room. Many patients need
little or no pain medication. Before being discharged,
you will be given instructions about care for your incisions,
what activities you should avoid, and which exercises
you should do to aid your recovery. During the follow
up visit the surgeon will inspect your incisions, remove
sutures, if present and discuss your rehabilitation
The amount of surgery required and recovery time will
depend on the complexity of your problem. Occasionally,
during arthroscopy, the surgeon may discover that the
injury or disease cannot be treated adequately with
arthroscopy alone. The extensive “open” surgery may
be performed while you are still anesthetized or at
a later date after you have discussed the findings with
What are the possible complications?
Although uncommon complications do occur occasionally
during or following arthroscopy infection ,phlebitis,
excessive swelling or bleeding, damage to blood vessels
or nerves, and instrument breakage are the most common
complications but occur in far less than 1 percent of
all arthroscopic procedures.
What are the advantages?
Although arthroscopy surgery has received a lot of public
attention because it is used to treat well-known athletes,
it is an extremely valuable tool for all orthopedic
patients and is generally easier on the patient than
“ open” surgery. Most patients have their arthroscopic
surgery as outpatients and are home several hours after
Recovery after Arthroscopy
The small puncture wounds take few days to heal.
The operative dressing can usually be removed the morning
after surgery and adhesive strips can be applied to
cover the small healing incisions. Although the puncture
wounds are small and pain in the joint that underwent
arthroscopy is minimal, it takes few weeks for the
joint to maximally recover. A specific activity and
rehabilitation program may be suggested to speed your
recovery and protect future joint function. It is not unusual
for patients to go back to work or school or resume
daily activities within a few days. Athletes and others
who are in good physical condition may in some cases
return to athletic activities within few weeks.