Arthroscopy is a surgical procedure that involves inserting a small camera through small incisions to view the inside of a joint. Arthroscopy is done by an orthopaedic surgeon for a variety of different conditions involving the joints of the body. According to the American Academy of Orthopaedic Surgeons, there are over four million knee arthroscopy procedures done every year worldwide.
Indications
Surgical indications of arthroscopy include meniscal tears, articular cartilage injury, ligament tears, arthritis and to diagnose a variety of conditions not well visualized on imaging studies according to "Wheeless' Textbook of Orthopaedics." Septic joints or joint infections can be washed out surgically by inserting an arthroscope and irrigating the joint, for example.
Arthroscopic Knee Surgery
Once small incisions are made in the skin and a camera or arthroscope inserted into the joint, surgeons do a diagnostic view of all the structures in the knee to evaluate the pathologies in the knee. Surgeons usually know what is causing pain in the knee from a combination of patient history, clinical exam, and pre-operative imaging. The surgeon then uses a variety of instruments to perform the surgery under the view of the arthroscope. The knee is irrigated with fluids during the procedure.
Complications
Complications of arthroscopic surgery include bleeding, infection, blood clots and need for further surgery. A patient should call her surgeon if the she has a fever greater than 101.5 F; chills; redness around the incision site; pain not relieved by pain medications; worsening swelling or pain in the calf muscle. It is important to talk to the surgeon prior to having surgery about the possible complications of the procedure.
Immediate Post-Operative Course
Arthroscopy is generally a same-day procedure and patients typically go home a few hours after surgery. Some patients however may be admitted after surgery. Immediately after surgery, the patient is brought to the recovery room where he is monitored until deemed stable to be discharged. Patients are typically discharged with pain medications and some with braces and crutches for support.
Outcome
Surgical outcomes are heavily dependent upon what is done during the surgery. Major ligament reconstruction such as an anterior cruciate ligament , or ACL repair requires a longer rehabilitation time than minor procedures. According to the American Academy of Orthopaedic Surgeons, some patients need to limit certain activities post-operatively due to intraoperative findings. Patients generally get physical therapy post-operatively to help with the recovery period.
References
- "AAOS Comprehensive Orthopaedic Review"; Dr. Jay Lieberman; 2008.
- MayoClinic: Arthroscopy
- Wheeless' Textbook of Orthopaedics: Knee Arthroscopy
- American Academy of Orthopaedic Surgeons:
