Arthroscopy

How It Is Done

Arthroscopy is usually done by a doctor who specializes in bone, muscle, and joint surgery (orthopedic surgeon).

You will be asked to remove any jewelry and to wear a hospital gown. You may be given a sedative shortly before the procedure to help you relax. The skin around your joint may be shaved.

If general or regional is used, an anesthesia specialist will administer the medication. A general anesthetic will make you unconscious during the procedure. Your heart rate and rhythm, blood pressure, and respirations will be monitored during the procedure. If a local anesthetic is used, it will be injected into the skin and joint space. If a local or regional anesthetic is used, your limb will be numb and you will be relaxed and drowsy but will remain conscious.

You usually lie on your back. Depending on which joint is being looked at, an inflatable band (tourniquet) may be used to temporarily restrict blood flow to your joint so your doctor can see all the structures in your joint. Your joint is scrubbed with an antiseptic solution and draped with sterile towels. Before the tourniquet is inflated, the joint will be elevated and may be wrapped with an elastic bandage to reduce blood flow to the joint.

A small incision about 0.25 in (0.6 cm) will be made near your joint. Before inserting the arthroscope, an irrigation solution (usually saline) will be used to flush the joint space to provide a better view of the entire joint. A steady low flow of solution is usually used during the procedure to clear out any debris or blood in the joint so your doctor can evaluate your joint.

Once the arthroscope is inserted, your doctor will be able to see inside the joint by viewing a video monitor attached to the arthroscope. Your doctor or the surgical assistants may bend, extend, and reposition the joint to see it from different angles. Videotapes or photographs of the joint may also be taken.

If additional surgery is required to repair your joint problem, more small incisions will be made and other thin instruments will be inserted into your joint. When the arthroscope and any other instruments are taken out, any blood and debris will be flushed with saline and drained. To reduce inflammation or pain, local anesthetics or corticosteroids may be injected into your joint.

The small incision is closed with stitches. Depending on which joint was looked at, you may need to use splints, slings, or crutches to support movement of your joint during recovery.

After the procedure, you may need to rest your joint for several days. You may not be able to drive for 24 hours after the procedure, depending on which joint was looked at and what type of anesthetic you had. If your stitches are not absorbable, they will be removed in 7 to 10 days. Ice, elevation, and a compression bandage may be used to reduce any swelling, and pain relievers may be used to relieve any pain or discomfort. Ask your doctor for advice on strengthening your joint with exercise and when you can resume normal activity.

The time arthroscopy takes depends on what is done. It may take only about 15 minutes but it could take an hour or longer.

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Author:	Shannon Erstad, MBA/MPH	Last Updated: January 28, 2009
Medical Review:	Adam Husney, MD - Family Medicine William M. Green, MD - Emergency Medicine Patrick J. McMahon, MD - Orthopedics Kenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma
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