Surgical Arthroscopy is a surgical procedure that is performed by orthopedic surgeons in an outpatient setting. When performed in the outpatient setting, patients can usually return home after the procedure. The technique for this procedure involves inserting the arthroscope, a small tube that contains lenses, and optical fiber, through tiny incisions in the skin into the joint to be examined. This instrument connected to a video camera and the interior of the joint is seen on a television monitor.
The size of the arthroscope varies with the size of the joint being examined. For example, the knee is examined with an arthroscope that is approximately five millimeters in diameter. There are arthroscopes as small as 0.5 millimeters in diameter to examine small joints such as the wrist. If procedures are performed in addition to examining the joint
with the arthroscope, this is called arthroscopic surgery.
ARTHROSCOPIC SURGERY is a procedure to diagnose, visualize, and treat joint problems. It is also used to identify and diagnose joint injuries and disease, or to repair ligaments or tendons. It is performed when medical history, physical exam, x rays, and other tests such as MRIs or CTs don’t provide a definitive diagnosis.
In arthroscopic surgery, an orthopedic surgeon uses an arthroscope, a fiber-optic instrument, to see the inside of a joint. After making an incision about the size of a buttonhole in the patients skin, a sterile sodium chloride solution is injected to distend the joint. The arthroscope has a lens and a lighting system through which the structures inside the joint are transmitted to a miniature television camera attached to the end of the arthroscope. The surgeon uses irrigation and suction to remove blood and debris from the joint before examining it. Other incisions may be made in order to see other parts of the joint or to insert additional instruments. Looking at the interior of the joint on the television screen, the surgeon can then determine the amount or type of injury and, if necessary, take a biopsy specimen or repair or correct the problem.
Arthroscopic surgery can be used to remove floating bits of cartilage and treat minor tears and other disorders. When the procedure is finished, the arthroscope is removed and the joint is irrigated. The site of the incision is bandaged. It is most often performed as an outpatient procedure.
Arthroscopy can be performed under a general anesthetic, a spinal or epidural anesthetic, a regional block where only the extremity being examined is numbed, or even a local anesthetic. After adequate anesthesia is achieved, the procedure can begin. Other instruments are sometimes placed in another incision to help maneuver certain structures into the view of the arthroscope.
In arthroscopic surgery, additional instruments for surgical repairs are inserted into the joint through the arthroscope. These instruments can be used to cut, remove, and sew damaged tissues. Once the procedure is completed, the arthroscope in removed and the incisions are sutured sewn closed. Most importantly, the patient should be able tolerate the anesthetic that is used during the procedure. A person’s heart and lung function should be adequate. If there are existing problems such as heart failure or emphysema, these should be optimized as possible prior to surgery. Patients who are on anticoagulants blood thinners should have these medications carefully adjusted prior to surgery. Diabetes and high blood pressure should also be controlled prior to surgery.
