Because arthroscopic surgery requires smaller incisions thanopen surgery, recovery times tend to be shorter.
Arthroscopy has become an increasingly attractive alternative to traditional procedures, but may not be appropriate in all cases.
What Is Arthroscopic Surgery?
(Arthro-meaning “joint” and-scopymeaning to “study or examination.")
Today, arthroscopic surgery is considered both commonplace and indispensable, enablingoutpatienttreatment where hospitalization was once needed.
Contraindications
There are few absolute contraindications to arthroscopic surgery other than thoserelated to surgery in general.
Arthroscopic surgery should be delayed if there is local soft-tissue infection around the joint.
The use of arthroscopy may cause more harm than good in such cases compared to open surgery.
Similar concerns are warranted if the joint space has narrowed excessively beyond expected limits.
The appropriateness of arthroscopic versus open surgery needs to be weighed on a case-by-case basis.
Potential Risks
Arthroscopic surgery is generally considered safe with relatively few complications.
Of these, 1% require revision surgery.
However, healthcare provider experience plays a large part in the risk of such injuries.
The spaces within these joints are large enough to accommodate the surgical instruments.
Technically speaking,anyjoint can have arthroscopic surgery performed on it.
Less complicated procedures can be performed in the orthopedist’s office usinglocal anesthesia.
Live images are fed to a video monitor via a cable.
Some of these are fed through the neck of the scope, while others are used separately.
Dress in casual clothes that are easy to remove.
A hospital gown will be provided if needed.
There are no food or drink restrictions if only local anesthesia is used.
If you are unsure about any food/drink restrictions, ask your healthcare provider.
Medications
To prepare for surgery, the surgeon will review the list of medications that you take.
Some of these may need to be temporarily stopped before and after surgery.
These restrictions vary by the throw in of surgery being performed.
Leave all valuables at home.
This may include the cessation of certain sports or a change of responsibilities if the injury is work-related.
You are then led to the back to undress and change into a hospital gown.
In-office procedures may only require an orthopedist and assistant.
A blood sample may also be taken to check your blood chemistry.
You are then placed in the best position for the procedure you are having.
This may be supine (upward-facing), prone (downward-facing), or lateral decubitus (sideway-facing).
For elbow and wrist surgery, the joint is typically placed on an elevated platform called an arm table.
The tools used for wrist arthroscopy, for example, would be different than those used for hip arthroscopy.
(An increasing number ofrotator cuff injuriesare repaired in this way.)
By definition, arthroscopy involves incisions of less than 3 centimeters (roughly 1 inch).
Many procedures can be performed with incisions as small as 0.25 centimeters (1/4 inch) or even less.
A primary incision is made to insert the arthroscope to help guide the placement of tools.
Sometimes, this incision is the only one that is needed.
The total number of incisions depends on the joint and the aim of the surgery.
This helps widen the space and provides a clearer view within the joint.
Next steps differ depending on the exact procedure being done.
This can take anywhere from 10 to 45 minutes.
People who have undergone in-office arthroscopy under local anesthesia can usually leave immediately after the procedure.
Even so, arthroscopy is still considered surgery, and precautions may need to be taken.
These may include joint immobilization, pain medications, and theuse of crutchesor other mobility devices.
Recovery
Recovery from arthroscopic surgery can vary by the throw in of procedure used.
Typically, pain and inflammation are treated withR.I.C.E.
(rest, ice system, compression, and elevation of the joint).
Less extensive surgeries may only require over-the-counterTylenol (acetaminophen)to alleviate pain.
This requires the dailychanging of the dressing, during which you should check forsigns of infection.
During this time, there are limitations to how much activity you should do.
Gradually increasing your activity levels can help to ensure these problems do not occur.
Even so, arthroscopic surgery is not a one-size-fits-all solution.
DeMaio M.Giants of orthopaedic surgery: Masaki Watanabe MD.Clin Orthop Relat Res.
doi:10.5435/JAAOSGlobal-D-18-00093
American Academy of Orthopedic Surgeons.Arthroscopy.
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