Whether it's an arthritic shoulder, hand, wrist, hip, knee, ankle, or foot that's troubling you, arthroscopic surgery might be recommended to ease the pain and improve the quality of your day-to-day life.

Surgeons use a minimally-invasive procedure called arthroscopy to repair torn cartilage, take tissue samples from inside a joint, and get a more accurate diagnosis when a physical exam and patient history indicate a problem that cannot be seen on an MRI, or if the condition is not improving with rest and physical therapy.

Some common reasons for arthroscopy include:

  • Repairing a torn meniscus (cartilage found between the bones in the knee)
  • Trimming or removing damaged or broken cartilage caused by degenerative arthritis
  • Removing a cyst
  • Assessing damage from inflammation

A surgeon performing arthroscopy inserts a tool known as an arthroscope into a joint through one or more small incisions. The arthroscope is essentially a tube with a tiny camera on one end that can provide multiple views of the area in and around the joint. The doctor is able to see what the scope picks up on a video screen in the operating room and perform surgery with tiny tools while using the video as a guide.

Nathan Wei, MD, director of the Arthritis Treatment Center in Frederick, MD, performs arthroscopic surgery, but is currently the only rheumatologist who is a member of the Arthroscopy Association of North America. "Arthroscopy is most often performed by orthopaedic surgeons," Wei points out. "But other physicians may also be qualified to perform the procedure."

Although arthroscopy has been around for about 100 years, late twentieth-century fiber optics technology and the development of new and improved instruments have made the procedure much safer and easier for surgeons to perform. Simple arthroscopy can be performed with local anesthesia delivered to the joint or regional anesthesia that numbs a larger area or an entire limb. In more complicated cases, spinal or general anesthesia may be required. Depending on what the doctor finds and how many repairs must be made, arthroscopy can take anywhere from 30 minutes to several hours.

Post-surgery, you will need to keep the joint raised to minimize swelling, and may be instructed to wear a tight bandage, wrap, or other support. Your surgeon or office staff will provide you with directions on caring for your bandages and stitches and instructions for keeping your limb elevated, using ice to reduce inflammation and medications for post-operative pain relief. If you are told to use ice on the area you may find that a bag of frozen peas, corn, or mixed diced vegetables works better than a pricey ice pack. If you have surgery on your knee, ankle, or foot, you may require crutches and will get instructions on using them as well. Your surgeon may recommend physical therapy to help regain strength and range of movement.

Nathan Wei, MD, reviewed this article.



Sources:

Cedars-Sinai: Arthroscopy. Accessed December 2013. http://www.cedars-sinai.edu/Patients/Programs-and-Services/Orthopaedic-Center/Treatment/Arthroscopy.aspx

New York University: "Arthroscopy". Reviewed December 2012 by John C. Keel, MD; accessed December 2013. http://www.med.nyu.edu/content?ChunkIID=14769