A method of viewing or performing surgery on a joint (shoulder, knee, ankle, elbow, or wrist) by use of an arthroscope, which consists of a tube, lens, and a light source designed from fiber optics. Typically, this procedure is performed on the knee joint. A local or regional anesthetic is administered, and the area is cleaned with antiseptic soap. A pressure band may be applied to restrict blood flow.
An incision is made above the joint and sterile fluid is introduced into the joint space to provide a better view. Next, a small incision is made on one side of the joint and the arthroscope is inserted. The inside of the joint may be viewed through the eyepiece or the image can be reproduced on a screen. The tube may be used to introduce fluid, remove floating bits of cartilage or bone, take a tissue biopsy, or perform minor surgery. The average length of time for a diagnostic or simple arthroscopy (not requiring surgery during the procedure) is about one hour.
Prior to surgery You must sign an informed consent form. Fast overnight before the test (to minimize effects of the anesthetic). You will be instructed if you need to shave your joint area. You may be given a sedative before leaving for the hospital. The joint must be accessible, so special clothing may be required (shorts for a knee or ankle arthroscopy or a hospital gown for a shoulder exam). The physical and psychological preparation you can provide for this or any test or procedure depends on age, interests, previous experience, and level of trust.
How the test will feel The injection may sting, but once the anesthetic has taken effect, there is no pain. The joint may be manipulated to provide a better view, so, there may be some tugging on the leg (or arm, if done on the shoulder).
After the test, the joint will probably be stiff and sore for a few days. Slight activity (walking) can be resumed immediately, however, excessive use of the joint may cause swelling, pain, and increase the chance of injury. Depending on the diagnosis, there may be other exercises or restrictions.
Risks Swelling, increased pain, localized inflammation, infection (fever).
Indications Suspected ligament tear, damaged meniscus cartilage, evidence of bone fragments, joint pain from an injury, unexplainable joint pain, lesions or other problems detected by x–rays, joint disease. There should not be any torn muscles or ligaments, bone fragments, or bleeding. The joint should have a full range of motion. An arthroscopy is not performed unless there is a problem, so, there are rarely normal results. Normal activity should not be resumed for several days or longer. Special preparations may need to be made concerning work and other responsibilities. Physical therapy may also be recommended.