Arthroscopic surgery


Arthroscopic surgery is a procedure that allows surgeons to visualize, diagnose, and treat joint problems. The name is derived from the Greek words arthron , joint, and skopein , to look at. Arthroscopy is performed using an arthroscope, a small fiber-optic instrument that enables a close look at the inside of a joint through a small incision.


Arthroscopic surgery is used to diagnose, treat, and monitor joint injuries and diseases that affect the joints. Diagnostic arthroscopic surgery is performed when the medical history, physical exam, x rays, and bone scanning examinations, such as MRI or CT, do not provide a definitive diagnosis. Corrective arthroscopic surgery is used primarily to remove bone or cartilage or repair tendons or ligaments.


Diagnostic arthroscopic surgery is not recommended unless non-surgical treatment does not fix the problem.


Arthroscopic surgery is performed most commonly on the knees, and also on ankles, shoulders, wrists, elbows, and hips. Knee joints are large enough to allow free movement of arthroscopic instruments and therefore are ideal for the benefits of this type of examination and treatment. The technique is valued because it allows surgeons to see inside the joint through incisions as tiny as a quarter of an inch (about 1 cm) rather than the large incisions that open surgery procedures require. The accuracy of arthroscopy is said to be 100% for diagnosis compared to diagnostic imaging such as MRI. Arthroscopic surgery may be used to relieve mechanical joint problems, such as buckling, stiffness, or locking, and can preclude or delay the need for more aggressive surgery such as a joint replacement.

In arthroscopic surgery, an orthopedic surgeon uses a pencil-sized arthroscope—a fiber-optic instrument fitted with a lens, a light source, and a miniature video camera—to see inside a joint. Advanced fiber optics allow even more detail to be seen than in open surgery, often identifying problems that may have been difficult to diagnose with other methods. The arthroscope transmits highlighted images of the structures to a television monitor in the operating room . The surgeon is able to view the entire examination, getting a full view of the joint, its cartilage, and surrounding tissue. The type and extent of the injury can be determined and repair or correction can be performed if necessary. Some of the most common joint problems diagnosed and treated with arthroscopic surgery are:

Arthroscopic procedures are performed in a hospital or outpatient surgical facility by an orthopedic surgeon. The type of anesthesia used (local, spinal, or general) varies, as does the length of the procedure; both depend on the joint that will be operated on, the type and extent of the suspected joint injury, and/or the complexity of the anticipated repair. Arthroscopic surgery rarely takes more than an hour. Most patients who have arthroscopic surgery, whether diagnostic or corrective, are discharged within the same day; some patients, depending on the complexity of the surgery or their post-operative condition, may stay in the hospital one or two days.

Considered the most important orthopedic development in the twentieth century, arthroscopic surgery is widely used. The American Association of Orthopedic Surgeons reports that it is performed by 80% of all orthopedic surgeons. The use of arthroscopic surgery on famous athletes has been well publicized. Although arthroscopic surgery was initially only a diagnostic tool used prior to open surgery, the availability of better instruments and techniques has encouraged its use to actually treat a variety of joint problems, often avoiding more complicated surgeries with longer recovery times. New techniques under development are likely to lead to other joints being treated with arthroscopic surgery in the future. Laser technology has been introduced as a treatment option in arthroscopic surgery and other advanced technologies are being explored.

Surgical procedure

After making two small incisions about the size of a buttonhole in the skin near the joint, the surgeon injects sterile sodium chloride solution through one incision into the joint to expand it for better viewing and movement of the instruments. The surgeon will also use this access to irrigate (flood with fluid) the joint area during surgery and to suction blood and debris away from the joint. This irrigation, or "washing" part of the procedure, is believed to be of value in itself, improving joint function. The arthroscope is then inserted into the second incision. While looking at the interior of the joint on the television monitor, the surgeon can determine the extent or type of injury and, if necessary, take a biopsy specimen or repair or treat the problem. A third tiny incision may be made in order to see other parts of the joint or to insert additional instruments, such as laser or tiny scalpels, when repairs or corrections need to be made. Arthroscopic surgery can be used to remove floating bits of cartilage, to debride (clean by removing tissue or bone), and to treat minor tears and other disorders. When the procedure is finished, the arthroscope is removed and the joint is once again irrigated. The site of the incision is dressed with compression bandages (ace bandages).


Prior to arthroscopy, the patient's medical history will be reviewed and the patient will have a complete physical examination . Standard pre-operative blood and urine tests will be done as well as scans of the affected joint, such as MRI ( magnetic resonance imaging ), CT (computed tomography), and arthrogram (an x ray using dye). In some cases, an exercise regimen or muscle stimulation treatment (TENS) may be recommended to strengthen muscles around the joint prior to surgery. Surgeons may recommend pre-operative guidelines, such as:


Immediately after the procedure, the patient will spend up to two hours in a recovery area before being discharged. Some patients may be transferred to a hospital room if the surgeon determines overnight care is necessary. The surgical site will be dressed with a compression bandage (ace bandage) or a tightly fitting stocking (support hose). An ice pack will be placed on the joint that was examined or treated by arthroscopy. This treatment may continue for up to 72 hours after surgery to keep swelling down and help prevent the formation of clots. Pain medication will be administered if needed, although most patients require little or no medicine for pain. Dressings can usually be removed on the morning after surgery and replaced by adhesive strips. The surgeon should be notified if the patient experiences any increase in pain, swelling, redness, drainage or bleeding at the site of the surgery, signs of infection (headache, muscle aches, dizziness, fever), and nausea or vomiting.

It takes several days for the puncture wounds to heal and several weeks for the joint to fully recover. Many patients can resume their daily activities, including going back to work, within a few days of the procedure. Muscle strength must be regained as soon as possible after surgery to help support the affected joint. A rehabilitation program, including physical therapy, may be suggested to speed recovery and improve the functioning of the joint. The surgeon's recommendations for recovery may include:


Few complications are to be expected with arthroscopy. Those that may occur occasionally (fewer than 1% of all arthroscopies, according to the American Academy of Orthopedic Surgeons) are infection, blood clot formation, swelling or bleeding, or damage to blood vessels or nerves. Rare instrument breakage during procedures has also been reported.

Normal results

Most patients undergo arthroscopic surgery as an outpatient and are home with hours or at most a day or two. Pain and complications are rare and most patients will enjoy improved mobility as they recover over a period of days, possibly with the aid of physical therapy and gentle exercise.

Some people undergoing arthroscopy may have preexisting conditions and diseases that will affect the surgical result. Recovery times will vary depending on each patient's overall condition. Certain problems may need to be treated with a combination of arthroscopic and open surgical procedures.


Alternatives to arthroscopic surgery include:



Andrews, James R. and Laura A. Timmerman. Diagnostic and Operative Arthroscopy. Philadelphia: W. B. Saunders Co., 1997.

Brillhart, Allen T., ed. Arthroscopic Laser Surgery: Clinical Applications. New York: Springer-Verlag, 1995.

Oxford Medical Publications. Oxford Textbook of Sports Medicine. New York: Oxford Medical Publications, 1994.


Wilkinson, Todd. "Pop, Crackle, Snap." Women's Sports & Fitness (April 1998): 68.


American Academy of Orthopedic Surgeons(AAOS). 6300 North River Road, Rosemont, IL 60018. (800) 346-AAOS. .

Institute for Bone and Joint Disorders. 2222 East Highland Avenue, Phoenix, AZ 85016; 602-553-3113. .


American Academy of Orthopaedic Surgeons. Arthroscopy. April 15, 1998 [cited April 2003]. .

The Arthritis Foundation. About Arthroscopic Surgery. [cited April 2003]. .

Cooke, K. V. "Arthroscopy for Rheumatoid Arthritis." September 5, 2002 [cited April 2003]. .

"Joint Irrigation for Osteoarthritis." Ivanhoe Newswire 5(2003): 20–26 [cited April 2003]. .

"Knee Arthroscopy." The Center for Orthopaedics and Sports Medicine. April 15, 1998 [cited April 2003]. .

Lori De Milto L. Lee Culvert


Arthroscopic surgery is performed in a hospital operating room or an outpatient surgical facility by an orthopedic surgeon.


User Contributions:

Thanks excellent articale,regarding my leg knee problem I got superb idea after red.

Once again thank you

Akshay Jain
Thanks for this very good informative article. Provides valuable information and good set of questions...
Thanks - got information here about aftercare that my hospital never gave me!
I am 77years old I have OSTEOARTHRITIS in both knees I had xrays taken and was told that it is not bad enough to have a knee replacement do you think that having this scope done would help me. I look towards your reply thank you
This answered my questions and I feel more comfortable about having chosen to go ahead with arthroscopic surgery on my knee, which has a torn menascil, inside and outside the knee. I am a horse back rider at 76 years and want to get as many more years doing so as possible out of this body! I just got my first horse of my own for my birthday last month! He's a senior too.
Newly qualified nurse. The comments are most helpful
Chris Heslop
I had a total knee replacement on the 10th Nov 2014. My knee was swollen about three times the size.I did finally receive physio on my knee,but beleive it was far to late as my knee would not bend more than 50 deg.i then started physio privately this year,but can only achieve up to 51 deg
only if I have physio twice a week.I would like to know if I can have arthroscopic surgery to cut the scar tissue to try again with physio this time
Within a week of having arthroscopic surgery.Has anybody ever had this done on there knee because it will not bend.

Chris Heslop

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