Arthroscopic Surgery

Arthroscopic procedures are relatively simple. Before knee, ankle, or hip surgery, a patient may want to practice walking on crutches to make the post-operative recovery more comfortable. Fasting is usually required before the procedure because of the use of anesthetics. Anesthesia is usually local, although in more complicated surgeries general anesthesia can be given. A spinal anesthesia or epidural is given to numb the patient from the waist down if necessary. A patient may also be given a sedative to help with relaxation during the procedure. Hair will typically need to be shaved around the incision sites. Monitoring devices such as a pulse reader or an EKG may be attached to the patient in some cases. All instruments, as well as the incision sites, must be completely sterilized to reduce the risk of infection.

The surgery itself begins when a tourniquet is wrapped around the joint. The limb is then elevated to drain blood away from the joint. Saline solution is injected into the joint through a cannula, or drainage tube, first to distend the joint, or cause it to swell, and then to irrigate it, or flush it during the procedure. Swelling of the joint gives the surgeon more room to operate. The continuous flushing washes away any cartilage or other fragments that might break off into the joint during the procedure. The arthroscope is then inserted and the surgeon examines the joint using high-resolution imagery. After an initial diagnosis, a surgical procedure may be performed, such as using a cutter to remove tissue. After the procedure is finished, the instruments are removed from the joint and the saline is squeezed out. Sometimes steroids are injected into the joint to reduce inflammation. The incisions are closed with sutures and covered with bandages, thus completing the surgery.

Post-operative procedures include icing the joint and elevating the limb to minimize swelling. Patients are often advised not to drive for 24 hours. Painkillers may be prescribed to alleviate soreness or discomfort. Incisions should be kept clean and dry until they are completely healed. The patient may need to return to the surgeon for removal of sutures. Use of the joint is usually limited for a time after surgery, and physical therapy is often recommended to help restore mobility and strength. Complications are uncommon but may include infection or bleeding in the area of the incision.