What is Arthroscopy?
The term arthroscopy comes from Greek words meaning
to look into a joint. Arthroscopy is a surgical procedure in which the
orthopaedic surgeon makes a small skin incision and inserts a pencil-sized
lighted viewing tube (arthroscope) into the joint. With the arthroscope
attached to a miniature TV camera, the inside of the joint can be visualized
without the need for a larger incision. The surgeon can look all around
the shoulder or elbow joint, and examine the bones, cartilage, muscles,
ligaments and tendons to determine the type and degree of injury. If
necessary, many problems can then be repaired or corrected with the
aid of the arthroscope.
When is Arthroscopy Necessary?
In order to diagnose your shoulder or elbow problem,
your doctor will begin with a thorough history, physical examination
and usually plain x-rays. Additional imaging tests may be necessary
to help your doctor decide what the problem is that bothers you. With
the arthroscope, a final diagnosis can be made which may be more accurate
than other tests or surgery that opens up the joint.
Once a diagnosis is made, your surgeon will decide if
the shoulder or elbow joint needs to be opened through a larger incision
to treat the underlying problem, or whether it can be done through two
or three small incisions using the arthroscope and small instruments.
Since arthroscopy requires only small incisions and disturbs the joint
less than a larger incision, recovery is usually quicker than with open
surgery. Since arthroscopy is a surgical procedure, it carries a small
risk of infection, blood vessel or nerve injury, or instrument breakage.
Remember that arthroscopy cannot be used to treat all shoulder and elbow
problems, but it can diagnose most of them.
Some of the more common conditions found during shoulder
arthroscopy include loose bodies inside the joint, synovitis or inflammation
of the joint lining, partial and complete tears of the rotator cuff,
impingement or tendinitis, torn cartilage, arthritis and instability.
For the elbow joint, the arthroscope can frequently diagnose loose bodies,
arthritis, fractures and synovitis.
The Arthroscopic Procedure
Arthroscopy is frequently done as an outpatient procedure,
so no overnight hospital stay may be necessary. Laboratory tests may
be ordered by your doctor prior to surgery, and you will not be able
to eat or drink anything after midnight prior to surgery. Arthroscopy
requires a hospital operating room or outpatient surgical suite, and
some type of anesthetic is used -- either general, regional or local.
Your surgeon will use the arthroscope to visualize and
inspect the joint in a systematic fashion, and may treat the problem
with specially designed instruments inserted into the joint through
additional small incisions, if necessary. Following the one to two hour
procedure, the tiny incisions will be stitched or taped up and a bandage
applied. A sling may be applied for the first few days for comfort.
You will be kept in the recovery room until the anesthetic wears off,
and then sent home with pain medication.
Recovery from Arthroscopy
Once home, follow your doctor's instructions about caring
for your incisions, what activities you can and cannot do and what exercises
or physical therapy you should be doing to aid in your recovery. The
exercises are aimed at restoring motion and strength to your joint,
and the specific plan will depend on your diagnosis and the treatment
performed. Follow-up visits with your surgeon are important to help
ensure a safe and speedy recovery. Patients are often able to return
to work or school or resume normal daily activities within a few days.
However, each patient's arthroscopy is unique to that individual depending
on his/her diagnosis and treatment, and therefore recovery times will