Arthroscopy and arthroscopic surgery may be done under local or general anaesthesia. The type of anaesthesia chosen depends on the joint being examined, and various other considerations. The skin over the joint will be cleaned. You will be asked to adopt a position best suited for the procedure. For example, you may need to lie on your back with your knee bent for knee procedures, or lie on your side for shoulder procedures, etc. For arthroscopy of the knee a tourniquet (pressure band) may be put round the upper part of the leg to restrict blood flow.
The surgeon makes a small incision (cut) next to the joint - just a few millimetres long. The arthroscope is pushed through the incision into the joint. An arthroscope used for the knee joint is about the width of a pencil. A thinner one is used for smaller joints such as the wrist and ankle. One or more separate incisions are made to push a thin examining probe into the joint, or fine instruments which are used for surgery, or fluid to make viewing easier and to flush out the joint.
The arthroscope transmits pictures through a camera attachment on to a TV monitor. By looking at the monitor, the surgeon can see inside the joint, including the ends of the probe or operating instruments. So, for much of the time, the surgeon is watching the TV monitor to guide him or her as he or she manipulates the instruments within the joint.
When the procedure is finished, the arthroscope and other instruments are removed. The incisions may need a stitch or two, but stitches are often not needed as the incisions are so small. A sterile dressing is put over the incisions. An ice pack may be applied for a while to minimise any swelling. Depending on what was done and the problem you have, a knee joint may then be covered with a large bandage or other knee support.
Some of the most frequent arthroscopic surgical procedures include:
- Rotator cuff surgery
- Repair or resection of torn cartilage (meniscus) from knee or shoulder
- Reconstruction of anterior cruciate ligament in knee
- Removal of inflamed lining (synovium) in knee, shoulder, elbow, wrist, ankle
- Release of carpal tunnel
- Repair of torn ligaments
- Removal of loose bone or cartilage in knee, shoulder, elbow, ankle, wrist