Arthroscopic surgery (Arthroscopy)

Procedure • By Biraj Patel

When it comes to orthopedic surgery, one term you might frequently encounter is “arthroscopic surgery.” But what exactly is it, and how does it differ from other surgical procedures? Let's delve into the world of arthroscopy, simplifying complex concepts and providing you with a comprehensive understanding of this minimally invasive surgical technique.

Is arthroscopic surgery a major surgery?

The short answer is no; arthroscopic surgery is not considered a major surgery. Unlike traditional open surgeries, which often involve large incisions and extensive tissue disruption, arthroscopic surgery is minimally invasive. This means that it utilizes small incisions and specialized instruments to diagnose and treat various joint-related issues, making it a less invasive option compared to major orthopedic surgeries.

Why is arthroscopic surgery done?

Arthroscopic surgery is primarily performed to diagnose and treat a variety of joint problems. Patients can get arthroscopy done on any joint, typically, it’s done on the knee, shoulder, elbow, ankle, hip, or wrist. It's commonly used to investigate and address issues such as torn ligaments, damaged cartilage, joint inflammation, and more.

This procedure allows orthopedic surgeons to visualize the interior of a joint, identify issues, and, in many cases, treat them during the same procedure. It's a go-to choice when the goal is to minimize pain, scarring, and recovery time.

What is an arthroscope?

The term “arthroscope” is derived from two Greek words: “arthro,” meaning joint, and “skopein,” meaning to look at or examine.

An arthroscope is a specialized instrument used in arthroscopic surgery. It's a slender, tube-like device equipped with a camera and light source, allowing surgeons to visualize the interior of a joint on a screen, in real-time. This innovative tool has revolutionized the field of orthopedics, enabling precise diagnosis and targeted treatment.

The difference between arthroscopic vs. laparoscopic surgery

Both arthroscopic and laparoscopic surgeries are minimally invasive procedures, but they differ in their focus areas.

Arthroscopic surgery is specifically designed for diagnosing and treating joint-related issues, whereas laparoscopic surgery pertains to the abdominal and pelvic regions, typically addressing issues within the abdomen, like gallbladder problems or appendicitis.

How to prepare for arthroscopic surgery

Before undergoing arthroscopic surgery, you can expect a series of preparatory steps. The orthopedic surgeon will review your medical history, perform a physical examination, and may order additional tests like X-rays or MRI scans. This thorough assessment helps in creating a personalized surgical plan.

Before the procedure, patients are typically advised to fast for several hours, and they must arrange for a responsible adult to accompany them home post-surgery. Lastly, make sure to wear comfortable loose clothes, especially around the joint that’s going to be operated on.

How arthroscopic surgery is performed

Understanding how arthroscopic surgery is performed is essential for anyone considering or simply curious about this minimally invasive orthopedic procedure.

Step 1: Anesthesia

Arthroscopic surgery begins with the administration of anesthesia. Depending on the specific joint and procedure, the patient will either receive local anesthesia, which numbs the area around the joint, or general anesthesia, which induces a state of unconsciousness for the duration of the surgery. The choice of anesthesia is made after thorough consultation between the surgeon and patient.

Step 2: Incisions

Once the anesthesia has taken effect, the orthopedic surgeon makes small incisions near the joint being treated. These incisions are typically no more than a few millimeters in length, which is one of the hallmarks of arthroscopic surgery. The size and location of these incisions are carefully planned to minimize scarring and tissue disruption.

Step 3: Arthroscope insertion

An arthroscope is then inserted through one of the incisions. This instrument is the key to the entire procedure. The camera provides real-time images of the interior of the joint, which are displayed on a monitor in the operating room. The surgeon uses these images to guide the surgery.

Step 4: Exploration and treatment

With a clear view of the joint's interior, the surgeon explores the area, looking for any issues such as torn ligaments, damaged cartilage, or signs of inflammation. If any problems are identified, additional specialized instruments are inserted through the other incisions. These instruments can be used for various purposes, including cutting, suturing, and removing damaged tissue.

Step 5: Rinse and closure

Throughout the procedure, a sterile saline solution is used to rinse the joint, providing a clear field of vision and removing any debris. Once the necessary repairs or treatments have been completed, the instruments are removed, and the incisions are closed. In most cases, dissolvable sutures or adhesive strips are used, minimizing the need for postoperative suture removal.

Arthroscopic surgery recovery time and care

Arthroscopic surgery is renowned for its minimally invasive nature, but like any medical procedure, it comes with a recovery phase. Right after arthroscopic surgery, patients will be observed in a recovery area until the effects of anesthesia wear off and they are stable. Once cleared by the medical team, patients are usually allowed to return home on the same day as the surgery, which is another advantage of this minimally invasive procedure.

Pain management

It's common to experience some discomfort or pain in the operated joint for a few days following surgery. Your orthopedic surgeon will prescribe pain medications or recommend over-the-counter pain relievers to help manage this discomfort.

Rest and elevation

Rest is a vital component of the recovery process. To reduce swelling and promote healing, it's recommended to keep the operated joint elevated above the level of your heart when at rest. This can be achieved by propping up the limb with pillows or using specialized cushions designed for this purpose.

Compression and ice

In some cases, your surgeon may recommend applying a compression bandage to reduce swelling. Cold therapy, using ice packs, can also be beneficial in managing inflammation. It's essential to follow your surgeon's guidance on the frequency and duration of cold therapy.

Physical therapy

Recovery from arthroscopic surgery often involves physical therapy. Your surgeon will create a tailored rehabilitation plan to help you regain strength, mobility, and function in the operated joint. Physical therapy typically starts within a few days to a week after the procedure and can continue for several weeks or months, depending on the type of surgery and individual factors.

Follow-up appointments

Regular follow-up appointments with your orthopedic surgeon are crucial during the recovery period. These appointments allow your surgeon to monitor your progress, assess healing, and make any necessary adjustments to your treatment plan.

Recovery time for different arthroscopic surgeries

These are general recovery timeframes and can vary. Your orthopedic surgeon will assess your specific case, taking into account factors such as the extent of the injury or condition, your overall health, and your commitment to postoperative rehabilitation.

Knee arthroscopy

Most patients can resume light activities within a few days to a week after surgery.
Depending on the procedure, it may take 4 to 8 weeks to return to normal daily activities and work.
Full recovery for knee arthroscopy can range from a few weeks to several months, particularly for those involved in sports or physically demanding jobs.

Shoulder arthroscopy

Patients often experience improved comfort within a few days, but full recovery may take 4 to 6 weeks.
Light activities and desk jobs can usually be resumed within a week or two.
Returning to sports or strenuous activities may require 4 to 6 months of rehabilitation.

Hip arthroscopy

Patients may be able to walk with crutches immediately after surgery.
Full weight-bearing walking can begin within a few weeks.
Depending on the procedure, full recovery may take several months to a year.

Ankle arthroscopy

Immediate weight-bearing is often allowed, but patients may need crutches for support.
Depending on the surgery, return to normal activities can range from 2 to 6 weeks.
Full recovery can take several months, with physical therapy playing a crucial role in regaining strength and mobility.

Arthroscopic surgery cost

The cost of arthroscopic surgery varies depending on the specific type of arthroscopy, the location of the surgery, the healthcare facility, the surgeon's fees, and whether you have insurance coverage. Keep in mind that the figures provided below are approximate and may change over time.

Knee arthroscopy can range from $5,000 to $7,500 or more.
Shoulder arthroscopy typically falls in the range of $8,000 to $12,000.
Hip arthroscopy tends to be on the higher end of the cost spectrum, with estimates ranging from $10,000 to $15,000 or more.
Ankle arthroscopy may cost between $5,000 and $9,000.

Discuss arthroscopic surgery with the best orthopedic surgeons on PreferredMD

Choosing the best orthopedic surgeon for arthroscopic surgery is a crucial step in the process. Patients should seek out a skilled and experienced surgeon with a proven track record in performing arthroscopic procedures. Don't hesitate to ask for recommendations, conduct thorough research, and schedule consultations to ensure you're in the best hands for your journey towards improved joint health.