Overview-Arthroscopy
It's most commonly used on the knees, ankles, shoulders, elbows, wrists and hips.
The equipment used during an arthroscopy is very small, so only small cuts in the skin are needed. This means it has some advantages over traditional, "open" surgery, including:
- less pain after the operation
- faster healing time
- lower risk of infection
- you can often go home the same day
- you may be able to return to normal activities more quickly
When an arthroscopy is used
You might need an arthroscopy if you have problems such as persistent joint pain, swelling or stiffness, and scans haven't been able to identify the cause.
An arthroscopy can be used to assess the level of joint damage resulting from an injury, such as a sports injury, or from underlying conditions that can cause joint damage, such as osteoarthritis.
The procedure can also be used to treat a range of joint problems and conditions, including:
- repairing damaged cartilage
- removing fragments of loose bone or cartilage
- draining away any excess fluid
- treating arthritis, frozen shoulder, carpal tunnel syndrome or temporomandibular disorder (TMD)
How an arthroscopy is carried out
Preparing for surgery
Before having an arthroscopy, you'll usually be given an appointment to attend a pre-admission clinic.
During the appointment, your general health will be assessed to make sure you're ready for surgery. You'll also be given information about issues such as:
- what and when you can eat and drink on the day of surgery
- whether you should stop or start any medications before surgery
- how long it will take for you to recover from surgery
- whether you'll need to do rehabilitation exercises after surgery
The surgical team will explain the benefits and risks associated with having an arthroscopy. You'll also be asked to sign a consent form to confirm you agree to have the operation and that you understand what's involved, including the potential risks.
The procedure
An arthroscopy is usually carried out under general anaesthetic, although sometimes a spinal or local anaesthetic is used.
Your anaesthetist will explain which type of anaesthetic is most suitable for you. In some cases, you may be able to say which you would prefer.
If you have a local anaesthetic, your joint will be numbed so you don't feel any pain. You may still feel some sensations during the procedure, such as a slight tugging, as the surgeon works on the joint.
Antibacterial fluid is used to clean the skin over the affected joint and a small cut, a few millimetres long, is made in the skin next to the joint so that a device called an arthroscope (a thin, metal tube with a light and camera at one end) can be inserted.
One or more additional incisions will also be made so that an examining probe or other fine surgical instruments can be inserted.
The joint is sometimes filled with a sterile fluid to expand it and make it easier for the surgeon to view. The arthroscope sends images to a video screen or eyepiece, allowing the surgeon to see inside your joint.
As well as examining the inside of the joint, if necessary, your surgeon will be able to remove any unwanted tissue or repair any damaged areas using tiny surgical instruments inserted through the additional incisions.
After the procedure, the arthroscope and any attachments are removed, along with any excess fluid from the joint. The incisions are usually closed using special tape or stitches and covered with a sterile dressing.
An arthroscopy usually takes between 30 minutes and two hours, depending on the type of procedure carried out. You'll either be able to go home on the same day as the surgery or the following morning.
Recovering from an arthroscopy
How long it takes to recover from an arthroscopy depends on the joint involved and the specific procedure you had.
It's often possible to return to work and light, physical activities within a few weeks, but more demanding physical activities such as lifting and sport may not be possible for several months.
Your surgeon or care team will let you know how long it's likely to take to recover and what activities to avoid until you've fully recovered.
While recovering, contact your GP or surgical team for advice if you think you may have developed one of the complications described below.
What are the risks?
An arthroscopy is generally considered to be a safe procedure, but like all types of surgery it does carry some risks.
It's normal to experience short-lived problems such as swelling, bruising, stiffness and discomfort after an arthroscopy. These will usually improve during the days and weeks following the procedure.
More serious problems are much less common, occurring in less than 1 in 100 cases. They include:
- a blood clot that develops in one of the limbs – known as deep vein thrombosis (DVT), it can cause pain and swelling in the affected limb
- infection inside the joint – known as septic arthritis, it can cause fever, pain and swelling in the joint
- bleeding inside the joint – which often causes severe pain and swelling
- accidental damage to the nerves near the joint – which can lead to temporary or permanent numbness and some loss of sensation
Speak to your surgeon about the possible risks before agreeing to have an arthroscopy.
Recovery-Arthroscopy
How long it takes to recover after an arthroscopy will depend on your general health, the joint involved and the specific procedure you had.
Some people feel better after a few days, while others may not be back to normal for several months.
After the operation
After your arthroscopy, you'll be taken to a room to recover from the effects of the general anaesthetic, if it was used during the procedure.
You may experience some pain in the affected joint. If you do, tell a member of the hospital staff, who will be able to give you painkillers.
Most people who have an arthroscopy are able to leave hospital either on the day of surgery or the following morning. Before leaving, you may see a physiotherapist who will discuss exercises for you to do at home.
Depending on the procedure you had, you may need a temporary sling, splint or crutches to support and protect the joint while you recover. In some cases, special pumps or compression bandages are used to help improve blood flow.
Recovery advice
You'll probably feel tired and light-headed after having a general anaesthetic, so you'll need to ask someone to take you home and stay with you for the first 24 hours after surgery. Most people will recover from the effects of the anaesthetic within 48 hours.
Make sure you elevate the joint and apply ice packs to help reduce the swelling when you get home, if advised to do so. You should also do any joint exercises that have been recommended for you.
Keep dressings as dry as possible by covering them with a plastic bag when having a bath or shower. If your dressings get wet or fall off, they'll need to be replaced. Dressings can usually be removed after 5 to 10 days.
Your wounds should start to heal within a few days. If non-dissolvable stitches were used, they'll need to be removed after a week or two. This can usually be done by a practice nurse at your local GP surgery.
You'll have a follow-up appointment a few weeks after the operation to discuss the results of the surgery, your recovery, and any additional treatment you may need.
Returning to normal activities
Your surgeon or care team will let you know how long it's likely to take for you to fully recover and what activities you should avoid until you're feeling better.
You'll probably need at least a week or two off work, although this varies from person to person. It will largely depend on whether your job involves strenuous activity that could damage the joint.
You'll be able to drive when you're able to do so without pain and you can safely perform an emergency stop. This may not be for a few weeks or several months after surgery. Your surgeon can give you more specific advice.
They'll also be able to advise you about how long it will be before you can undertake strenuous physical activities, such as sport and heavy lifting. For many people, this will be around six weeks after surgery, but in some cases it may not be for several months.
When to see a doctor
Contact your GP or the clinic where you had your operation if you experience:
- a high temperature (fever)
- severe or increasing pain
- severe or increasing redness or swelling
- discoloured or foul-smelling discharge from your wounds
- numbness or tingling
These problems could be a sign of a complication of surgery, such as an infection or nerve damage.