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A guide to arthroscopy

When medicine, physical therapy and other common treatments fail to improve the function of a balky or painful joint, it may be time to think about surgery.

But if you think surgery means a long scar and an even longer recovery period, think again.

Many people with joint problems are candidates for arthroscopic surgery, where recovery is often quicker and the scar is no bigger than a buttonhole, according to the American Academy of Orthopaedic Surgeons (AAOS).

Surgery on TV

According to the AAOS, arthroscopic surgery involves one or more small cuts in the skin through which miniature instruments are inserted directly into a problematic joint.

Among the instruments is a tiny camera that sends pictures to a monitor. By watching the monitor, the surgeon can see cartilage, ligaments, bone and other structures inside the joint without making the large incision often needed for standard open surgery.

Arthroscopy is most often used to diagnose and treat problems in a knee, shoulder, elbow, ankle, hip or wrist joint, according to the AAOS. Common problems found during arthroscopy include those linked to arthritis, tears in cartilage or ligaments, or loose pieces of bone or other debris in a joint.

Is it for you?

Arthroscopy may be an option if more conservative treatments haven't helped a joint that's swollen, painful, or that catches or gives way, according to the AAOS.

Talk to your primary care physician about your joint problem and ask if an orthopedic surgeon should evaluate you.

During an evaluation, the orthopedic surgeon may take your medical history, do a physical exam and order tests, such as magnetic resonance imaging (MRI) or an x-ray. If the doctor feels that arthroscopy may be helpful, he or she will describe the procedure along with its potential benefits and complications.

Complications may include infection, blood clots in a vein, damage to blood vessels or nerves, and excessive bleeding or swelling. According to the AAOS, complications are very uncommon, occurring in less than 1 percent of all arthroscopic procedures.

How it's done

Most arthroscopic surgeries are outpatient procedures, done at a hospital or surgery center.

Before the operation, you'll receive local, regional or general anesthesia. Once the anesthesia takes effect, the surgeon will make a small cut in the skin, insert the arthroscope into the joint and evaluate the problem.

The exact procedure varies but may involve the insertion of other tiny tools such as scissors or clamps through additional small cuts.

After surgery

Once the procedure is over, the cuts are closed with sutures or tape and covered with a dressing. After an hour or two in the recovery room, you'll be discharged. Plan to have someone else drive you home.

Follow the postoperative instructions your doctor gives you, including those about:

  • Prescribed medicines you should take to prevent infection or pain.
  • How to care for the incisions.
  • Any activities you should avoid while you're healing.
  • The exercises you should do to speed recovery.

The cuts usually heal in several days. The joint itself may take several weeks to fully recover. Patients are often allowed to resume light work duties within a few days.

Arthroscopy isn't the best choice for every joint problem. Talk to your doctor about all treatment options before deciding which one is most likely to work for you.

reviewed 1/18/2019

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