Arthroscopy

What is arthroscopic surgery?

Arthroscopic surgery is a common orthopedic procedure that is used to diagnose and treat problems in joints. The word "arthroscopy" comes from two Greek words: 'arthro,' meaning "joint," and 'scope,' meaning "look." Simply put, arthroscopic surgery is a means to look inside a joint. But arthroscopy is much more than that!

What parts of the body can undergo arthroscopic surgery?
Arthroscopic surgery is most commonly performed on the knee and shoulder joints. Less commonly arthroscoped joints include the wrist, elbow, ankle and hip. The reason the knee and shoulder are the most commonly arthroscoped joints is that they are large enough to manipulate the instruments around, and they are amenable to arthroscopic surgery treatments.

Technically speaking, any joint can be arthroscoped. However, the practicality and the instrumentation available limit our ability to arthroscope every joint for all types of problems. The most common arthroscopic procedures include repairing cartilage and meniscus problems in the knee, and removing inflammation and repairing rotator cuff tears in the shoulder.

How is arthroscopic surgery performed?
When a knee arthroscopy is performed, a camera is inserted into the joint through a small incision (about one centimeter). The arthroscopic surgery camera is attached to a fiberoptic light source and shows a picture of the inside of the joint on a television monitor. The surgeon uses water under pressure to "inflate" the knee allowing more maneuverability and to remove any debris. One or more other incisions are made to insert instruments that can treat the underlying problem. For example, a shaver can be inserted to trim the edges of a meniscus tear.

What is arthroscopic surgery a good treatment for?
Many common knee and shoulder problems are amenable to arthroscopic surgery. As mentioned above, some common arthroscopic procedures include:

• Trimming a torn meniscus

• Repairing a torn meniscus

• Treatment of shoulder bursitis

• Repair of the rotator cuff

• Treatment of cartilage damage in the knee

• Treatment of labral tears in the shoulder

However, not all conditions are best treated with arthroscopic procedures. A recent controversy arose in the past several years about the effectiveness of arthroscopic surgery in treating arthritis of the knee. The study, from the New England Journal of Medicine, reported that arthroscopic surgery for treatment of moderate arthritic changes of the knee is no more effective than 'sham surgery,' where incisions are made but no surgery is performed. Talk to your doctor about why arthroscopy may or may not help your condition.

Is arthroscopic surgery safe?
Understand that arthroscopic surgery is a surgical procedure and involves risks. These may include infection, blood clots, problems with anesthesia, etc. These are serious risks and the decision to undergo arthroscopic surgery should be taken seriously. That said, arthroscopic surgery is a "less invasive" procedure, and when performed for the right indications (meaning the right problems) it is often very successful. Ask your doctor for more information about arthroscopic surgery, and talk about the possible risks of undergoing the procedure.