Arthroscopy Health Article

Definition

Arthroscopy is the examination of a joint, specifically, the inside structures. The procedure is performed by inserting a specifically designed illuminated device, called an arthroscope, into the joint through a small incision. Arthroscopy may be used to diagnose, as well as treat, conditions. When a repair is performed, the procedure is called arthroscopic surgery.

Purpose

Arthroscopy is used primarily by physicians who specialize in treating disorders of the bones and related structures (orthopedics) to help diagnose joint problems. Once described as essential for those who primarily care for athletic injuries, arthroscopy is now a technique commonly used by orthopedic surgeons for the treatment of patients of all ages. The six joints most frequently examined are:

• knee
• shoulder
• elbow
• ankle
• hip
• wrist

A joint is a complex system. Within a joint, ligaments attach bones to other bones, tendons attach muscles to bones, cartilage lines and helps protect the ends of bones, and a special fluid (synovial fluid) cushions and lubricates the structures. Direct visualization of the joint allows the doctor to see exactly which structures are damaged. Arthroscopy also permits earlier diagnosis of many types of joint problems, including those that had been difficult to detect in previous years.

Precautions

Arthroscopy is contraindicated for patients with ankylosis, due to the stiffness of the joint involved. Arthroscopy is also contraindicated in patients with an existing local infection, due to the potential for sepsis. Because of inflammation after the use of contrast dye, arthroscopy is contraindicated in patients who have recently undergone an arthrogram. Most arthroscopic procedures are performed as same-day surgery and do not require hospital admission. A few hours following the procedure, the patient is allowed to return home, although usually someone else must drive. Depending on the type of anesthesia used, the patient may need to remain NPO (nil per os, nothing by mouth) for several hours prior to the arthroscopy. Before the procedure, the anesthesiologist will ask if the patient has any known

allergies to local or general anesthetics. Airway obstruction is always possible in any patient who receives a general anesthesia. Because of this, oxygen, suction, and monitoring equipment must be available. Cardiac status should be monitored in the event that any abnormalities arise during the procedure.