Arthroscopy is a surgical procedure to diagnose or treat problems in the joints. This procedure is minimally invasive as the surgeon makes a small incision to insert an arthroscope to view inside the joint. This procedure is also known as Keyhole Surgery.
Arthroscopy is used on the knees, ankles, hips, shoulders, wrists and elbows. This procedure is usually a daycare procedure where the patient can be discharged within 24 hours. The recovery after the surgery is generally quick and effortless.
|Alternative Name||Keyhole surgery|
Loose bone fragments, Inflammation in joints, Torn ligaments, Joint scarring
|Benefits of the Surgery||Minimally invasive, Quick recovery, Less pain|
|Treated by||Orthopaedic surgeon|
What is Arthroscopy?
Arthroscopy is a surgical procedure to diagnose or repair a joint's structural problems. In this procedure, a surgeon inserts a narrow tube into a fibre-optic video camera through a small incision (about the size of a buttonhole attached) to view inside the joint and can also repair some types of joint damage with pencil-thin surgical instruments inserted through additional small incisions.
Arthroscopy is most commonly done for the following joints
Anatomy and Physiology of Joints in the Human Body
A joint in the human body is a point where two bones lay adjacent to each other (with or without the ability to move). The joints have been classified based on functionality (the range of motion) and histologically (the type of tissue that holds two adjacent bones together).
Histologically the joints in the body are classified as:
- Fibrous joint: It is a fixed joint where fibrous tissue comprised primarily of collagen connects bones. They are usually immovable (synarthroses) and have no joint cavity.
- Cartilaginous joint: It is the joint in which the bone is attached by hyaline cartilage or fibrocartilage. These joints can be slightly mobile (amphiarthroses) or immobile (synarthroses).
- Synovial joint: They are the main functional joints of the body. They are freely mobile (diarthroses). These joints are characterized by a cavity filled with synovial fluid, secreted by the synovial membrane (synovium).
Functional classification of joints includes:
- Hinge joint: This joint is uniaxial which means the joint only allows movement in one direction (like a hinge of the door), such as a knee and elbow joint.
- Pivot joint: The joint also known as rotary joint is characterised by one bone that can rotate within the ring formed by the second bone, such as the joint between the first and second vertebrae in the neck.
- Saddle joint: This is a biaxial joint which means the joint allows movement back and forth and side to side, such as the joint at the base of the thumb. This joint does not allow rotation.
- Condyloid joint: The joint that allows movement without rotation, such as in the jaw or finger joints.
- Ball and socket joint: This is a multiaxial joint that allows movement in all directions. In such joints, the round head of one bone sits within the cavity of another bone, such as the hip or shoulder joint.
- Gliding joint: This is a multiaxial joint that allows many movements. In this, bones with smooth surfaces slip over one another, such as the wrist joints.
Conditions treated with Arthroscopy
Generally, arthroscopy is done by a doctor to help diagnose or treat joint conditions. Below mentioned are some of the common conditions that are treated using arthroscopy are:
- Loose bone fragments
- The cartilage that is damaged or torn
- Inflammation in joints (synovitis)
- Ligaments that are torn
- Joint scarring
- Recurrent shoulder dislocation
- Some problems associated with arthritis
Who needs Arthroscopy?
The doctor may recommend an arthroscopy procedure if a person has an injury or damage to the meniscus, cartilage, tendons and/or ligaments. Arthroscopy may also be an option if someone doesn’t get relief from non-surgical treatments.
How is Arthroscopy performed?
Arthroscopy is typically an out-patient invasive procedure and usually takes about 30 to 45 mins to complete. The procedure is done under anaesthesia (medication used to reduce the sensation in a specific body part). The type of anaesthesia used varies depending on where and for what procedure is being used.
- Local Anaesthesia: The drug is injected below the skin to block sensation in a limited area (e.g. knee). The patient is awake and may feel some pressure or sensation of movement within the joint but no pain.
- Regional Anaesthesia: The drug is injected using a small needle placed between 2 of the spine's lumbar vertebrae. This numbs the bottom half of the body. The patient is conscious, but nothing is felt below the waist.
- General Anaesthesia: The drug is injected intravenously. The patient is unconscious (asleep) and does not feel anything.
The steps involved in the arthroscopy procedure may vary depending on the condition. During an arthroscopy, an orthopaedic surgeon:
- Makes a small incision (one which can be closed with 1 or 2 stitches or sterile adhesive tape) in the skin after appropriately positioning the area to be examined (Positioning may involve fixing the area with a tourniquet and managing the blood flow to the area using pressure cuffs. Sometimes a sterile liquid may also be injected into the area to improve visibility).
- Inserts an arthroscope (a small, thin pencil-sized instrument attached to a camera and light source). This instrument helps magnify and illuminate the structures inside the joint.
- Views the inside of the joint, cartilage, ligaments or tendons by images sent from the arthroscope on a video monitor. The extent or type of injury is then determined.
- If possible, the problem is corrected by making additional small incisions around the joint to insert surgical tools to grasp, cut, grind and provide suction as needed for repairing the joint.
- Removes the arthroscope and other instruments.
- Closes the incision (either with sutures or sterile adhesive tape), and the patient is moved to a recovery room to monitor vitals and post-operative recovery.
- Will monitor the patient’s vitals throughout the procedure.
What to expect before and on the day of Arthroscopy?
Prior to the arthroscopy, the doctor/surgeon will discuss and prepare the patient for the surgery. These steps often involve:
- The patient should discuss any allergies with the doctor.
- While taking instructions about the medications, the patient should ensure that he/she has discussed his/her full medical history, including any supplements or medications the patient takes.
- The patient will be advised to avoid taking certain medications or dietary supplements before the procedure.
- The patient may also be advised to avoid eating solid food 8 hours before the procedure.
- The patient will also be instructed about medications, recovery time and the exercises that the patient needs to do after the arthroscopy.
On the day of Arthroscopy
- The patient will be asked to sign the consent form in the presence of his/her family.
- The patient will be asked to remove his/her street clothes and jewellery and wear a hospital gown or shorts.
- A nurse will place an intravenous catheter in the patient’s hand or forearm and inject a mild sedative.
- Vitals will be monitored.
- The patient will then be shifted to the operation theatre.
What to expect after Arthroscopy?
Usually, arthroscopic surgery doesn’t take long. The patient can go home within a couple of hours after the procedure. The patient may expect the following after the surgery:
The recovery process at the hospital
- Usually, the operating surgeon will remove the dressing the next day of surgery.
- The surgeon may prescribe medication to relieve pain and inflammation. Most patients need very little to no pain medication post the arthroscopy.
- For most patients, daily activities may be resumed within a few days of arthroscopy.
- The puncture wounds (small incisions) and complete joint recovery take several weeks to heal, although arthroscopy is a minimally invasive procedure.
- Physical therapy/rehabilitation and specific exercises may help speed up the recovery and protect future joint function.
- The patient should ensure that someone is available to pick him/her up after discharge as he/she won’t be allowed to drive home alone.
Recovery process/expectation after hospital discharge
- The surgeon may prescribe R.I.C.E. (R=Rest, I=Ice, C=Compression, and E=Elevation) for several days to reduce swelling and pain.
- The patient should use temporary splints, slings, or crutches for comfort and protection.
- Physical therapy/rehabilitation and exercises recommended by the surgeon should be done to regain muscle strength and improve joint function.
- The patient should wear loose clothing for ease and comfort.
First follow-up appointment
- The first follow-up will be scheduled within 2 to 3 weeks after the surgery.
- The doctor will also change the dressing from the incision site.
- The doctor might also change the medication or advise the patient to continue with the previous medication for some more time, depending on the condition and recovery of the surgical area.
- The doctor will advise the patient for further timely follow-ups as well.
Benefits of Arthroscopy
Generally, arthroscopic surgery is a minimally invasive procedure as it occurs through small incisions. The benefits of arthroscopy include:
- Faster recovery
- Less pain
- Minimal blood loss and scarring
Risks and complications of Arthroscopy
Arthroscopy is a relatively safe procedure, but it is a surgical procedure, and just like any other surgical procedure, arthroscopy has few complications associated with it. The risks and complications of arthroscopy include:
- Bleeding or swelling
- Tissue or nerve damage
- Blood clots
- Allergic reactions to anaesthesia
When is consultation with the doctor needed?
The patient can consult the doctor if he/she develops:
- Pain not helped by medication
- Drainage from the incision
- Redness or swelling
- New numbness or tingling
Risks of delayed Arthroscopy
Delaying an arthroscopy procedure can increase the severity of the pain leading to reduced quality of life. Below mentioned are some the common risks of delayed arthroscopy.
- Severe pain in joints
- Inflammation in the joints
- Stiffness in joints
- Tenderness of the joints
- Rheumatoid arthritis
- Frailty in elderly
Cost of Arthroscopy
The cost of arthroscopy ranges from ₹30,000 to ₹80,000. The cost varies based on the following factors:
- Type of arthroscopy surgery
- Age of the patient
- The medical condition of the patient
- The type of hospital facility availed - individual room or shared.
|Procedure Name||Cost Value|
|Arthroscopy||₹30,000 to ₹80,000|
Frequently Asked Questions on Arthroscopy
What are the myths versus facts about arthroscopy?
- Myth: Rehabilitation takes a long time after arthroscopy.
Fact: Every person is different anatomically and physiologically. Some people have underlying health conditions that may take longer to heal. Usually, ligament takes a longer time to heal than bones or muscles because of fewer blood vessels in ligaments. This means that less blood and nutrition to tissue will take a longer time to heal.
- Myth: You will have large scars and stiffness after an arthroscopy surgery.
Fact: Arthroscopy surgery is a minimally invasive procedure thus the scars are very small. The patient may have some stiffness at first, but it subsides eventually.
- Myth: There will be certain limitations when a patient will try to engage him/her in activities after arthroscopy surgery.
Fact: For a patient who wishes to try, no such limit is applicable. If the patient feels like he/she cannot participate in activities after arthroscopy surgery, that is just a myth. The patient can engage him/her in activities willingly without any trouble.
- Myth: A patient needs to take painkillers forever after arthroscopy surgery.
Fact: Generally, the orthopaedic doctor will not suggest a patient consume painkillers regularly until and unless it is urgent. Moreover, during the recovery period, if the patient feels pain, then only the patient needs to consume painkillers.
- Myth: The arthroscopy procedure is very painful.
Fact: Modern medications and modernization have evolved the technique used to treat medical conditions. Now doctors always use anaesthesia based on the operation site so that the patient does not face any pain or sensation during the surgical procedure.
What is arthroscopy?
Arthroscopy is a surgical procedure done to diagnose or treat injury or damage to the meniscus, cartilage, tendons and/or ligaments.
What is the approximate duration of arthroscopy?
Usually, an arthroscopy may take around 30 to 45 minutes to complete.
Who performs arthroscopy?
Skilled and qualified doctors specialised in orthopaedics conduct arthroscopy with our professional assistance.
Is arthroscopy safe?
Arthroscopy is a safe procedure as it is minimally invasive with a faster recovery rate.
How does arthroscopy feel?
Arthroscopy is done under anaesthesia. The type of anaesthesia used varies depending on where and for what procedure is being used. The patient will not feel any pain or discomfort during the procedure.
What are the advantages of arthroscopy?
Arthroscopy is a daycare outpatient procedure with several benefits. The benefits of arthroscopy include faster recovery, less pain, and minimal blood loss and scarring.
How long does it take to recover from a arthroscopy?
A patient who has undergone arthroscopic surgery takes around 1 week to several months to recover. This can depend on several factors including the joint where the surgery was done, the patient’s age and other medical conditions.
Is arthroscopy painful during surgery?
Because arthroscopy surgery is a surgical procedure and involves a small incisions, it does involve minimal scarring and pain.
What are the risks associated with arthroscopy?
Arthroscopy is a safe and simple procedure, but as it is a surgical procedure, certain risks are associated with the arthroscopy including bleeding or swelling, infections, tissue or nerve damage, blood clots, and allergic reactions to anaesthesia.
What are the serious complications of arthroscopy?
Arthroscopy is usually a safe procedure, but in rare cases, it can cause serious complications such as deep vein thrombosis (formation of a blood clot in the deep vein in one of the limbs), septic arthritis (infection in the joint), and bleeding inside the joints.
Do I have to stay in the hospital after the arthroscopy?
No, the patient can go home on the same day of the surgery. However, in some conditions, the patient may also have to stay are 24 hours in the hospital.
What is the cost of arthroscopy?
The cost of arthroscopy ranges from ₹30,000 to ₹80,000.
Why does the cost of arthroscopy vary for different patients?
The cost of arthroscopy differs due to factors including the type of arthroscopy surgery, the age of the patient, the medical condition of the patient, the type of hospital, and the admission room that a patient opts for.
Does insurance cover arthroscopy?
Yes, all health insurance plans cover arthroscopy. Paperwork is facilitated by our team on your behalf ensuring smooth approval and a cashless facility. Contact HexaHealth for a simple cashless and hassle-free experience.
When will I likely be able to resume your daily activity?
Most patients may resume daily activities within a few days of arthroscopy.