Arthroscopy is a minimally invasive procedure that allows doctors to examine tissues inside the knee. It is often performed to confirm a diagnosis made after a physical examination and other imaging tests such as MRI, CT or X-rays.
Arthroscopy is performed in a hospital operating room under general anaesthetic.
The arthroscope is a small fiber-optic viewing instrument made up of a tiny lens, light source and video camera. The surgical instruments used in arthroscopic surgery are very small (only 3 or 4 mm in diameter), but appear much larger when viewed through an arthroscope.
The television camera attached to the arthroscope displays the image of the joint on a television screen, allowing the surgeon to look, for example, throughout the knee-at cartilage and ligaments, and under the kneecap. The surgeon can determine the amount or type of injury, and then repair or correct the problem, if it is necessary.
The surgeon makes two small incisions (about 1/4 of an inch), around the joint area. Each incision is called a portal. These incisions result in very small scars which in many cases are unnoticeable.
In one portal, the arthroscope is inserted to view the knee joint. Along with the arthroscope, a sterile solution is pumped to the joint which expands the knee joint, giving the surgeon a clear view and room to work. The sterile solution is regulated by a drainage needle for the amount of fluid in the joint during the procedure.
With the images from the arthroscope as a guide, the surgeon can look for any pathology or anomaly. The large image on the television screen allows the surgeon to see the joint directly and to determine the extent of the injuries and then to perform the particular surgical procedure if necessary.
The other portal is used for the insertion of surgical instruments. A surgical instrument is used to probe various parts within the joint to determine the extent of the problem. If the surgeon sees an opportunity to treat a problem, a variety of surgical instruments can be inserted through this portal. After treating the problem, the portals (incisions) are closed by suturing or by tape. Arthroscopy is much less traumatic to the muscles, ligaments, and tissues than the traditional method of surgically opening the knee with long incisions (arthrotomy).
Sports injuries are often repairable with arthroscopy. Knee injuries that are frequently treated using arthroscopic techniques include meniscal tears, mild arthritis, loose bone or cartilage, ACL and PCL tears, synovitis (swelling of the joint lining) and patellar (knee cap) misalignment.
Because it is minimally invasive, arthroscopy offers many benefits to the patient over traditional surgery. These include:
- No cutting of muscles or tendons
- Less bleeding during surgery
- Less scarring
- Smaller incisions
- Faster recovery and return to regular activities
- Faster and more comfortable rehabilitation
Risks and Complications
Risks related to Arthroscopic knee surgery include:
- Post-operative bleeding
- Deep Vein Thrombosis (DVT)
- Numbness to part of the skin near the incisions
- Injury to vessels, nerves and a chronic pain syndrome
- Progression of the disease process