Arthroscopy is a method of viewing or performing surgery on a joint by use of an arthroscope, which consists of a tube, a lens, and a light source utilizing fiber optics to visualize the surgical area. A common use for this procedure is knee arthroscopy.

Typically, this procedure is performed on the knee joint. A local or regional anesthetic is administered, which numbs the affected area, but the patient remains awake and able to respond. For more extensive surgery, general anesthesia may be used. In this case the patient is unconscious and pain-free.

The area is cleaned with antiseptic soap. A pressure band may be applied to restrict blood flow (tourniquet). An incision is made into the joint, and sterile fluid is introduced into the joint space to provide a better view. The arthroscope is then inserted, and the inside of the joint is viewed by displaying the image on a monitor.

One or two small additional incisions by the knee may be needed, in order to use other instruments. These instruments can be used to remove bits of cartilage or bone, take a tissue biopsy, or perform other minor surgery. In addition, ligament reconstruction can be performed mostly using the arthroscope in many cases.

The procedure is similar for the shoulder except for the band used to restrict blood flow.

Diagnostic or simple arthroscopy usually lasts about 1 hour.

You should not consume any food or fluid for 12 hours before the procedure. You may be instructed to shave your joint area. You may be given a sedative before leaving for the hospital. You will be given a hospital gown at the time of surgery so the body part for surgery is accessible.

You must sign an informed consent form. Make arrangements for transportation from the hospital and for work, child care, and other commitments immediately after the procedure.

Infants and children:

The physical and psychological preparation you can provide for this or any test or procedure depends on your child's age, interests, previous experience, and level of trust. For specific information regarding how you can prepare your child, see the following topics as they correspond to your child's age:

• Infant test/procedure preparation (birth to 1 year)
• Toddler test/procedure preparation (1 to 3 years)
• Preschooler test/procedure preparation (3 to 6 years)
• Schoolage test/procedure preparation (6 to 12 years)
• Adolescent test/procedure preparation (12 to 18 years)

The injection of local anesthesia may sting, but once the anesthetic has taken effect, there is no pain.

The joint may need to be manipulated to provide a better view, so there may be some tugging on the leg (or arm, if done on the shoulder).

After the test, the joint will probably be stiff and sore for a few days. Slight activity such as walking can be resumed immediately, however excessive use of the joint may cause swelling and pain and may increase the chance of injury.

Depending on your diagnosis, there may be other exercises or restrictions.

• Suspected ligament tear
• Damaged meniscus cartilage
• Evidence of bone fragments
• Joint pain from an injury
• Unexplainable joint pain
• Lesions or other problems detected by X-rays
• Joint disease
• A need for joint surgery

Generally arthroscopy is not performed unless there is a problem, so there are rarely normal results.

If diagnostic arthroscopy is performed, no problem with the cartilage or ligaments is a normal result.

• Torn ligaments
• Bleeding
• Damaged meniscus cartilage
• Bone fragments
• Lesions
• Dislocation
• Broken bone
• Rotator cuff tendonitis

• Swelling
• Increased pain
• Localized inflammation
• Infection (fever)

• Perforate tissue
• Tear a ligament or muscle
• Cause excessive bleeding (especially if a biopsy is performed)

The diagnostic accuracy of an arthroscopy is about 98%, although X-rays and sometimes MRI scans are taken first because they are a noninvasive.

Ice is commonly recommended after arthroscopy to help relieve swelling and pain.

The incision made for inserting the arthroscope is very small, and stitches may not be required. If a bandage is applied, you may be given instructions for changing the dressing.

Normal activity should not be resumed for several days or longer. Special preparations may need to be made concerning work and other responsibilities. Physical therapy may also be recommended.