Arthroscopic Surgery

Arthroscopy, also referred to as Arthroscopic Surgery, involves the use of a small telescope, called an arthroscope, to look inside joints, and sometimes around them. Joints most amenable to arthroscopic surgery include the knee, shoulder, elbow, hip, ankle, and wrist.

Arthroscopes are currently offered by several manufacturers and vary somewhat in size, especially length, but are usually no thicker than a standard sized pencil. They are inserted through small (approximately ¼ to ½ inch) incisions called “portals” and display the image seen by the scope in real time on a view screen similar to a standard computer display. Other instruments of similar size are inserted through a portal other than the one occupied by the arthroscope in order to probe, excise, or repair tissue under direct visualization by the arthroscope. Because the field of view of the arthroscope is rather limited, sometimes visualization needs to be performed through different portals in order to get a complete picture of all important structures visible in the joint. Therefore, most arthroscopic procedures require two or more portals.

Arthroscopy has several advantages over open surgery. It allows excellent illumination with magnification of structures deep within joints. Yet arthroscopic portals leave much smaller scars than traditional open surgical approaches. Because of the less invasive nature of arthroscopic procedures, they are associated with less postoperative pain and therefore easier and usually quicker rehabilitation compared to open surgery. However, performing a procedure with arthroscopic means does not much alter the healing rate of repaired or reconstructed tissues. So even if there is less pain with an arthroscopic repair compared to an open repair, activity restrictions after surgery may not always be shorter or to a lesser degree. Also, there are some procedures that cannot be performed arthroscopically. Only a surgeon skilled in arthroscopic surgery can help determine if the best method to treat a particular surgical problem involving a joint is through arthroscopy or a traditional open approach.

Note:  Sometimes people mistake arthroscopic surgery for laser surgery. Although lasers have been used in a limited way in some arthroscopic procedures, they really offer little advantage over other current techniques. Actually, several significant complications have been associated with the use of lasers during arthroscopic procedures.