Introduction
Arthroscopy is a minimally invasive surgical procedure used by orthopedic surgeons to visualize, diagnose, and treat problems inside a joint. The term comes from two Greek words, “arthro” (joint) and “skopein” (to look). During an arthroscopy, the surgeon inserts a narrow tube attached to a fiber-optic video camera (an arthroscope) through a small incision—about the size of a buttonhole. The view inside the joint is transmitted to a high-definition video monitor, allowing the surgeon to see the joint’s interior in great detail. Arthroscopy is most commonly performed on the knee, shoulder, elbow, ankle, hip, and wrist. It is frequently used to treat torn cartilage (like the meniscus in the knee), reconstruct torn ligaments, remove loose bone or cartilage fragments, or repair a damaged joint lining. Because it requires smaller incisions than open surgery, patients generally experience less pain, minimal scarring, and a faster recovery.

Surgical Procedure
Arthroscopy can be performed under local, regional (such as a spinal block), or general anesthesia, depending on the joint being examined and the suspected problem.
Once the anesthesia takes effect, the surgeon makes a small incision (portal) near the joint and inserts the arthroscope. Sterile fluid is pumped into the joint to expand it, providing a clearer view and more room for the surgeon to work. The surgeon examines the joint thoroughly using the video monitor to diagnose the issue.
If surgical treatment is necessary, the surgeon makes one or more additional small incisions to insert specialized, tiny surgical instruments. These tools are used to cut, shave, grasp, or anchor tissues. For example, a torn meniscus might be trimmed or repaired with sutures, or a torn ligament might be reconstructed. Once the repair is complete, the fluid is drained from the joint. The small incisions are closed with one or two stitches or sterile adhesive strips (Steri-Strips) and covered with a soft dressing.

Surgical Risks
While arthroscopy is considered a very safe procedure, it still carries standard surgical risks, including adverse reactions to anesthesia, minor bleeding, and a small risk of developing blood clots in the legs, particularly after knee or hip arthroscopy.

General Complications
Common and expected complications during the initial recovery period include:
– Mild to moderate pain and swelling around the joint, which can be managed with rest, ice, compression, and elevation (RICE), along with prescribed or over-the-counter pain medications.
– Stiffness in the joint, which usually improves as swelling subsides and physical therapy begins.
– Bruising around the incision sites.

Rare but Serious Complications
Although rare, serious complications can occur and may include:
– Infection inside the joint (septic arthritis), which is a medical emergency requiring prompt antibiotic treatment and possibly further surgery to clean the joint.
– Damage to blood vessels or nerves surrounding the joint, which can cause numbness, tingling, or weakness.
– Hemarthrosis: Excessive bleeding into the joint space, causing severe pain and swelling.
– Compartment syndrome: A rare but severe condition where pressure builds up in the muscles, restricting blood flow.

Pre-operative Preparation
– Medical Evaluation: A physical examination and review of your medical history are required.
– Medication Management: You may need to stop taking blood thinners, aspirin, or anti-inflammatory drugs several days before the procedure to reduce the risk of bleeding.
– Fasting: If regional or general anesthesia is planned, you will be instructed not to eat or drink for 8 to 12 hours before the surgery.
– Arrange Transportation: Because of the anesthesia, you will need someone to drive you home after the procedure.

Post-operative Care
Arthroscopy is almost always performed as an outpatient procedure, meaning you can go home the same day, usually within a few hours after the surgery. Pain medication will be prescribed. For lower extremity arthroscopy (knee, ankle), you may need crutches for a few days to keep weight off the joint. A physical therapy program is often recommended to restore joint strength and mobility.

Wound Care
– Keep the dressing clean and dry. Your surgeon will tell you when you can remove the bandage and shower, usually after 48 hours.
– Do not soak the joint in a bath, hot tub, or swimming pool until the incisions are completely healed.
– Watch for signs of infection, such as increasing redness, warmth, swelling, or purulent drainage from the incisions.

Diet
Start with a light diet (clear liquids, soup, toast) if you feel nauseous from the anesthesia. You can resume a normal, balanced diet as tolerated.

Post-discharge Notes
Recovery time varies widely depending on the joint involved and the specific repairs made. A simple diagnostic arthroscopy may require only a few days of rest, while a complex ligament repair can take months of rehabilitation.
– Follow your surgeon’s specific instructions regarding weight-bearing and activity restrictions.
– Elevate the joint above heart level for the first few days to minimize swelling.
– Apply ice packs to the joint for 20 minutes at a time several times a day.
– Contact your doctor immediately if you experience a fever, severe pain not relieved by medication, significant swelling, or numbness/tingling in the limb.