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Arthroscopy How the Test is Performed:
Typically, this procedure is performed on the knee joint. A local or regional anesthetic is administered, and the area is cleaned with antiseptic soap. A pressure band may be applied to restrict blood flow.
An incision is made above the joint and sterile fluid is introduced into the joint space to provide a better view. Next, a small incision is made on one side of the joint and the arthroscope is inserted. The inside of the joint may be viewed through the eyepiece or the image can be reproduced on a screen. The tube may be used to introduce fluid, remove floating bits of cartilage or bone, take a tissue biopsy , or perform minor surgery.
The procedure is similar for the shoulder except for the band used to restrict blood flow.
The average length of time for a diagnostic or simple arthroscopy (not requiring surgery during the procedure) is about 1 hour.
How to Prepare:
You must sign an informed consent form must be signed. Fast overnight before the test (to minimize effects of the anesthetic). You will be instructed if you need to shave your joint area. You may be given a sedative before leaving for the hospital.
The joint must be accessible, so special clothing may be required (shorts for a knee or ankle arthroscopy or a hospital gown for a shoulder exam).
Make arrangements for transportation from the hospital and for work, child care, and other commitments.
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:
How it Feels:
The injection may sting, but once the anesthetic has taken effect, there is no pain.
The joint may 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 (walking) can be resumed immediately, however excessive use of the joint may cause swelling , pain, and increase the chance of injury. Depending on the diagnosis, there may be other exercises or restrictions.
Risks:
- swelling
- increased pain
- localized inflammation
- infection ( fever )
There is a slight risk that the arthroscope may: - perforate tissue
- tear a ligament or muscle
- cause excessive bleeding (especially if a biopsy is performed)
Why this Test is Performed:
This test is performed when there is: - 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
An arthroscopy can help monitor the progression of a disease or determine if a treatment is working.
Normal Values:
There should not be any torn muscles or ligaments, bone fragments , or bleeding . The joint should have a full range of motion. An arthroscopy is not performed unless there is a problem, so there are rarely normal results.
Abnormal Results:
Cost:
The average cost for a knee arthroscopy is $500 to $1,000. The shoulder costs an extra $100 to $200, and the other joints usually cost under $500.
Special Considerations:
The diagnostic accuracy of an arthroscopy is about 95 to 98%, however, X-rays are typically taken first because they are a noninvasive .
Ice is commonly recommended after the 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, there may be instructions given 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.
Arthroscopy allows for the visualization of the interior of a joint through the use of optic instruments. Surgery can now be performed on larger joints using direct visualization and miniaturized techniques. After this procedure, the person can often go home the same day.
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