Arthroscopy
The word arthroscopy comes from two Greek words, “arthro” (joint) and “skopein” (to look). The term literally means “to look within the joint.”
In arthroscopic surgery, an orthopaedic surgeon makes a small incision in the patient’s skin, then inserts pencil-sized instruments that contain a small lens and lighting system to magnify and illuminate the structures inside the joint. Light is transmitted through fiber optics to the end of the arthroscope that is inserted into the joint.
By attaching the arthroscope to a miniature camera, the surgeon is able to see the interior of the joint through this very small incision, rather than the larger incision needed for open surgery.
The camera attached to the arthroscope displays the image of the joint on a video monitor, allowing the surgeon to look, for example, throughout the knee. This lets the surgeon see the cartilage, 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.
When is arthroscopy used?
Your bones, cartilage, ligaments, muscles, and tendons can all be damaged by disease and injury. To diagnose your condition, your doctor will take a thorough medical history, perform a physical examination and order imaging studies — usually X-rays. For some conditions, an additional imaging study — such as a magnetic resonance imaging (MRI) scan or a computerized tomography (CT) scan — may also be needed. After making a diagnosis, your doctor will determine the most appropriate treatment choice for your condition.
Conditions
Conditions that are commonly treated with arthroscopic procedures include:
- Inflammation. For example, synovitis is a condition that causes the tissues surrounding the knee, shoulder, elbow, wrist, and ankle joint to become inflamed.
- Acute or chronic injuries, including:
- Rotator cuff tendon tears
- Shoulder impingement
- Recurrent dislocation in the shoulder
- Meniscal (cartilage) tears in the knee
- Chondromalacia (wearing or injury of the cartilage cushion in the knee)
- Anterior cruciate ligament (ACL) tears with instability in the knee
- Carpal tunnel syndrome in the wrist
- Loose bodies of bone and/or cartilage, particularly in the knee, shoulder, elbow, ankle, or wrist
Some problems associated with arthritis can also be treated arthroscopically.
Procedures
The procedures below are performed either with arthroscopy or with a combination of arthroscopic and open surgery:
- Rotator cuff repair
- Repair or resection of torn cartilage (meniscus) from the knee or shoulder
- Reconstruction of the anterior cruciate ligament (ACL) in the knee
- Removal of the synovium in the knee, shoulder, elbow, wrist, or ankle
- Release of the carpal tunnel in the wrist
- Repair of torn ligaments
- Removal of loose bone or cartilage in the knee, shoulder, elbow, wrist, or ankle
Although the inside of nearly all joints can be viewed with an arthroscope, six joints are most frequently examined with this instrument. These are the knee, shoulder, elbow, ankle, hip and wrist. As advances are made in fiberoptic technology and new techniques are developed by orthopaedic surgeons, other joints may be treated more frequently in the future.