Arthroscopy [3]

Arthroscopy has dramatically changed our approach to the diagnosis and treatment of a variety of joint ailments. A high degree of clinical accuracy, combined with low morbidity and infrequent complications, has encouraged the use of the arthroscope to assist in diagnosis, to determine prognosis, and to provide treatment. The advantages of arthroscopic surgery far outweigh the disadvantages.

Complications during or after arthroscopy are infrequent and are usually minor. Most are preventable with good preoperative planning. Damage to articular structures is probably the most common complication. There are risks associated with anesthesia or postoperative medications. Thrombophlebitis is potentially the most dangerous risk. Fortunately, these complications rarely occur with routine arthroscopic procedures.

Advantages of Arthroscopy

Arthroscopy offers several advantages when compared to other surgical techniques. Key advantages that benefit surgeons and patients are:

• Smaller incisions
• Reduced hospital cost
• Reduced complication rate
• Improved follow-up evaluation
• Reduced postoperative morbidity
• Less intense inflammatory response
• Improved thoroughness of diagnosis

Disadvantages

The disadvantages of arthroscopy are few, but they may be significant to the individual surgeon. Not every surgeon has the temperament or skill to perform arthroscopic surgery, because it requires working through small portals with delicate and fragile instruments. Arthroscopic procedures can be extremely time consuming. Also, the specialized equipment required is extensive and expensive. These disadvantages can be important to the surgeon, but the advantages to the patients far outweigh them.

What are the Risks of Arthroscopic Surgery?

Like all surgical procedures, arthroscopy has potential risks. In general, arthroscopy requires anesthesia, and there are risks associated with anesthesia. Different types of drugs are given during and after arthroscopy that may cause an unpleasant or unpredictable reaction.

The arthroscopic procedure itself can result in damage to the joint structures or damage to nerves and blood vessels around the joint. Infection of the joint or soft tissues around the joint can occur after arthroscopy and may require additional operations to drain or treat the infection. Infection rates are generally lower after arthroscopic procedures due to smaller incisions, shorter operations, and the fact that the joint is constantly being flushed out during the procedure.

Blood clots (thrombophlebitis) can sometimes occur after arthroscopy. Thrombophlebitis occurs when the blood in the large veins of a limb forms blood clots. This may cause the limb to swell and become warm to the touch and painful. If the blood clots in the veins break apart, they can travel to the lung, where they get lodged in the small blood vessels of the lung and cut off the blood supply to a portion of the lung. This is called a pulmonary embolism. Pulmonary means lung, and embolism refers to a fragment of something traveling through the vascular system. Most surgeons take preventing thrombophlebitis very seriously. There are many ways to reduce the risk of clotting, and it is uncommon following most routine arthroscopic procedures.

What should I do after Arthroscopic Surgery?

You will be given specific instructions about what to do after your arthroscopy depending on what type of procedure you had performed. In general, you should take it easy for several days following surgery. Watch for any signs of infection such as fever or chills, redness around the incisions, increasing swelling, or fluid build-up around the joint. If you experience any of these post-surgical symptoms, contact your doctor immediately.