Medical Facts

Arthroscopy is an important surgical test, which is used to diagnose and treat problems within the joint. It is mainly used to examine injuries in the knee but techniques have been developed for surgery in other joints, including the shoulder, hip, ankle, wrist and small joints of the fingers.

Arthroscopy is a ‘keyhole’ operation that is used to look inside a joint so that it can be closely examined.

An arthroscope is a narrow tube with a light source attached to a tiny video camera, which transmits pictures back to a TV monitor. The arthroscope is passed through small incisions (cuts) in the skin and lights up and magnifies the damaged area, so the doctor can see everything inside the joint.

Arthroscopy can be used to investigate conditions like arthritis or symptoms such as pain, joint weakness and damage to cartilage and ligaments. There are also small instruments that can be attached to the arthroscope, if needed, to take any biopsy samples or to cut, trim or remove any loose fragments of tissue, bone or cartilage.

Why should it be done?

Arthroscopy is used when it is necessary to know exactly what is happening within a joint and what can be done to put it right.

Surgery through the arthroscope allows the doctor to look into a place otherwise only easily reached by surgically opening up the joint. The ‘keyhole’ technique is much safer, puts less pressure on the joint surfaces and doesn’t take as long to heal.

Surgeons don't like opening joints widely because they know how sensitive joints are to the slightest infection. Joints can be seriously damaged by infection, so anything that reduces this risk is an advantage.

Surgery performed by arthroscopy rarely has complications and you can usually go home the same day. You can return to your daily tasks more quickly than after other forms of surgery.

Why is it necessary?

Arthroscopy is very helpful when trying to find the cause of a problem.

In many cases, joint problems can be diagnosed using non-surgical methods such as MRI (magnetic resonance imaging) or treated with physiotherapy. Physiotherapy involves a range of treatments, including manipulation, massage, exercise, electrotherapy and hydrotherapy.

However, sometimes X-rays and MRI scans are not always clear enough to make a proper diagnosis e.g. if the problem involves the soft tissues around the bone.

A few reasons why you may need an arthroscopy are:

• there is a need to look inside your joint to find out exactly what is causing your problem e.g. pain, swelling and inflammation,
• you may have a tear in your cartilage (smooth, connecting tissue that covers the ends of bones in a joint),
• you may have torn one of the ligaments (a band of fibrous tissue that connects bones or cartilage),
• you may have a loose piece of bone,
• you have been experiencing unsteady joints, or
• you may have arthritis in one or more of your joints.

Many types of arthritis including rheumatoid arthritis, involve a thickening of an internal membrane called the synovium and the removal of this can be done very easily with an arthroscopy.

How is it performed?

Arthroscopy can be performed using local or general anaesthetic and the operation may last from 30 minutes to over an hour, depending on the amount of work to be done.

The skin over the affected joint will be cleaned with an anti-bacterial fluid then two small cuts will be made - one for the arthroscope and the other for an examining probe or any attachment that is needed to assist with the procedure.

The doctor will watch using an eyepiece or a TV monitor and will carry out any biopsy tests, repair or remove any damaged areas, if possible, during the operation. A sterile fluid may also be used to make viewing of the area easier. Salty water is sometimes used on patients with arthritis to wash out the affected joint, which can relieve symptoms for a few months.

At the end of the procedure the arthroscope and attachments are removed, fluid is drained from the joint and the incisions are closed with paper tapes or stitches, if needed. A sterile dressing is put on and, if necessary, bandages.

You will be asked to rest for a while afterwards, longer if you have had a general anaesthetic and the doctor will make arrangements to discuss the results at a later stage.

Results

Keyhole or arthroscopic surgery is very helpful to patients because it involves a minimally invasive technique, you do not usually have to stay in hospital and there is a shorter recovery time.

Most arthroscopies for sporting type injuries do result in a successful return to sport, however arthroscopies for conditions e.g. arthritis, often only temporarily relieve the symptoms.

In the case of the knee joint, patients with symptoms such as locking from a torn cartilage are currently getting the most benefit from arthroscopic surgery.

Internal washing (therapeutic lavage) results in an improvement that lasts for over a year in the majority of patients.

Recovery

Recovery after arthroscopic keyhole surgery is much quicker than from usual open surgery and patients can go home shortly after the procedure.

Usually the wound is pain-free but you may be given painkillers to take home to ease any discomfort.

Depending on which joint required the procedure, you may need to temporarily use splints, slings or crutches for comfort and protection.

For a couple of weeks after surgery you may experience some swelling and discomfort. This can sometimes last longer if the treatment has been for arthritis.

Most people are able to return to work fairly soon afterwards, usually within a week, but it does depend on the job you do e.g. the time will be longer if your job involves bending, lifting or carrying or will put increased pressure on the joint that has been examined.

A doctor or nurse will advise you of what you need to do after the procedure e.g. rest or exercise and can answer any questions you may have regarding sick notes, certificates etc.

Facts

About 17 in 20 arthroscopic procedures are done on the knee joint, about 2 in 20 involve the shoulder, and a small number are done on other joints including the hip, ankle, elbow, wrist and fingers.

Risks

Arthroscopy is a generally safe procedure and in the majority of cases, is done without any problems.

Any problems that may happen depend on the exact type of operation and other factors, such as your general health.

Some pain and stiffness around the joint are common after surgery but complications are very rare.

They include:

• accidental damage to the joint,
• damage to the structures inside or near to the joint,
• infection of the joint,
• bleeding into the joint,
• unexpected reaction to anaesthetic,
• loss of feeling in the skin around the joint, and
• small scars from the incisions.

More serious complications may happen but again, are very rare. For example, blood clot in the veins of one of the legs (deep vein thrombosis or DVT). Further treatment may be needed, such as antibiotics, to deal with an infection or returning to theatre to stop any bleeding.

Speak to the doctor if you experience any of the following after surgery:

• have pain, swelling, a hot feeling or tenderness in the joint, which gets worse,
• develop a high temperature,
• see fluid, pus or blood coming from the incisions, or
• develop numbness or tingling near to the joint.

How You Will Feel:

Strong pain killers will be required for a few days after surgery. If corrective surgery has also been done, then an extensive period of rehabilitation with input from physiotherapists, occupational therapists and others will be required. However, the outlook after rehabilitation is usually very good.

How Long Will you stay in Hospital after your Arthroscopy?

4 Days as inpatient

What to do next:

We specialise in providing medical care and surgery abroad. We only work with medical institutions that we have inspected and checked. We offer Arthroscopy in both North and South India as well as facilitation on all the other elements in your journey such as flights, accommodation and activities. Our team in India operate as your personal agents while you are in country and is tasked with supporting you in any way you need.

We work with hospitals across the world including France, UK, Canada, India, Pakistan, Malta and Hungary to provide our patients with the most appropriate levels of care and treatment.

We have teams in the UK, India and Pakistan who manage your stay and provide you with support whenever you need it. Please contact us to find out how we can help you. Contact us even if you are at the early stages of considering the possibility of treatment abroad.

WHY TRAVEL FOR ARTHROSCOPY

Travelling abroad for Arthroscopy can give you access to top quality health care quickly and cheaply. Our mission is to make your journey absolutely successful - in terms of treatment, in terms of outcomes and in terms of experience. We offer treatment in a wide range of locations including Europe, India and Singapore.

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