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What Happens Before, During and After Arthroscopy?

  • Patients should become comfortable with crutch walking before an arthroscopic procedure on the knee or other joint of the leg.
  • Complications from arthroscopy are rare, but risks may include infection, swelling, synovial rupture, blood clots, numbness, and joint injury.
  • Patients are typically asked to fast the night before and morning of the procedure.
  • Arthroscopy may be performed using local anesthesia. Patients may feel brief discomfort from the injection and the pressure of the tourniquet on the joint. In some cases, general anesthesia may be given.
  • Just before the procedure, a nurse may shave the area of the joint where the insertion will be made.
  • Monitoring equipment (EKG, pulse oximeter, etc.) may be attached to the patient.
  • Patients under local anesthesia may be given a mild sedative to help them relax during the procedure.

What happens during arthroscopy?

  • An inflatable tourniquet is placed around the joint to be examined.
  • The joint is scrubbed according to standard surgical procedure and a waterproof stocking net is applied.
  • The limb (arm or leg) is elevated and wrapped with an elastic bandage to drain as much blood from the limb and joint as possible.
  • The tourniquet is inflated and the elastic bandage is removed so the local anesthetic can be given. Some surgeons choose not to inflate the tourniquet.
  • The joint is first distended (enlarged or swollen) by injecting a normal saline solution. The joint is irrigated (flushed continuously with a stream of saline) throughout the procedure and joint washings may be collected and examined for loose bodies or cartilage fragments.
  • The endoscope is inserted into the joint through a small incision in the skin. While watching the inside of the joint through the endoscope or on a monitor, the surgeon can probe and examine joint structures to check for damage or disease.
  • Surgical intervention or biopsy may be performed if indicated.
  • When the surgeon has completed the diagnosis and/or treatment, the arthroscope, accessories and irrigating needles are withdrawn and the joint is compressed to squeeze out excess irrigation fluid.
  • Steroids or local anesthetics may be injected into the joint for reduction of inflammation and postoperative pain control.
  • The entry point incisions are closed with sutures (stitches) or adhesive strips, and small dressings are applied to the wounds. Splints or other compressive dressings and immobilizers may then be applied to the extremity.

What Happens After Arthroscopic Surgery?

  • Ice is applied to the joint and the limb should be kept elevated for an initial period to minimize swelling and pain.
  • Patients should not drive or consume alcohol for 24 hours after the procedure.
  • Patients may resume their normal diet after the test.
  • The dressing should be kept clean and dry.
  • Patients should monitor the location of the surgery for signs of bleeding, excessive numbness, tingling, swelling, or abnormal pain and report them to their physician if present.
  • The degree of physical activity and weight bearing on the joint after surgery should be determined by the physician.
  • Exercises and physical therapy are often prescribed after the surgery.

Updated: November 2, 2007