At California Pacific Orthopaedics, we are committed to providing our patients in the San Francisco Bay Area with the most advanced and effective treatments for joint pain and injuries. One of the most common and successful procedures we perform is arthroscopy, a minimally invasive surgical technique that allows our orthopedic surgeons to diagnose and treat a wide range of joint problems.
This page will provide you with a comprehensive overview of arthroscopy, including what it is, why it’s done, and what you can expect before, during, and after the procedure for the wrist, elbow, shoulder, and knee.
Overview: What is Arthroscopy?
Arthroscopy, also known as “keyhole surgery,” is a surgical procedure that allows an orthopedic surgeon to see inside a joint without making a large incision. The name comes from two Greek words: “arthro,” meaning “joint,” and “skopein,” meaning “to look.”
During an arthroscopic procedure, your surgeon will make a few small incisions, about the size of a buttonhole, around the affected joint. Through one of these incisions, they will insert a thin, flexible instrument called an arthroscope. The arthroscope is equipped with a tiny camera and a light source, which project a magnified view of the inside of the joint onto a high-definition monitor in the operating room. This allows your surgeon to get a clear and detailed look at the bones, cartilage, ligaments, and tendons that make up the joint.
If your surgeon identifies a problem, they can then insert specialized surgical instruments through the other small incisions to repair or remove damaged tissue. This could involve anything from trimming torn cartilage to repairing a torn ligament.
Because arthroscopy is minimally invasive, it offers several advantages over traditional open surgery, including:
- Less pain
- Less scarring
- Faster recovery time
- Lower risk of complications
Why is Arthroscopy Done?
Arthroscopy can be used to diagnose and treat a wide variety of conditions affecting the wrist, elbow, shoulder, and knee. Some of the most common reasons for arthroscopy include:
Wrist
- Chronic wrist pain: When the cause of wrist pain is unclear, arthroscopy can be used to get a definitive diagnosis.
- Ganglion cysts: These are small, noncancerous lumps that can form on the wrist and cause pain or limit movement.
- Ligament tears: A fall or other injury can tear the ligaments in the wrist, leading to instability and pain.
- Triangular fibrocartilage complex (TFCC) tears: The TFCC is a cartilage structure on the small-finger side of the wrist that can be torn by an injury.
- Carpal tunnel release: In some cases, arthroscopy can be used to relieve pressure on the median nerve in the wrist, which is the cause of carpal tunnel syndrome.
- Wrist fractures: Arthroscopy can be used to remove bone fragments and realign the bones after a fracture.
Elbow
- Loose bodies: Fragments of bone or cartilage can break off and float around in the elbow joint, causing pain and catching.
- Tennis elbow: This is a condition that causes pain on the outside of the elbow, often due to overuse.
- Stiffness: After an injury or surgery, the elbow can become stiff. Arthroscopy can be used to release scar tissue and improve range of motion.
- Elbow fractures: Similar to wrist fractures, arthroscopy can be used to help repair certain types of elbow fractures.
- Arthritis: In some cases, arthroscopy can be used to remove inflamed tissue and bone spurs in patients with elbow arthritis.
Shoulder
- Rotator cuff tears: The rotator cuff is a group of tendons that surrounds the shoulder joint. Tears in these tendons are a common cause of shoulder pain and weakness.
- Shoulder impingement: This occurs when the rotator cuff tendons are pinched between the bones of the shoulder.
- Labral tears: The labrum is a ring of cartilage that surrounds the shoulder socket. Tears in the labrum can cause pain, instability, and a catching sensation.
- Biceps tendon problems: The biceps tendon can become inflamed or torn, leading to pain in the front of the shoulder.
- Frozen shoulder: This is a condition that causes stiffness and pain in the shoulder joint.
- Shoulder instability: If the shoulder joint is loose and prone to dislocation, arthroscopy can be used to tighten the ligaments and stabilize the joint.
Knee
- Meniscus tears: The meniscus is a C-shaped piece of cartilage that acts as a shock absorber in the knee. Tears in the meniscus are a very common knee injury.
- Anterior cruciate ligament (ACL) tears: The ACL is one of the main ligaments that stabilizes the knee. ACL tears are common in athletes who play sports that involve sudden stops and changes in direction.
- Posterior cruciate ligament (PCL) tears: The PCL is another important ligament in the knee that can be torn by a direct blow to the front of the knee.
- Articular cartilage damage: The articular cartilage is the smooth, white tissue that covers the ends of the bones in the knee. Damage to this cartilage can lead to pain and arthritis.
- Patellar (kneecap) problems: Arthroscopy can be used to treat a variety of kneecap problems, including instability and malalignment.
- Removal of loose bodies: Just like in the elbow, fragments of bone or cartilage can break off and float around in the knee joint.
What to Expect: Before, During, and After Your Arthroscopy
If you and your surgeon at California Pacific Orthopaedics decide that arthroscopy is the right treatment for you, here is a general overview of what you can expect.
Before the Procedure
- Consultation and Evaluation: You will have a thorough consultation with your orthopedic surgeon, who will review your medical history, perform a physical examination, and order any necessary imaging tests, such as X-rays or an MRI.
- Pre-operative Instructions: You will be given specific instructions to follow before your surgery, such as when to stop eating and drinking, and which medications to take or avoid.
- Anesthesia: You will meet with an anesthesiologist to discuss the type of anesthesia that will be used for your procedure. This could be general anesthesia (you will be asleep), regional anesthesia (a specific part of your body will be numbed), or local anesthesia (only the area around the joint will be numbed).
During the Procedure
- Positioning: You will be positioned on the operating table in a way that gives your surgeon the best access to the joint.
- Incisions: Your surgeon will make a few small incisions around the joint.
- Arthroscope Insertion: The arthroscope will be inserted through one of the incisions, and the joint will be filled with a sterile fluid to expand it and provide a clear view.
- Diagnosis and Treatment: Your surgeon will carefully examine the inside of the joint and perform any necessary repairs or treatments.
- Closure: The incisions will be closed with stitches or surgical tape and covered with a sterile dressing.
After the Procedure
- Recovery Room: You will be taken to a recovery room where you will be monitored as you wake up from the anesthesia.
- Pain Management: You may experience some pain and discomfort after the procedure, which can be managed with pain medication.
- R.I.C.E.: You will be instructed to follow the R.I.C.E. protocol for the first few days after surgery:
- Rest: Avoid putting weight on the affected joint.
- Ice: Apply ice packs to the joint for 20 minutes at a time, several times a day.
- Compression: Wear a compression bandage to help reduce swelling.
- Elevation: Keep the joint elevated above the level of your heart.
- Rehabilitation: Physical therapy is a crucial part of the recovery process. Your physical therapist will work with you to regain strength, flexibility, and range of motion in the joint.
- Follow-up: You will have a follow-up appointment with your surgeon to check on your progress and remove any stitches.
Recovery time varies depending on the type of procedure you have and the joint that was treated. Some people are able to return to their normal activities within a few days, while others may need several weeks or months to fully recover.
Your Trusted Partner in Orthopedic Care
At California Pacific Orthopaedics, our team of board-certified orthopedic surgeons has extensive experience in performing arthroscopic procedures for the wrist, elbow, shoulder, and knee. We are dedicated to providing our patients with the highest quality of care in a compassionate and supportive environment.
If you are experiencing joint pain or have been diagnosed with a condition that may require arthroscopy, we encourage you to schedule a consultation with one of our specialists. We will work with you to develop a personalized treatment plan that will help you get back to the activities you love.
Contact us today to schedule an appointment at one of our convenient locations in the San Francisco Bay Area.
