Arthroscopy is a less invasive method for the assessment, diagnosis, and treatment of joint problems. In this method, a narrowed tube equipped with a fiber-optic video camera is used to see inside the joint. The inner view of the joint will be shown on a high-resolution monitor. Arthroscopy lets the surgeon see inside the joint without making a big incision. By arthroscopy, surgeons can repair some joint damage by making a small incision with tools as thin as a pencil. In addition, if X-rays and other imaging methods cannot help diagnose, doctors usually use arthroscopy. Diseases that could be treated by arthroscopy include:
• Loosening of bone fragment
• Injury or rupture of cartilage
• Inflammation of the joint covering
• Rupture of ligaments and meniscus
• Injuries inside the joints

In knee arthroscopy, you can observe the joint without making a big incision on the skin and other soft tissues. Arthroscopy is used to diagnose and treat a wide range of knee problems, such as:

• Removal or meniscus or repair its rupture
• Reconstruction of anterior or posterior cruciate ligament rupture
• Removal of inflamed joint tissue
• Removal of a part of damaged joint cartilage
• Removal of a loose piece of bone or cartilage
• Treatment of patellar problems
• Treatment of knee infection

The recovery period of knee arthroscopy depends on its damage. However, after arthroscopy, some people can resume their activity without restriction.

In cases where non-surgical treatments were ineffective on severe shoulder joint pain, doctors may recommend shoulder arthroscopy.

Most shoulder problems are from injuries, excessive use of the shoulder, and erosion caused by aging. Shoulder arthroscopy treats many problems of the tendon, labrum, cartilage, and other soft tissue and relieves the pain.

Shoulder arthroscopy is done for the below problems:

• Rotator cuff repair
• Removal or repairing the labrum
• Repairing ligaments
• Removing inflamed tissue or loose cartilage
• Repairing frequent shoulder dislocation

Less common procedures, such as nerve release, fracture repair, and cyst removal are done by arthroscopy. But some other methods of surgery, such as shoulder replacement, require open surgery with large incisions

Hip arthroscopy is a less invasive procedure that is performed to diagnose and treat hip problems and the soft tissues around them. Hip arthroscopy usually takes about 1.5 to 2 hours; however, depending on the type of method, the operation time could vary.

Hip arthroscopy is performed when the problem is not solved by non-surgical procedures. Such as:

• Stuck hip
• Liberal rupture
• Removal of loose pieces of cartilage inside the hip joint

Ankle arthroscopy can be sometimes used as a replacement for open ankle surgery. If there are pieces of ruptured cartilage or bone chips in an ankle, you might need ankle arthroscopy. Also, if ligaments get injured in case of ankle sprint, arthroscopy is required to assess the extent of injury and treatment, as necessary.

Problems that ankle arthroscopy can help with include:

• Talus cartilage defect
• Anterior and posterior ankle sprains
• Arthritis (synovitis)
• Removal of injured cartilage pieces
• Arthrofibrosis (dry joints)
• Infections
• Ankle fracture
• Tibiotic arthritis

Ankle arthroscopy has a good or excellent result in more than 70-90% of patients.

Arthroscopy is a safe method and usually doesn’t have many complications after the operation. Possible problems include:
• Tissue or nerve damage: Placing and moving tools inside the joint might damage the joint’s structure.
• Infection: Every invasive surgery has the risk of infection.
• Blood clotting: Procedures that take more than an hour increase the risk of blood clotting in the legs or lungs, but this happens rarely.

• You should avoid using medications or dietary supplements that increase bleeding before the procedure.
• Depending on the type of anesthesia, you might not be allowed to eat solid food before 8 hours of the operation.
• You are not allowed to drive after the operation, so you need someone to accompany you.
• Wear loose and comfortable clothes to be easy for you to dress after the operation.

Depending on the diagnosis, you might be locally or generally anesthetized. Then, depending on the area of surgery, you will be in a proper position.

Next to the joint, a small incision is made to insert the arthroscope. Then the joint is filled with a sterile fluid to be easily seen; later, the surgeon examines the joint to diagnose the problem and determine the type of surgery. If your problem can be treated by arthroscopy, the surgeon makes some other small incisions around the joint. Then the surgeon enters the surgical tool into the joint through those incisions. After the procedure, the incisions are sutured. These incisions are small enough to be closed with 1 or 2 sutures or a thin slice of sterile adhesive.

Arthroscopic surgery usually doesn’t take too long. For example, knee arthroscopy takes about 1 hour.

• After the day of surgery, remove the surgical bandage and replace it with small strips to cover the wound.
• The doctor will remove the non-absorbable stitches after 1 or 2 weeks.
• During wound healing, you should keep the wound area dry. This means you should cover it with plastic while taking a shower.
• Taking the prescribed medication for pain control is necessary.
• Performing the RICE method (rest, ice, compression, elevation) will be help reduce pain and swelling.
• You might need to use a splint or crutch temporarily for more comfort and to protect the joint.
• The doctor might prescribe physiotherapy and rehabilitation to help strengthen muscles and improve joint function.
• You can resume background work and light activities a few days after the operation.
• You can drive again in 1 to 3 weeks after the operation.
• You can do hard work in 4 to 5 weeks.

However, the recovery period is not the same for everyone. Depending on your condition, you might need a longer recovery and rehabilitation period.

While arthroscopy is a less invasive and outpatient surgery, the recovery and rehabilitation period are shorter than open surgery. The joint healing process will usually take a few weeks, but it might take months until you get to normal condition. Rehabilitation and special exercises will speed up recovery.

Arthroscopy is a less invasive and effective method for treating joint problems. The final result of this procedure will usually be known about 5 weeks of operation. If you follow the care tips, the desired limb will work many for years. Pain and joint stiffness are usually less in arthroscopy than in open surgery

Arthroscopy cost depends on the type of joint, injury type, and the length of the operation. For example, in America, it costs 5-10 thousand dollars for knee arthroscopy and 4-7 thousand dollars for ankle arthroscopy. In Iran, these operations are performed in a private hospital equipped with modern equipment and skilled personnel for only one-tenth of the price. Knee arthroscopy in Iran costs about $600, and shoulder arthroscopy is between 1,900-3,500 dollars.

Read More: Orthopedics in Iran