What is an arthroscopy?

Arthroscopy is a minimally invasive surgery used to diagnose and treat joint injuries and diseases. Common conditions include damaged cartilage and ligaments. Arthroscopy involves inserting small surgical tools and an arthroscope (a tiny camera) through small incisions. The arthroscope sends pictures of the inside of your joint to a video screen that your doctor watches while performing surgery.

Arthroscopy has risks and potential complications. You may have less invasive treatment options. Consider getting a second opinion about all of your treatment choices before having an arthroscopy. 

Other surgical procedures that may be performed

Your doctor may also perform a biopsy. A biopsy is the removal of a sample of cells or tissue. The sample is tested for cancer and other diseases. 

You may need open surgery (arthrotomy) for a joint condition that your doctor cannot treat with arthroscopy. Open surgery involves making a longer incision that allows your doctor to directly view and treat the joint.

Why is an arthroscopy performed? 

Your doctor may recommend an arthroscopy to diagnose and possibly treat joint conditions of the knee, shoulder, elbow, hip, wrist or ankle. Joints conditions treated by arthroscopy include:

  • Acute and chronic joint pain from such conditions as a torn ligament or arthritis
  • Arthritis, or inflammation of the joint. Both osteoarthritis and rheumatoid arthritis can lead to pain, swelling and destruction of the joint.
  • Carpal tunnel syndrome, which is compression of the median nerve in the wrist
  • Cartilage conditions, such as loose or torn cartilage, meniscal tears in the knee and shoulder, and wearing down or injury of cartilage
  • Frozen shoulder (adhesive capsulitis), which is inflammation of the shoulder joint, or shoulder impingement, which is pinching of a shoulder tendon or bursa, a fluid-filled sac that helps cushion joints
  • Joint infection, which is also called septic arthritis
  • Joint inflammation, most commonly of the knee, shoulder, elbow, wrist or ankle. Inflammation can be caused by a variety of conditions, such as rheumatoid arthritis, bursitis, and lupus.
  • Joint scarring, which can be due to an injury, previous surgery, or chronic inflammation
  • Ligament injuries and conditions, such as anterior cruciate ligament (ACL) tear in the knee and recurrent shoulder dislocations
  • Loose bone and bone spurs, which are abnormal bony growths found most often in the joints. Loose bone and bone spurs are most commonly caused by osteoarthritis. 
  • Tendon injuries and conditions, such as a tear of the rotator cuff tendon in the shoulder and patellar tendon rupture in the knee
  • Tissue biopsy, which involves removing and testing samples of tissues for cancer and other diseases

Ask your doctor about all of your treatment options and consider getting a second opinion before deciding on arthroscopy.

Who performs arthroscopy?

An orthopedic surgeon or podiatric surgeon performs arthroplasty. Orthopedic surgeons specialize in conditions of the bones and connective tissues. Podiatric surgeons are podiatrists who specialize in foot and ankle surgery. 

How is an arthroscopy performed?

Your arthroscopy will be performed in a hospital. Your surgeon will insert an arthroscope through a small incision near or over the joint. A camera attached to the arthroscope allows the surgeon to see the joint on a video screen during surgery. Your surgeon will examine and repair joint damage with special instruments as needed. You may need more than one small incision, depending on your condition.

Types of anesthesia that may be used

Your surgeon will perform your arthroscopy using either general anesthesia or regional anesthesia, depending on the specific procedure: 

  • General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the surgery and do not feel any pain. You may also receive a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.
  • Regional anesthesia is also known as a nerve block. It involves injecting an anesthetic around certain nerves to numb a large area of the body. You will likely have sedation with regional anesthesia to keep you relaxed and comfortable.