Arthroscopy: Preparation, Procedure and Recovery

Waking up with joint pain can disrupt daily life by limiting mobility, causing morning stiffness, and making routine tasks challenging. While traditional open surgery was once the only option, modern medical technology now offers a less invasive solution: arthroscopy. This comprehensive guide explains everything readers need to know about arthroscopy, from preparation and procedure details to recovery expectations. Whether someone is considering this procedure or has already scheduled their surgery, this information will help them understand what lies ahead and prepare accordingly.

What is Arthroscopy?

Modern surgical techniques have made joint preserving treatments more precise and less invasive. Arthroscopy works through tiny incisions about the size of a buttonhole, where surgeons insert specialised instruments with a camera and light (arthroscope) connected to a video screen. This setup allows them to see inside the joint in real time, making precise diagnoses and repairs possible. The camera sends detailed images to a high-definition monitor, allowing surgeons to examine the entire joint area thoroughly.

Why do Doctors Choose Arthroscopy over Traditional Surgery?

This minimally invasive surgical procedure offers several advantages over traditional open surgery:

• Smaller incisions that heal faster (only 1cm)
• Less damage to surrounding tissues
• Reduced risk of infection
• Better cosmetic results with minimal scarring
• Quicker return to daily activities

Most patients can go home within 1-2 hours after the procedure, and many return to normal activities within days.

Common Conditions Treated with Arthroscopy

Arthroscopy helps doctors diagnose and treat various joint problems, including:

• Torn rotator cuff tendons in shoulder 
• Meniscal tears in the knee
• Anterior cruciate ligament (ACL) injuries in knee 
• Shoulder dislocation/Bankart Articular
• Joint inflammation
• Loose bone fragments

The procedure is particularly effective for treating conditions that haven't improved with non-surgical treatments like medications, physical therapy, or steroid injections.

Pre-surgery Preparation

Adequate surgical preparation plays a crucial role in ensuring a successful arthroscopic surgery. Patients need to follow specific instructions and take several essential steps in the weeks leading up to their procedure.

Essential Steps Before Your Procedure

The preparation process begins several weeks before the surgery date. Patients need to schedule a pre-operative physical exam with their primary care physician to ensure they're in good health for the procedure. They should stop taking certain medications (such as anti-inflammatory drugs or aspirin) at least one weeks before surgery.

Necessary medication adjustments include:

• Stopping blood thinners and arthritis medications 7-10 days before surgery
• Discontinuing herbal supplements ten days before the procedure
• What to bring to the hospital:

Individuals should arrive at the hospital wearing comfortable, loose-fitting clothing on the day of surgery. They need to bring:

• Comfortable, supportive shoes (no flip-flops or heels)
• Any prescribed medications in their original bottles
• Result papers of all diagnostic procedures
• Insurance cards and identification
• A responsible adult to drive them home

Doctors recommend avoiding harsh scrubbing of the surgical area and removing all jewellery before arriving at the hospital. Patients should also make their homes safer for post-surgical recovery by removing potential tripping hazards like mats and placing frequently used items within easy reach.

On the Day of Surgery 

The day of arthroscopic surgery involves several carefully planned steps, starting when a patient arrives at the hospital. The whole procedure typically takes about 40-45 minutes, though timing can vary based on the specific joint problem being treated.

Step-by-Step Walkthrough of the Procedure

• Patient Preparation: The surgical team begins by appropriately positioning the patient in a semi-seated position or lying on their side. The surgical team cleans the surgical area with an antiseptic solution and prepares the joint for the procedure. 
• Anaesthesia Induction: Types of anaesthesia used:
  • Local anaesthesia: Numbing medication is injected around the joint, leaving the patient awake but pain-free
  • Spinal/Regional anaesthesia: Medication is administered to numb the lower half of the body while staying conscious
  • General anaesthesia: The patient sleeps through the procedure
  • The choice of anaesthesia depends on various factors, including the specific procedure and patient preference.
• Incision: The surgeon makes two or three small incisions, about the size of a buttonhole, and inserts specialised instruments, including the arthroscope. A special fluid is pumped into the joint to provide a clear view of the area.
• Inspection of the Joint: The surgeon examines the joint to identify damage, inflammation, or abnormalities.
• Treatment Implementation: The surgeon performs procedures like removing damaged tissue, repairing ligaments, or smoothing cartilage. After treatment, the surgeon uses sterile fluid to clear debris and improve healing. 
• Incision Closure: The surgeon removes the arthroscope and surgical instruments from the incisions and closes the incisions with stitches and sterile bandages.
• Recovery Room: After surgery, patients are moved to a recovery area where medical staff monitors their vital signs. The recovery period typically lasts one to two hours. During this time, doctors manage post-operative pain and ensure the patient responds well to the procedure. Most patients can go home the same day, though they need someone to drive them. Recovery room staff will also provide specific instructions about wound care, pain management, and activity restrictions before discharge.

Recovery after Arthroscopy

Recovery after arthroscopic surgery requires patience and dedication. While the procedure is minimally invasive, following proper recovery guidelines ensures optimal healing and return to normal activities.

The First Week after Surgery

The initial week focuses on managing swelling and beginning basic movements. Patients should regularly apply ice packs and keep the leg above the heart. Most individuals can walk normally without a brace or crutches within an hour after the procedure, though some may need support for balance. Regular exercise sessions lasting 20-30 minutes, 2-3 times daily, help maintain muscle strength. We allow full weight bearing after knee, all reconstructive surgery, though patients should consult their treating doctors 

Physical Therapy and Exercises

Physical therapy forms the cornerstone of recovery, beginning immediately after surgery. The doctors typically recommend the following exercises:

• Quadriceps setting - tightening thigh muscles while keeping the knee straight
• Heel slides - sliding the heel backwards to bend the knee
• Straight leg raises - lifting the leg while keeping the knee straight
• Ankle pumps - flexing the foot to promote circulation

Following their therapist's guidance, patients should perform these exercises for approximately 20-30 minutes. If the knee swells or hurts after specific activities, patients should limit or stop that exercise until they feel better.

Return to Daily Activities Timeline

Recovery milestones vary based on individual healing and the specific procedure performed. Office workers can typically return to work within 2-3 days, while those with physically demanding jobs may need up to 4 weeks off. Driving can resume once patients stop taking pain medication and can control the vehicle safely. Most patients can begin light daily activities within a few weeks, but complete recovery may take between 4 to 6 weeks. Patients typically wait 3 months for more demanding activities like sports before returning to full participation.

Conclusion

Successful arthroscopic surgery depends on proper preparation and dedicated follow-through during recovery. Patients who follow their doctor's pre-operative guidelines and commit to their physical therapy programme after surgery often experience the best outcomes. Most people return to desk jobs within days, while complete recovery for more demanding activities typically takes 6-8 weeks.

FAQs

1. How long does recovery from arthroscopy typically take? 

Recovery time varies and depends on the joint treated and individual factors. Most patients can start light activities within a few weeks, but complete recovery usually takes 6 weeks. For more demanding activities like sports, a 3 month wait is common before full participation.

2. What are the main advantages of arthroscopic surgery over traditional open surgery? 

Arthroscopy offers several benefits, including smaller incisions, minimal pain, faster healing, less tissue damage, reduced infection risk, minimal scarring, and a quicker return to daily activities. Most patients can go home within 1-2 hours after the procedure.

3. What types of joint problems can be treated with arthroscopy? 

Arthroscopy is effective for diagnosing and treating various conditions, including torn rotator cuffs, meniscal tears, ACL injuries, Shoulder dislocation, HIPAVN, joint inflammation, and loose bone fragments. It's beneficial for issues that haven't improved with non-surgical treatments.

4. What kind of anaesthesia is used during arthroscopic surgery? 

Patients have several options: local anaesthesia (numbing the joint area), regional anaesthesia (numbing the lower half of the body), or general anaesthesia (putting the patient to sleep). The anaesthesia choice depends on the specific procedure and patient preference.

5. What should I expect immediately after arthroscopic surgery? 

After the procedure, the surgical staff will shift you to a recovery area where they will monitor your vital signs for 1-2 hours. Most patients can go home the same day. You will receive guidelines on wound care, pain management, and activity restrictions before discharge.