Arthroscopic surgery involves the use of a small telescope, called an arthroscope, to look inside joints. The joints typically amenable to arthroscopic surgery include the knee, the shoulder, the elbow, the ankle, and the hip.
The arthroscope is about the size of a pencil and is inserted into the joint through an incision, usually about ½ inch long (referred to as a portal.) Other instruments of the same size are also inserted into the knee in order to probe, excise, or repair injured tissues. The viewing of the joint through such small instruments requires more than one angle of approach. Therefore, most arthroscopic procedures require two or more portals. Sometimes people mistake arthroscopic surgery for laser surgery. Although lasers have been used in arthroscopic surgery, they currently offer little benefit compared to other techniques. Actually, several complications have been associated with the use of lasers in arthroscopic procedures.
Arthroscopic surgery has many advantages over traditional open surgery. It allows for excellent illumination and magnification of structures deep inside the joints. The small incisions leave much smaller scars than traditional open surgical procedures. Because a large open wound is avoided, patients typically have less pain and can more often be treated as outpatients, allowing them to return to their normal activities quicker. However, arthroscopic surgery does not change the biology of the healing process. As a result, any repair still takes the same amount of time to heal. Although the pain may be less, restrictions on activity may not be different just because someone has had arthroscopic surgery as opposed to traditional open surgery. Also, there are some procedures that cannot be done arthroscopically and do require an open approach. A surgeon who is skilled in arthroscopic surgery can best make the determination of whether the patient is best-suited to an arthroscopic or open surgical procedure.