Arthroscopy

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Read about a professional athlete's rehabilitation from arthroscopic surgery for a torn ACL.

Torn ACL (Anterior Cruciate Ligament) of the Knee

Medical Author: Benjamin C. Wedro, MD, FAAEM
Medical Editor: Melissa Conrad Stöppler, MD

Do people appreciate how amazing it is that Philip Rivers (quarterback for the San Diego Chargers) played on Sun., Jan. 20, 2008, just six days after having arthroscopic surgery? Aside from the fact that he likely had some cartilage debris cleaned out and the rehab time is measured in weeks, he still had a torn anterior cruciate ligament(ACL).

For regular people and pseudo-athletes, the days after arthroscopic knee surgery are spent reducing knee swelling and starting range-of-motion exercises. This process is hampered by a couple of physiologic barriers.

When the knee is invaded, the muscles around it tend to shut down involuntarily. The quadriceps muscle in the front of the thigh tends to get immediately weaker, and since it is one of the stabilizing muscles of the knee, it is a big deal when this muscle decides not to work. The next barrier has to do with hydraulics. The knee joint has its largest volume of fluid when it's flexed at 15 degrees. When there is even a little fluid, straightening it out combats the law of physics that says "you can't compress fluids."

Rivers gets out of surgery and presumably hops into the training room and is attacked by the physical therapists. Appreciate that for mere mortals, physical therapists can be kind and gentle, but when they want the patient to do something, they can become relentless therapists. Pushing the body to its limits is not something regular patients do. Putting it into perspective, a routine course of rehabilitation in the first week might have a patient trying to get the pedals on a stationary bicycle to go around without resistance...once.

Arthroscopy facts

  • Arthroscopy is a surgical procedure that can be performed for diagnosis and/or treatment of joint abnormalities.
  • Arthroscopy is most often an outpatient procedure.
  • Arthroscopy can be performed using general, spinal, regional, or local anesthetic.
  • The surgical incisions required for arthroscopy are several, approximately ¼ inch, on either side of the joint.

What is arthroscopy?

Arthroscopy is a surgical procedure by which the internal structure of a joint is examined for diagnosis and/or treatment using a tube-like viewing instrument called an arthroscope. Arthroscopy was popularized in the 1960s and is now commonplace throughout the world. Typically, it is performed by orthopedic surgeons in an outpatient setting. When performed in the outpatient setting, patients can usually return home on the same day the procedure is completed.

The technique of arthroscopy involves inserting the arthroscope, a small tube that contains optical fibers and lenses, through tiny incisions in the skin into the joint to be examined. The arthroscope is connected to a video camera and the interior of the joint is seen on a television monitor. The size of the arthroscope varies with the size of the joint being examined. For example, the knee is examined with an arthroscope that is approximately 5 millimeters in diameter. There are arthroscopes as small as 0.5 millimeters in diameter to examine small joints such as the wrist.

If procedures are performed in addition to examining the joint with the arthroscope, this is called arthroscopic surgery. There are a number of procedures that are done in this fashion. If a procedure can be done arthroscopically instead of by traditional surgical techniques, it usually causes less tissue trauma, may result in less pain, and may promote a quicker recovery.

Medically Reviewed by a Doctor on 5/19/2015

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