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What is done in preparation for arthroscopy?
Arthroscopy is essentially a low blood loss procedure and generally has few complications. The underlying health of the patient is considered when determining who is a candidate for arthroscopy. Most importantly, the patient should be able tolerate the anesthetic that is used during the procedure. A person's heart, kidney, liver, and lung function should be adequate. If there are existing problems such as heart failure or emphysema, these should be optimized as possible prior to surgery. Patients who are on anticoagulants (blood thinners) should have these medications carefully adjusted prior to surgery. Other medical problems should also be controlled prior to surgery, such as diabetes and high blood pressure.
Preoperative evaluation of a patient's health will generally include a physical examination, blood tests, and a urinalysis. Patients who have a history of heart or lung problems and generally anyone over the age of 50 will usually be asked to obtain an electrocardiogram (EKG) and a chest X-ray. Any signs of ongoing infection in the body usually postpones arthroscopy, unless it is being done for possible infection of the joint in question.
How is arthroscopy performed?
Arthroscopy is most often performed as an outpatient procedure. The patient will check into the facility where the procedure is being performed and an intravenous line (IV) established in order to administer fluids and medication. The type of anesthesia used varies depending on the joint being examined and the medical health of the patient. Arthroscopy can be performed under a general anesthetic, a spinal or epidural anesthetic, a regional block (where only the extremity being examined is numbed), or even a local anesthetic. If a general anesthetic is not used, the patient is often sedated.After adequate anesthesia is achieved, the procedure can begin. An incision is made on the side of the joint to be examined and the arthroscope is inserted into the incision. Other instruments are sometimes placed in another incision to help maneuver certain structures into the view of the arthroscope. In arthroscopic surgery, additional instruments for surgical repairs are inserted into the joint through additional small incisions in the joint. These instruments can be used to cut, remove, and suture (sew) damaged tissues. Once the procedure is completed, the arthroscope in removed and the incisions are sutured closed. A sterile dressing is placed over the incision and a brace or ACE wrap may be placed around the joint.