Athroscopy Definition Arthroscopy (ahr-THROS-skuh-pee) is a procedure for diagnosing and treating joint problems.

During arthroscopy, a surgeon inserts a narrow tube containing a fiber-optic video camera through a small incision about the size of a buttonhole. The view inside your joint is transmitted to a video monitor. Arthroscopy allows the surgeon to see inside your joint without having to make a large incision. Surgeons can even repair some types of joint damage during arthroscopy, with pencil-thin surgical instruments inserted through additional small incisions. Why it's done Doctors use arthroscopy to help diagnose and treat a variety of joint conditions, most commonly those affecting the: Knee Shoulder Elbow Ankle Hip Wrist

Choose loose clothing. Wear loose, comfortable clothing baggy gym shorts, for example, if you're having knee arthroscopy so you can dress easily after the procedure.

What you can expect Although the experience varies depending on why you're having the procedure and on which joint is involved, some aspects of arthroscopy are fairly standard. You'll remove your street clothes and jewelry and put on a hospital gown or shorts. A nurse will place an intravenous catheter in your hand or forearm and inject a mild sedative.

During the procedure The type of anesthesia used varies by procedure. Local anesthesia. Numbing agents are injected below the skin to block sensation in a limited area, such as your knee. With local anesthesia, you'll be awake during your arthroscopy, but the most you'll feel is pressure or a sensation of movement within the joint. Regional anesthesia. The most common form of regional anesthesia is delivered through a small tube placed between two of your spine's lumbar vertebrae. This numbs the bottom half of your body, but you are still awake. General anesthesia. Depending on the length of the operation, it may be better for you to be unconscious during the procedure. General anesthesia is delivered intravenously. You'll be placed in the best position for the procedure you're having. This may be on your back, on your stomach or on your side. The limb being worked on will be placed in a positioning device, and a tourniquet may be used to decrease blood loss and make it easier to see inside the joint. Another technique to improve the view inside your joint is to fill it with a sterile fluid, which helps distend the area and provide more maneuvering room. One small incision will admit the viewing device. Additional small incisions at different points around the joint allow the surgeon to insert surgical tools to grasp, cut, grind and provide suction as needed for joint repair. Each incision will be less than 1/4 inch (7 millimeters) long and can be closed with one or two stitches, or with narrow strips of sterile adhesive tape. After the procedure Arthroscopic surgery usually takes between 30 minutes and two hours, depending on the procedure performed. After that, you'll be taken to a separate room to recover for a few hours before going home. Your aftercare may include: Medications. Your doctor may prescribe antibiotics to prevent infection, as well as medication to relieve pain and inflammation. R.I.C.E. At home, you'll need to rest, ice, compress and elevate the joint for several days to reduce swelling and pain. Protection. You may need to temporarily use splints, slings or crutches for comfort and protection. Exercises. Your doctor may prescribe physical therapy and rehabilitation to help strengthen your muscles and improve the function of your joint.

Diagnostic procedures Doctors often turn to arthroscopy if X-rays and other imaging studies have left some diagnostic questions unanswered. Surgical procedures Conditions treated with arthroscopy include: Risks Complications, though uncommon, may include: Tissue damage. The placement and movement of the instruments within the joint can damage the joint's structures, blood vessels or nerves. Infection. Any type of invasive surgery carries a risk of infection. Blood clots. Rarely, procedures that last longer than an hour can increase the risk of blood clots developing in your legs or lungs. Bone spurs or loose bone fragments Damaged or torn cartilage Inflamed joint linings Joint infections Torn ligaments and tendons Scarring or tissue overgrowth within joints

How you prepare Exact preparations depend on which of your joints the surgeon is examining or repairing. In general, you should: Avoid certain medications. Your doctor may want you to avoid taking medications or dietary supplements that can increase your risk of bleeding. Fast beforehand. Depending on the type of anesthesia you'll have, your doctor may want you to avoid eating solid foods eight hours before your procedure. Arrange for a ride. You won't be allowed to drive yourself home after the procedure, so make sure someone will be available to transport you.

Call your surgeon if you develop:

A temperature of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher Pain not helped by medication Drainage from your incision Redness or swelling New numbness or tingling

physical therapy and muscle strengthening to stabilize the knee joint. Introduction to the knee The knee is the largest joint in the body. The knee allows the leg to bend where the femur (thighbone) attaches to the tibia (shinbone). The knee flexes and extends, allowing the body to perform many activities, from walking and running to climbing and squatting. There are a variety of structures that surround the knee and allow it to bend and to protect the knee joint from injury.

In general, you should be able to resume desk work and light activity in a week, and more strenuous activity in about four weeks. Remember, however, that your situation may dictate a longer recovery period, along with rehabilitation. Results Your surgeon will review the findings of the arthroscopy with you as soon as possible. You may also receive a written report, as may your primary physician. After arthroscopic surgery to treat a joint injury or disease, healing may take several weeks. Your surgeon will monitor your progress in follow-up visits and address any problems that arise. Meniscectomy Torn meniscus facts The knee is the largest joint in the body. Cartilage within the knee joint helps protect the joint from the stresses placed on it from walking,running, climbing, and bending. The medial and lateral menisci are two large C-shaped cartilages that sit on the top of the tibia. A torn meniscus occurs because of trauma caused by forceful twisting or hyper-flexing of the knee joint. Symptoms of a torn meniscus include pain, swelling, popping, and giving way. Treatment of a torn meniscus may include surgery to repair the damage. Some meniscal tears can be watched and treated with

The quadriceps and hamstring muscles are responsible for moving the leg at the knee. When the quadriceps muscles (located on the front the thigh) contract, the knee extends or straightens. The hamstring muscles, located on the back of the thigh, are responsible for flexing or bending the knee. These muscles are also important in protecting the knee from being injured, acting to stabilize the knee, and prevent it from being pushed in directions it isn't meant to go. There are four ligaments that stabilize the knee joint and provide stability during knee movement, the medical and lateral collateral ligaments (MCL, LCL) and the anterior and posterior cruciate ligaments (ACL, PCL). Cartilage within the joint provides cushioning to protect the bones from of the routine stresses of walking, running, and climbing. The medial and lateral meniscus are two thicker wedge-shaped pads of cartilage attached to top of the tibia (shin bone), called the tibial plateau. Each meniscus is curved in a Cshape, with the front part of the cartilage called the anterior horn and the back part called the posterior horn. There is also articular cartilage that lines the joint surfaces of the bones within the knee, including the tibia, femur, and kneecap (patella). The term torn knee cartilage refers to one of the C-shaped menisci of the knee between the femur and tibia.

As with any injury in the body, when the meniscus is damaged, irritation occurs. If the surface that allows the bones to glide over each other in the knee joint is no longer smooth, pain can occur with each flexion or extension. The meniscus can be damaged because of a single event or it can gradually wear out because of age and overuse. Torn Meniscus torn meniscus is one of the most common knee injuries. Any activity that causes you to forcefully twist or rotate your knee, especially when putting the pressure of your full weight on it, can lead to a torn meniscus. Each of your knees has two menisci C-shaped pieces of cartilage that act like a cushion between your shinbone and your thighbone. A torn meniscus causes pain, swelling and stiffness. Your knee might feel unstable, as if it's going to collapse. Conservative treatment such as rest, ice and medication is sometimes enough to relieve the pain of a torn meniscus and give the injury time to heal on its own. In other cases, however, a torn meniscus requires surgical repair. Symptoms If you've torn your meniscus, you may experience the following signs and symptoms in your knee: A popping sensation

Swelling or stiffness Pain, especially when twisting or rotating your knee Difficulty straightening your knee fully or experiencing what feels like a block to movement of your knee, as if your knee were locked in place

Treatments and drugs Initial treatment Treatment for a torn meniscus often begins conservatively. Your doctor may recommend: Rest. Avoid activities that aggravate your knee pain, especially any activity that might cause you to twist your knee. You might want to use crutches to take pressure off your knee and promote healing. Ice. Ice can reduce knee pain and swelling. Use a cold pack, a bag of frozen vegetables or a towel filled with ice cubes for about 15 minutes at a time. Do this every four to six hours the first day or two, and then as often as needed. Medication. Over-the-counter pain relievers also can help ease knee pain. Therapy Physical therapy can help you strengthen the muscles around your knee and in your legs to help stabilize and support the knee joint. Arch supports or other shoe inserts can help to distribute force more evenly around your knee or decrease stress on certain areas of your knee. Surgery If your knee remains painful, stiff or locked, your doctor may recommend surgery. It's sometimes possible to repair a torn meniscus. In other cases, the meniscus is trimmed. Surgery may be done through an arthroscope. During arthroscopic surgery, your doctor inserts an instrument called an arthroscope through a tiny incision near your knee. The arthroscope contains a light and a small camera, which projects an enlarged image of the inside of your knee onto a monitor. Surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee. Recovery time following arthroscopic surgery tends to be much faster than it is for open-knee procedures. You can often go home the same day. Full recovery may take weeks or months, however, and you will need to do exercises to optimize knee strength and stability. Lifestyle and home remedies

When to see a doctor Contact your doctor if your knee is painful or swollen, or you can't move your knee like usual. Causes A torn meniscus can result from any activity that causes you to forcefully twist or rotate your knee, such as aggressive pivoting or sudden stops and turns. Even kneeling, deep squatting or lifting something heavy can sometimes lead to a torn meniscus. In older adults, degenerative changes of the knee may contribute to a torn meniscus. Risk factors Anyone performing activities involving aggressive twisting and pivoting of the knee is at risk of a torn meniscus. The risk is particularly high for athletes especially those who participate in contact sports, such as football, or activities that involve pivoting, such as tennis or basketball. The risk of a torn meniscus also increases as you get older, due to years of wear and tear on your knees. Complications A torn meniscus can lead to knee instability, the inability to move your knee normally, or persistent knee pain. You also may be more likely to develop osteoarthritis in the injured knee. Tests and diagnosis Often, a torn meniscus can be identified during a physical exam. Your doctor may manipulate your knee and leg bones into different positions to help pinpoint the cause of your signs and symptoms. Imaging tests X-rays. Because a torn meniscus is made of cartilage, it won't show up on X-rays. But X-rays can help rule out other problems with the knee that may have similar symptoms. Ultrasound. Ultrasound can allow the doctor to examine the inside of your knee in motion. This can help determine if you have a loose flap of cartilage getting caught between the moving parts in your knee. Magnetic resonance imaging (MRI). MRI uses radio waves and a strong magnetic field to produce cross-sectional images of internal structures. It can create detailed images of both hard and soft tissues within your knee. Arthroscopy In some cases, your doctor may use an instrument known as an arthroscope to study the inside of your knee. The arthroscope is inserted through a tiny incision near your knee. The device contains a light and a small camera, which projects an enlarged image of the inside of your knee onto a monitor. If necessary, surgical instruments can be inserted through the arthroscope or through additional small incisions in your knee.

Avoid activities that aggravate your knee pain especially sports that involve pivoting or twisting your knee until the pain disappears. Ice and over-the-counter pain relievers can help, too. Prevention Exercises to strengthen your leg muscles can help stabilize and protect your knee joints. Start slowly, and increase your intensity gradually. If you participate in recreational sports, use proper form and protective gear