Diagnostic Arthroscopy

What is Diagnostic Arthroscopy?

Diagnostic arthroscopy is a minimally invasive surgical technique commonly employed to identify problems in a body joint. It plays a crucial role in diagnosing intra-articular disorders of the joint and recommending suitable treatment accordingly. Diagnostic arthroscopy is performed with the aid of a specialised device known as an arthroscope.

An arthroscope is a thin, flexible, fibre-optic tubular instrument made up of a tiny lens, light source, and a video camera. The instrument is inserted through a small keyhole incision into a joint and the video camera transmits the image of the inside of your joint onto a television monitor that enables your surgeon to visually examine the joint and make an accurate diagnosis prior to selecting a surgical option.

Indications for Diagnostic Arthroscopy

Diagnostic arthroscopy is most commonly indicated to diagnose joints conditions pertaining to:

• Knee
• Hips
• Shoulder
• Elbow
• Ankle
• Wrist

Some of the conditions that can be diagnosed with diagnostic arthroscopy include:

• Meniscal (cartilage) injury/tears
• Impingement syndrome of the shoulder
• Recurrent shoulder dislocations
• Rotator cuff tendon injury/tears
• Anterior cruciate ligament (ACL) injury/tears with knee instability
• Carpal tunnel syndrome of the wrist
• Chondromalacia (injury or wear out of the cartilage cushion)
• Floating fragments of cartilage and/or loose bone, especially in the shoulder, knee, elbow, wrist, or ankle
• Inflammation in the knee, hips, shoulder, or elbow, including the synovium (soft tissue that lines the inside of the joint capsule throughout the body).

Preparation for Diagnostic Arthroscopy

Preoperative preparation for diagnostic arthroscopy will involve the following steps:

• A thorough examination by your doctor is performed to check for any medical issues that need to be addressed prior to surgery.
• Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could threaten the safety of the procedure.
• You will be asked if you have allergies to medications, anaesthesia, or latex.
• You should inform your doctor of any medications, vitamins, or supplements that you are taking.
• You should refrain from medications or supplements such as blood thinners, aspirin, or anti-inflammatory medicines for at least a few weeks prior to the procedure.
• You should not consume any solids or liquids at least 8 hours prior to the procedure.
• Arrange for someone to drive you home as you will not be able to drive yourself.
• A written consent will be obtained from you after the procedure has been explained in detail.

Procedure for Diagnostic Arthroscopy

Diagnostic arthroscopy is performed under local, spinal, or general anaesthesia and will involve the following:

• A small keyhole incision is made to insert an arthroscope into the joint.
• To enhance the clarity of the joint structures through the arthroscope, your surgeon will expand the joint with a sterile liquid.
• The liquid flows through the arthroscope to maintain clarity and restrict any bleeding.
• The camera attached to the arthroscope displays the internal structures of the joint on the monitor and helps your surgeon to evaluate the joint and decide on a suitable surgical option.
• Finally, the arthroscope is removed, and the surgical incision is closed with special tape or stitches.

Postoperative Care and Recovery

Diagnostic arthroscopy is an outpatient procedure and hence you will be discharged the same day of your procedure. However, in some cases, you may need an overnight hospital stay to recover. In general, postoperative care instructions and recovery after diagnostic arthroscopy will involve the following steps:

• You will be transferred to the recovery area to be monitored until you are awake from the anaesthesia.
• Your nurse will monitor your blood oxygen level and other vital signs as you recover.
• You may notice some pain, swelling, and discomfort in the joint area. Pain and anti-inflammatory medications are provided as needed.
• Medications may also be prescribed as needed for symptoms associated with anaesthesia, such as vomiting and nausea.
• Keep the incision site clean and dry. Instructions on incision site care and bathing will be provided.
• Refrain from strenuous activities for the first few weeks to promote faster recovery and healing of the joints.
• You will be able to resume your normal activities within a couple of days; however, may have certain weight-bearing activity restrictions.