Bone, Muscle, & Joint
Surgical Procedures
Contributed byKrish Tangella MD, MBAMar 06, 2018

Background Information:

What are the other Names for the Procedure?

  • Arthroscopic Procedure
  • Arthroscopic Surgery
  • Arthroscopy, NOS (Not Otherwise Specified)

What is Arthroscopy surgical procedure?

  • Arthroscopy involves the visual examination of a bone joint with a camera
  • This will not only help in the diagnosis, but also in the treatment of certain conditions

What part of the Body does the Procedure involve?

An Arthroscopy is performed on the joints; more commonly on the knee and shoulder joints.

Why is the Arthroscopy surgical procedure Performed?

An Arthroscopy is performed for the following reasons:

  • For diagnosis of a disease or injury to the joint
  • Removal of bone and/or cartilage
  • Repair of tendons or ligaments

What are some Alternative Choices for the Procedure?

  • Depending on the severity of the condition, one may choose non-surgical options too, which includes medication, exercises, physical therapy, non-steroidal anti-inflammatory medications (NSAIDs), periodic cortisone injections (excess dose of cortisone may lead to adverse effects)
  • If the condition worsens, joint replacement surgery is considered a good alternative
  • Arthroscopy is currently the best option available

What are the Recent Advances in the Procedure?

Arthroscopy involves the use of certain techniques to treat joint related ailments. Considering the method of diagnosis and treatment, Arthroscopy is an advancement in itself.

What is the Cost of performing the Arthroscopy surgical procedure?

The cost of Arthroscopy procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused by the information regarding Arthroscopy and on what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required

What are some Helpful Resources?

Prior to Arthroscopy surgical procedure:

How is the Arthroscopy surgical procedure Performed?

  • An incision is made on either sides of the joint (depending of the severity of the problem multiple incisions can be made), to get a complete visual picture of the affected joint
  • An arthroscope is next inserted through the incision to achieve a complete diagnosis and/or repair the joint
  • Post diagnosis and/or repair of the bone joint, the arthroscope is withdrawn and the skin closed with sutures and bandaged

Where is the Procedure Performed?

An Arthroscopy is performed in a hospital or at an out-patient facility. The patient is admitted, undergoes the procedure and is discharged as per the instruction of the physician.

Who Performs the Procedure?

The surgery is usually performed by an orthopedic surgeon assisted by an anesthesiologist.

How long will the Procedure take?

An Arthroscopic surgery may take anywhere between 30 minutes to 4 hours, depending on the severity of the problem and whether there is a need to repair the joint.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the surgical procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently, taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members, have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing, if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part, of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding and it may be recommended to discontinue them for a period of time, before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area, prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products, for a while, before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • The patient must avoid eating or drinking at least 8 hours prior to the surgical procedure, depending on when the procedure is arranged
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

A physician will request your consent for an Arthroscopic procedure using an Informed Consent Form.

What is the Consent Process before the Procedure?

A physician will request your consent for an Arthroscopic procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Arthroscopy surgical procedure?

Before an Arthroscopy, the patient may have to undergo certain tests, which maybe the following:

  • Routine blood and urine analysis
  • X-ray of the joint
  • MRI of affected joint 

The physician may suggest further tests depending on the health of the patient and their medical history.

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is an Arthroscopy?
  • Why is this procedure necessary?  How will this procedure help?
  • What does the procedure involve?
  • What choices do I have, apart from Arthroscopy?
  • Can oral medications solve the problem?
  • What are the risks while performing the procedure?
  • What are the complications that might take place, during recovery?
  • Are there any follow-up tests, periodic visits to the healthcare facility required, after the procedure?
  • Will I need post-surgery therapy?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you performed?
  • What are the costs involved?

During the Arthroscopy surgical procedure:

What kind of Anesthesia is given, during the Procedure?

Usually local or spinal anesthesia and in some cases, general anesthesia is administered. When general anesthesia is necessary, the procedure is usually performed at a hospital surgery facility.

How much Blood will you lose, during the Procedure?

Arthroscopy is a minimally invasive surgery; hence there is little, or no blood lost during the procedure.

What are the possible Risks and Complications during the Arthroscopy surgical procedure?

The possible complications that may arise during an Arthroscopy are:

  • Infection
  • Damage to neighboring tissues
  • Excessive bleeding
  • Blood clot formations

What Post-Operative Care is needed at the Healthcare Facility after the Arthroscopy surgical procedure?

At the healthcare facility, generally there is no requirement for any post-procedure care, unless any complications arise.

After the Arthroscopy surgical procedure:

What are the possible Risks and Complications after the Arthroscopy surgical procedure?

Post Arthroscopy the following complications may arise:

  • Infection
  • Bleeding into or around the joint
  • Slow healing
  • Swelling
  • Joint stiffness

What is the Prognosis after the Surgery?

  • Recovery from a less invasive Arthroscopic procedure occurs faster, than from a more invasive surgical procedure, such as non-arthroscopic open orthopedic procedure
  • If no repair is performed, then recovery is almost immediate
  • Patients may have to use crutches till the wound is completely healed

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

  • Bleeding and drainage from the surgical wound
  • Pain, swelling and redness around the wound
  • Signs of infection like fever, nausea, dizziness and so on
  • Any other related symptoms

What Post-Operative Care is needed at Home after the Arthroscopy surgical procedure?

At home, the following post-operative care is recommended, after an Arthroscopic procedure:

  • Complete the course of oral medication, as prescribed by the surgeon
  • Keep the wound clean and dry; while bathing, wash the wound with a soap
  • Physical therapy
  • Avoid strenuous exercise for 6 weeks
  • Use a heat pad or warm compress to relieve pain due to the incision

How long does it normally take to fully recover, from the Procedure?

It takes about 6 weeks to 3 months to fully recover from the surgery, if a repair is performed.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed, as per the standard medical procedure. 

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

  • The tissue removed is processed in the laboratory under a pathologist's supervision
  • Slide(s) are prepared once the tissue is processed and this is examined by a pathologist and a pathology report issued
  • Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Arthroscopy surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers. 

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

  • The outpatient facility or hospital
  • An orthopedic surgeon
  • An anesthesiologist (if anesthesia was administered)
  • A pathologist (if the tissue was sent for analysis) 

The patient is advised to inquire and confirm the type of billing, before an Arthroscopic procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

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Krish Tangella MD, MBA

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