Each year, several million Americans undergo arthroscopic surgery to repair cartilage, ligament, and tendon damage, mostly in the knee, shoulder, and hip. For the vast majority of orthopedic complaints, this minimally invasive procedure has replaced traditional open surgeries in successfully treating joint conditions with a lower risk of complications and speedier recovery.
Arthroscopic surgery rapidly became a standard treatment for knee, shoulder, and hip conditions in the mid-1980s. As with any medical innovation, arthroscopic surgery continues to evolve. At New York Bone & Joint Specialists, our arthroscopic surgery specialists stay current with cutting-edge techniques in arthroscopic surgery.
Although we recommend conservative methods to treat joint pain as the first line of treatment, our experienced physicians have the expertise to perform arthroscopic surgery to give you the best chance of a full recovery.
What is Arthroscopic Surgery? Understanding the Procedure
The earliest example of arthroscopic surgery was reported in 1912. In the 1970s, surgical techniques advanced with the invention of a fiber-optic light source combined with television monitors. A decade later, arthroscopic surgery overtook open surgery for most joint reconstruction operations.
Arthroscopic surgery basics
- Incision: Arthroscopic surgery is performed through a series of tiny incisions, about the size of a buttonhole.
- Arthroscope: The main instrument used in arthroscopic surgery is a thin fiber-optic tube that consists of a lens, a light, and a small video camera. The arthroscope is inserted through a small incision to view the joint.
- Real-time visualization: The physician receives a clear image of the joint structure transmitted by the camera onto a monitor. The surgeon can assess the damage and begin repairing the joint.
- Precision instruments: Pencil-thin instruments are inserted into other small incisions around the joint to make the necessary repairs.
- Outpatient procedure: Most arthroscopic surgeries are performed as outpatient procedures.
Benefits of Arthroscopic Surgery
Arthroscopic surgery offers patients numerous benefits:
- Less scarring due to smaller incisions
- Less damage to surrounding tissue
- Less blood loss
- Less post-operative pain and swelling
- Less time spent in recovery – patients can return to normal activities within days
- Minimal chance of complications
- Less expensive than traditional open surgery
Arthroscopic Knee Surgery: Common Procedures and Applications
Arthroscopic knee surgery is among the more common forms of this type of surgery.
Meniscectomy. The meniscus is the C-shaped, rubbery cartilage in the knee that acts as a shock absorber and stabilizer for the joint. Depending on the extent of the meniscus or cartilage tear in the knee, the surgeon will trim the torn fragment or repair it. Most people can return to their normal activities within three days.
ACL reconstruction. The anterior cruciate ligament (ACL) is one of the four major ligaments of the knee that connects the femur (thigh bone) to the tibia (shin bone) and helps stabilize the knee joint. ACL arthroscopy involves reconstructing the torn ligament with a tissue graft. Full recovery from ACL surgery can take up to a year for athletes who frequently suffer ACL tears.
Loose body removal. Arthroscopic surgery can remove small loose bodies of bone and cartilage in the knee joint. Healing can take up to two to four weeks.
Microfracture. The articular cartilage covering the ends of the bones in a joint can become injured and expose the bone. In a microfracture arthroscopic procedure in the knee, the surgeon makes holes in the bone at the base of the articular cartilage, which allows blood to seep into the injured area and form a clot. The clot turns into fibrocartilage and fills in the damaged area. Patients must keep weight off the knee for six weeks.
Arthroscopic Shoulder Surgery: Treating Shoulder Conditions
Shoulder conditions respond well to arthroscopic surgery. Your recovery time will depend on the severity of the damage. The surgery will be followed by physical therapy.
Rotator cuff repair. The shoulder is held together by a network of tendons called the rotator cuff. If a tendon ruptures, the surgeon will reattach the torn tendon through small incisions. The tendon is then held in place with an absorbable anchor for stability.
Labral tear repair. A SLAP (superior labrum anterior to posterior) tear is a rupture in the labrum or cartilage attached to the socket bone in the shoulder. Arthroscopic surgery repairs the tear. Recovery takes up to a year.
Shoulder impingement surgery. Typically affecting athletes like swimmers and weightlifters, shoulder impingement occurs when the tendons in the shoulder become inflamed, usually as the result of a bone spur. To restore full motion to the joint, the surgeon inserts micro-instruments into the shoulder to remove the inflamed bursa (a cushioning sac located in the shoulder joint) and any bone spurs.
Frozen shoulder. The shoulder bones are held together by the shoulder capsule. If it becomes inflamed, the shoulder joint loses range of motion. During an arthroscopic surgery, the surgeon breaks up the scar tissue and adhesions restricting shoulder movement. Recovery time can take six weeks to three months.
Dislocation repair. A shoulder dislocation develops when the ball of the shoulder joint is forced out of its socket. A severe dislocation can benefit from arthroscopic surgery. Patients wear a sling on the shoulder for about a month following the procedure, but it may take up to five months to fully recover.
Biceps tendonitis. Bicipital tendonitis is an inflammation of one of several tendons that connect the biceps to the shoulder. It most commonly affects the upper tendon, which joins the biceps and the socket of the shoulder joint. The condition is often accompanied by other disorders such as rotator cuff tears, labral tears, and shoulder impingement. The condition can be treated with a short arthroscopic surgery. During this procedure, the surgeon will either debride the torn biceps tendon, reattach the tendon to a more secure location on the bone, or simply release the biceps tendon without re-attaching it. Complete recovery can be achieved in four to six months.
Arthroscopic Hip Surgery: Advanced Joint Preservation
The growth in arthroscopic hip surgery has increased in the past decade and currently mirrors the number of knee arthroscopies.
Hip labral tear. A hip labral tear occurs within the labrum, a tough sheath of cartilage surrounding the socket, or acetabulum, of the joint. In an arthroscopic procedure, the surgeon enters the hip joint through a small incision and reattaches the torn labrum with small plastic or metal “anchors” into the joint socket. Crutches are recommended for two to three weeks after surgery. Another option is labral reconstruction for severe tears. The surgeon trims the damaged labrum tissue and attaches healthy tissue obtained from the patient or a donor bank to the acetabulum.
Hip impingement. Also termed femoroacetabular impingement or FAI, the condition refers to abnormal contact and friction between the bones in the hip joint, usually caused by a poor fit between the head of the femur (the ball) and the acetabulum (the socket). Surgeons can arthroscopically remove excess bone growth on the femoral head or modify the shape of the acetabular rim to make the bones fit together properly. Patients will be on crutches for two to three weeks, followed by a physical therapy program.
Removing loose bodies. Pieces of bone or cartilage causing painful locking and catching in the hip are removed in an arthroscopic procedure. Patients use crutches after surgery. A physical therapy program helps restore function to the joint.
Other Arthroscopic Procedures: Comprehensive Joint Care
Arthroscopic surgery is an effective treatment for any joint abnormality.
- Ankle arthroscopy for impingement, ligament tears, cartilage damage, and loose bodies.
- Elbow arthroscopy for tennis elbow, an inflammation in the outer elbow, medically termed lateral epicondylitis.
- Wrist arthroscopy for carpal tunnel syndrome to release pressure on the median nerve in the wrist.
- Spinal arthroscopy for disc conditions (herniated disc, degenerative disc disease).
Innovative techniques in arthroscopic surgery continue to emerge. One newer approach is a knotless, side-to-side and tendon-to-bone suture method for rotator cuff arthroscopies.
Preparing for Arthroscopic Surgery
Before surgery, your surgeon will request that you:
- Get medical clearance from your primary physician
- Discontinue certain medications (such as blood thinners) before surgery
- Refrain from eating and drinking for eight hours before surgery
- Arrange to have someone drive you to the facility and home after surgery due to anesthesia
- Wear loose, comfortable clothing for easier dressing before and after the procedure
Recovery After Arthroscopic Surgery: What to Expect
Anesthesia will be administered either locally, regionally (an epidural in the spine), or as general anesthesia. The procedure typically takes an hour, but could be longer depending on the type of surgery and the extent of the repair. Follow your doctor’s instructions for aftercare:
- Keep the incision clean and covered per the doctor’s orders
- Take showers, not baths
- You may need assistive devices (crutches, sling, or brace) to keep pressure off the joint
- Take nonsteroidal anti-inflammatories to manage pain. Your doctor may prescribe pain medications as well
- Ice and elevate the joint to reduce swelling
How long it takes for a full recovery depends on the surgery. In general, desk work and light activities can be resumed in a few days. A return to strenuous activities may take a few weeks more. The general rule is that patients can drive within one to four weeks.
Your doctor may also recommend physical therapy to strengthen muscles around the joint and promote faster recovery.
Complications and Risks of Arthroscopic Surgery
Although generally safe, arthroscopic surgery carries similar risks to traditional surgery, such as:
- Excessive bleeding and infection
- Blood clots
- Allergic reaction to the anesthesia.
- Swelling
Complications are rare after arthroscopic surgery, but the risks may include:
- Nerve or blood vessel damage
- Recurrent pain or stiffness due to scar tissue formation
- Re-injury
Contact your doctor if you experience:
- Fever
- Pain not helped by medicine
- Drainage from your incision.
- Persistent swelling and stiffness
- A change in skin color
- New numbness or tingling
Arthroscopic Surgery vs. Traditional Open Surgery
Arthroscopic surgery
- Smaller incision for faster healing
- Specialized tools (arthroscope and visual monitor)
- Quicker recovery
- Outpatient procedure
Open surgery
- Larger incision for direct access to the joint
- Recommended for more complex surgeries and joint replacements
- Better option for severe joint conditions and fractures
- May require a hospital stay
Why Choose New York Bone & Joint Specialists for Ankle Arthroscopy in NYC?
New Yorkers have trusted us for decades to provide the safest, most effective arthroscopic surgeries, and our prominence in the field reflects our unwavering commitment to patient well-being and successful outcomes.
- Comprehensive & Compassionate Care: Our world-class specialists provide expert, empathetic guidance throughout your journey, from accurate diagnosis to thorough rehabilitation.
- Prioritizing Joint Health: We understand the critical role healthy joints play in an active and fulfilling life. Your joint health and lasting healing are our top priorities.
- Effective Minimally Invasive Solutions: We successfully resolve many joint issues with advanced orthopedic treatments, often utilizing minimally invasive arthroscopic techniques.
- Dedicated to Full Recovery: We are committed to your complete recovery, always favoring conservative methods and only recommending expert surgical intervention when necessary.
NYC’s Leading Arthroscopic Surgery Specialists
At New York Bone & Joint Specialists, our foundational principle revolves around safeguarding your body’s innate structures, which is vital for enduring arthroscopic surgery recovery. Our commitment to outstanding care ensures that 90% of our patients achieve complete recovery without surgical intervention, thereby securing lasting health, optimal function, and peace of mind.
Make an appointment today
Ready to take the first step toward relief? Schedule an appointment with New York Bone & Joint Specialists and start your personalized recovery plan today.
Frequently Asked Questions About Arthroscopic Surgery
What conditions can be treated with arthroscopic knee surgery?
Damage to the tendons and ligaments of the knee can be successfully treated with arthroscopic knee surgery. That ranges from ACL and meniscus tears to removal of loose bone and cartilage fragments.
How long does arthroscopic surgery take?
Arthroscopic surgery is rather brief, usually an hour. But more complex surgeries may take longer. Arthroscopic surgery is an outpatient procedure, so you’ll leave the same day as the operation.
What are the advantages of arthroscopic over open surgery?
The biggest advantage of arthroscopic surgery is less chance of tissue damage and blood loss due to the smaller incision, which translates into a shorter recovery period. Open surgery requires a larger incision and may necessitate a hospital stay. However, open surgery may be the right choice for more complex joint surgeries and fractures.
How Soon Can I Drive After Arthroscopic Shoulder Surgery?
How soon you can drive depends on the surgery. The general timeline is one to four weeks, but your doctor will consider several factors, including your pain level and mobility restrictions. Don’t drive until pain medications have been discontinued.
After Shoulder Surgery:
- Able to move the arm straight forward and up at a 90-degree angle
- Able to move the arm out to the side, away from the body, at a 90-degree angle
- Full extension of the elbow
- Full function of hands and wrists
- The arms are strong enough to control the car
After Knee Surgery:
- If surgery was performed on your left leg and you drive an automatic transmission car, you may drive within two to three days after surgery
- Driving may be postponed for seven to 10 days if surgery was done on the right leg, orif yo
- The knee and leg are at full strength
- You have full control of the gas and brake pedals
