Overview

Why is it necessary?

An arthroscopy can be done for a number of reasons.

To find the cause of joint problems

An arthroscopy is often done to check what’s causing symptoms such as:

• joint pain
• swelling and stiffness
• joints locking, moving out of position or giving way

You will usually only have this procedure if other types of tests, such as X-rays, have not found anything.

To check the health of your joints

Sometimes a doctor will do an arthroscopy to see how well a joint is working.

This can help if you have:

• damaged your joint, for example a sports injury
• a condition that can damage joints over time, such as osteoarthritis

To repair damage to your joints

Your doctor may be able to repair some joint damage during the arthroscopy.

This can include:

• removing damaged sections of the tough tissue covering the surface of your joint (cartilage)
• repairing tears to the strips of tissue connecting the bones of your joint (ligaments)
• using a sterile liquid to wash out damaged bits of tissue stopping the joint from working properly

Getting ready

After your doctor refers you for an arthroscopy, you’ll get a letter or an email with details of your procedure.

Depending on the type of arthroscopy, you may need to go to the hospital or clinic for a health check before your arthroscopy. This appointment will be on a different day.

During this appointment, a doctor or nurse will check your general health to make sure you're well enough for keyhole surgery.

Before your surgery you'll usually receive information about:

• eating and drinking on the day of your arthroscopy
• stopping or starting any medicines beforehand
• how long you’ll take to recover
• any exercises you need to do after your arthroscopy

Planning for the procedure

You may need to take time off work after an arthroscopy.

It’s normal to have some pain for a few days afterwards, so it’s a good idea to have painkillers, such as paracetamol, at home.

Knee, hip or ankle arthroscopy

If you’re having a knee, hip or ankle arthroscopy you will probably need crutches for a few days and may have problems with stairs.

Driving after an arthroscopy

It will not be safe for you to drive until you can do an emergency stop and your arms are strong enough to fully control the steering wheel. This may take up to several months depending on the type of arthroscopy you are having.

General anaesthetic

If you are having a general anaesthetic (where you’re asleep for the arthroscopy), a friend or family member will need to collect you from the hospital and take you home. Someone will also need to stay with you for at least 24 hours after your arthroscopy.

It’s important not to drink or eat for several hours before a general anaesthetic. The hospital or clinic will give your more information.

Getting ready on the day

Have a shower or bath the morning of your arthroscopy, or the night before. Cleaning your skin will reduce your risk of infection.

Bring any medicines that you usually take to your appointment.

What happens?

On the day of your arthroscopy you may need to stop eating and drinking. Your appointment letter will tell you what to do.

You will also need to bring with you any medicines.

When you arrive

You'll speak with a nurse about what's going to happen, and they’ll ask some questions about your health and medical history, including whether you’re pregnant or could be pregnant.

Giving consent

A nurse or doctor will explain possible risks.

In rare cases, people may:

• have a reaction to the anaesthetic
• have damage to the joint
• get a blood clot
• bleed inside the joint
• get an infection in the joint

You'll be asked to sign a consent form. This is to confirm you understand the risks and agree to have the procedure as discussed.

It's important to remember these things are rare. If anything happens, the team will take care of you.

Type of anaesthetic used

There are 3 types of anaesthetic that can be used during an arthroscopy:

• general anaesthetic, to put you to sleep during the procedure
• local anaesthetic, where you are awake, and medicine is used to numb a joint and the surrounding area
• a spinal anaesthetic, where medicine is used to numb the body below the waist – this may be used if you are having a knee arthroscopy

The anaesthetic you have usually depends on the type of arthroscopy, what joint is involved and your general state of health.

You should be told what anaesthetic is going to be used before the day of your arthroscopy.

The procedure

An arthroscopy usually takes 30 minutes to 2 hours, depending on the type you’re having.

The main steps of an arthroscopy are:

• the surgeon will make a small cut or cuts in the skin, around 2mm to 3mm wide, near the joint
• a tiny camera with a light (an arthroscope) is placed into a cut
• the arthroscope sends images of the inside of the joint to a screen
• the surgeon will repair the joint if needed (you may feel some tugging if you’re awake, but it will not hurt)
• the cut is then sealed with tape or stitches and a dressing may be put on it

After the procedure

After the procedure you will go to a recovery room until you feel well enough to go home. This usually takes a few hours.

If your surgery takes place in the afternoon or evening, and you have a general anaesthetic, you may need to spend the night in hospital.

Getting home

You must not drive for at least 24 hours if you have a general anaesthetic. Someone will need to pick you up from hospital and take you home.

You should also not drive after having an arthroscopy involving your arms or legs, until you have recovered from the effects of surgery. This can take from around a week to several months.

At home

The joint is likely to be painful and stiff. Painkillers like paracetamol can help.

If you had an arthroscopy in one of your legs, you may be given a compression stocking (or similar) to wear to improve blood flow and reduce swelling. Keeping the affected leg elevated when sitting should help.

Applying an ice pack for 20 minutes every 2 to 3 hours to the affected joint may also help with swelling. If you do not have an ice pack you can use a bag of frozen vegetables wrapped in a tea towel.

Keep any dressings as dry as possible by covering them with a plastic bag when you have a bath or shower. Hospital staff will let you know when you can remove the dressing.

Follow advice from the hospital team about what you should or should not do in the days after your arthroscopy, such as when it’s safe for you to drive again.

Contact 111, or the hospital where you had your arthroscopy, if:

You have any of these issues after your procedure:

• a high temperature
• severe or increasing joint pain
• smelly liquid leaking from the cut – the liquid may be white, yellow or brown
• severe swelling or redness in or around the joint which may get worse – the redness may be harder to spot on brown or black skin
• numbness or tingling in or around the joint

Recovery

Recovering from an arthroscopy

It can take from around 1 week to several months to recover fully from an arthroscopy.

This can depend on a number of factors, such as:

• what joint was affected – for example, a knee arthroscopy tends to have a longer recovery period than a wrist arthroscopy
• whether you had any treatment, such as joint repair, during your arthroscopy
• your general state of health

The staff at the arthroscopy unit will be able to give you more detailed information.

Your recovery plan

You’ll usually get a written recovery plan before having an arthroscopy.

You may also have a follow-up appointment with the surgeon after your arthroscopy, where they can make changes to the plan if needed.

The plan will cover when it is safe for you to:

• return to work
• resume daily activities
• exercise
• lift heavy objects
• drive

Generally, you are ready to drive again if you can safely perform an emergency stop and your arms are strong enough to control the steering wheel.

You may need to tell your insurance company about your surgery.

Exercise

Exercise is an important part of your recovery plan.

You may get an information sheet with a series of daily exercises to do at home.

In some cases you may also be referred to a physiotherapist for a few weeks, for further help and support with exercise.