A sports medicine physician details what it means to get your hip, ankle, wrist, shoulder or knee scoped.
by Featured Provider Christopher Kim on Monday, June 28, 2021
Follow any sport and you’ll surely find a number of athletes who’ve undergone arthroscopy, or arthroscopic surgery, as it’s commonly known. This procedure is commonplace outside of competition as well. Nearly two million arthroscopic procedures are performed each year on everyone from young athletes to older adults.
Christopher Kim, MD, an orthopaedic surgeon and Sports Medicine specialist at The Iowa Clinic helps contribute to that number every year.
“A lot of procedures are done arthroscopically now because we have very advanced and well-known techniques. Arthroscopy offers a lot of advantages over the open surgeries used in the past,” he says.
So what is arthroscopy?
If you have an injury to your knee, shoulder, hip, wrist or ankle that requires surgery, there's a chance it's going to be arthroscopic surgery. Most people understand that but might know little beyond the fact that it’s a minimally-invasive surgery.
Yes, there are small incisions — about the size of keyholes. But the “scope” part of arthroscopy is what makes the minimally-invasive surgery possible.
“We use a small camera, inserted through one of the small incisions, and can do the whole surgery through those keyholes,” Dr. Kim says.
The camera allows the orthopaedic surgeon to see the joint without having to create a large opening in your skin to do so. Saline water is used to inflate the joint to maintain that visibility.
“We actually inflate the joint with fluid to create enough space for us to work,” Dr. Kim says. “It also pressurizes the joint so it doesn’t get all bloody and red so we can’t see anything.”
What happens during the procedure depends on the joint and the corrective surgery being performed.
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When do you need arthroscopic surgery?
Arthroscopy originated as a diagnostic tool to identify issues or problem areas. These days, sports medicine physicians are adept in their assessments and understand what repair is needed when they go into the procedure.
Almost any joint can be viewed with an arthroscope, but the knee, shoulder, elbow, ankle, hip and wrist are the most common areas for surgery. You might need arthroscopic surgery for a variety of injuries to these joints, including:
“When you come in with pain or a problem, we take a full history and do a physical exam to figure out what it is,” Dr. Kim says. “A lot of our sports medicine procedures can be done arthroscopically. But it depends on what we find. Not every knee or shoulder injury needs surgery.”
What can you expect after arthroscopic surgery?
There are many reasons arthroscopy has surpassed other techniques to repair the joints. The biggest ones are the benefits to the patient.
“There’s a very large difference between a few small 1-centimeter incisions and a 10-centimeter incision to open everything up,” Dr. Kim says. “Sometimes, those big incisions require inpatient surgery. Smaller incisions allow us to do quicker surgeries that allow you to go home.”
The reason you can get in and out of surgery the same day is because arthroscopy takes less of a toll on your body. Which means you have less pain and a smoother recovery.
“Overall, the length of your recovery might be similar. But it’s easier with arthroscopic surgery,” Dr. Kim says. “The smaller holes heal faster and cause less pain. So you can get to physical therapy and get your rehab started earlier.”
There are fewer risks, too. Arthroscopy has lower risks of infection, bleeding and nerve injury, among other potential complications after a big surgery. The only thing you may have to worry about is drainage, Dr. Kim says.
“After arthroscopic surgery, we want the fluid to continue draining out. The majority is removed during arthroscopy, but it continues to drain and may really soak the dressings, or padding, we apply,” he says. “Sometimes people get freaked out about that and think they are bleeding. But it doesn’t happen very often. A lot of times, it’s just a matter of telling us and we’ll reinforce it with a new pad to let it continue to drain.”
Although complications are rare, it’s important to follow up with your orthopaedic surgeon if you do get freaked out by anything like blood or drainage. If you experience any of these issues, call your doctor — they might be a sign of infection, blood clots, nerve damage or some other serious issue:
- Worsening pain
- Numbness or tingling in the joint or elsewhere in the limb
- Severe swelling at the spot of surgery
- Discolored or foul-smelling fluid coming out of the wound
Less than one percent of people have these issues. Most get better, faster, with arthroscopy — giving them a head start in their road to recovery.