| ICD-9-CM: |
| 80.2 - | Arthroscopy |
| 80.20 - | Arthroscopy, Unspecified Site |
| 80.21 - | Arthroscopy, Shoulder |
| 80.22 - | Arthroscopy, Elbow |
| 80.23 - | Arthroscopy, Wrist |
| 80.24 - | Arthroscopy, Hand and Finger |
| 80.25 - | Arthroscopy, Hip |
| 80.26 - | Arthroscopy, Knee |
| 80.27 - | Arthroscopy, Ankle |
| 80.28 - | Arthroscopy, Foot and Toe |
| 80.29 - | Arthroscopy, Other Specified Sites |
| | | |  | | © Reed Group | | |
Arthroscopy literally means "looking into a joint." The procedure involves making a tiny incision near the joint and inserting a thin, flexible, fiberoptic tube with lenses at each end (arthroscope) that works much like a periscope. It is fitted with a light source to illuminate the interior of the joint and a miniature camera that allows images to be displayed on a monitor. The surgeon can either look directly through the lenses into the joint or visualize the joint on a TV monitor. Arthroscopy is about 98% accurate as a diagnostic tool (Joseph).
A common misconception is that the arthroscope is a tool used to perform surgery. The "scope" is used only for visualization; other small instruments must be inserted into the joint through additional small incisions to actually perform the surgery. To allow visualization and performance of procedures, fluid or gas (irrigation) must be infused into the joint to expand the space and help clear debris. Special solutions or gases are used, depending on the joint being examined and the associated procedure to be performed. This requires two or more small incisions to allow for the insertion of the arthroscope, the irrigation fluid, and the surgical instruments. In very small joints, a special tube (cannula) is used to accommodate all the equipment necessary to perform the arthroscopy and associated surgical procedure.
Any joint can be examined using the arthroscope, but the most common are the knee and shoulder. Other joints include the elbow, wrist, hip, ankle, temporomandibular joint (TMJ), and spine. Arthroscopy has proven an invaluable adjunct to the diagnostic images obtained from x-ray, CT, MRI, or arthrography and often redefines the diagnosis. Procedures that occur during arthroscopy range from the removal of loose joint cartilage to major reconstructive procedures. Illuminated by the arthroscope, the surgeon can introduce and manipulate appropriate tools such as knife blades, motorized shavers, powered saw blades, or miniature osteotomes.
The use of arthroscopic-assisted techniques for many surgical procedures has gained wide acceptance by both patients and physicians. The decision to use this technique will be based on surgical experience, the availability of specialized equipment with well-trained staff, and agreement between physician and patient. Injuries, diseases, or conditions affecting joints could be appropriate choices for arthroscopic examination and arthroscopically assisted surgical procedures.
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Source: Medical Disability Advisor
| The procedure is used for diagnostic reasons, as well as to assist with or perform surgical techniques. Arthroscopy used as a diagnostic tool may further define conditions such as unexplained joint pain, bone fragments, suspected meniscal or ligament damage, joint disease, or lesions presented on x-ray. It may also assist in following the progress of a joint procedure and in obtaining the correct tissue during a biopsy. Arthroscopic-assisted surgery may allow for less soft tissue damage than an open procedure, decrease postoperative pain, and shorten hospital stays. Under direct visualization, structures can be palpated, probed, removed, irrigated, repaired, debrided, or abraded. Associated procedures are often scheduled as diagnostic arthroscopy with a "possible [named] procedure" to follow. |
Source: Medical Disability Advisor
| Through small skin incisions, the joint capsule is first expanded with either fluid or gas, passed into and out of the joint capsule via small tubes. The fluid pressure is maintained either by pumps or gravity. Draining the fluid clears the visual field of blood and debris created during surgery. The arthroscope is introduced into the joint capsule and then, most commonly, attached to a video monitor. Surgical instruments used to cut, scrape, or remove tissue are inserted through another hole (portal) in the skin. Depending on the procedure, tissue may be repaired, removed, or altered in some way. Orthopedic hardware may be inserted or removed, holes drilled, and fixation verified as well. The arthroscope is used only to look into the joint; the actual surgical procedure is done with other instruments. The surgical procedure may require many small incisions (portals) through which various instruments are passed.
Arthroscopy may be performed under local, regional, or general anesthesia. The procedure is done in ambulatory surgical centers, in hospital outpatient facilities, during inpatient stays, and rarely in physician's offices. The type of anesthesia and location of the surgery depends on the surgeon's, anesthesiologist's, and individual's preferences; the physical condition of the individual; and any expected associated procedures. |
Source: Medical Disability Advisor
| Clinical conditions being treated during an arthroscopic procedure dictate the possible outcome and vary tremendously. Anticipated results will vary from complete cure, to relief of pain either permanently or temporarily, to allowing for the staging or timing of multiple procedures. It is important for both the individual and physician to accept and agree on the expected outcome. |
Source: Medical Disability Advisor
| Complications from arthroscopic procedures include infection, nerve damage, absorption of gases used for inflation of the joint, collapse of lung (shoulder arthroscopy only), blood vessel damage, tissue perforation, ligament and muscle tears, and compartment syndrome (especially if a tourniquet was used on an extremity). |
Source: Medical Disability Advisor
| Restrictions and accommodations depend on the underlying diagnosis, treatment, and outcome. Following testing alone, the individual will experience joint stiffness for a few days. Excessive use of the affected area during this time is potentially difficult due to transient joint swelling and stiffness, so the individual is discouraged from resuming normal activity until the joint has had time to heal. |
Source: Medical Disability Advisor
| Joseph, Thomas N. "Arthroscopy." MedlinePlus. National Library of Medicine. 4 Jan. 2009 <http://www.nlm.nih.gov/medlineplus/ency/article/003418.htm>. |
Source: Medical Disability Advisor
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