Arthroscopy

What is an Arthroscopy?

Arthroscopy is a minimally invasive procedure that lets your doctor look inside a joint through a few tiny cuts, using a small camera. It helps find out what is causing joint pain, swelling or stiffness and, in many cases, the problem can be treated during the same procedure.

It examines the inside of a joint, including the joint surface, ligaments and cartilage, to detect injury, disease and wear and tear. It is done using an arthroscope, a thin tube with a light and a camera attached. The arthroscope is inserted through a small incision beside the joint, and it sends a video image of the inside of the joint to a screen so your doctor can see it in detail.

Because the cuts are small, arthroscopy is less invasive than traditional open surgery. It is performed as an outpatient procedure, which means you do not need to stay overnight in the hospital.

Which joints can be examined?

Arthroscopy is most commonly performed on the knee, shoulder and ankle, the joints that are most often injured or affected by arthritis. It can also be performed on the hip, wrist and elbow.

Why Might You Need an Athroscopy?

X-rays, ultrasound and MRI scans give your doctor useful information about a joint, but they do not always show the full picture. Arthroscopy allows your doctor to see the inside of the joint directly. It may be recommended to:

• Find the cause of joint pain, swelling, stiffness, locking or a feeling that the joint is giving way
• Assess the extent of an injury, such as a torn meniscus (the cushioning cartilage in the knee), ligament tears or cartilage damage
• Diagnose different forms of arthritis and other joint diseases
• Look for the cause of hip joint problems
• Check for inflammation of the joint lining or loose fragments of bone or cartilage inside the joint

Why This Matters in Singapore?

Joint problems are common in Singapore. Studies estimate that between about 5% and 11% of adults here have symptomatic knee osteoarthritis, and the numbers rise sharply after the age of 40. As our population ages, more people are living with joint wear and tear.

Singaporeans are also more active than before. Running, cycling and football are popular, and pivoting sports such as football, basketball and badminton are a common cause of knee injuries like meniscus and ligament tears. Left untreated, these injuries can wear down the joint earlier than expected, even in younger adults.

Everyday life matters too. Climbing stairs, squatting, kneeling and long hours of standing or walking can all become difficult when a joint is painful. If joint pain, swelling or locking is stopping you from enjoying your normal routine, it is worth seeing an orthopaedic specialist early rather than waiting for the problem to worsen.

Who May Need an Arthroscopy?

Your doctor may suggest arthroscopy if:

• Your joint symptoms have continued despite rest, medication or physiotherapy
• Your scans or examination suggest an injury or joint problem that needs a closer look, or that may benefit from treatment through keyhole surgery
• The cause of your symptoms remains unclear after other tests

Not everyone with joint pain needs arthroscopy. Many conditions improve with rest, exercise and physiotherapy. Your doctor will recommend arthroscopy only when it is likely to help.

Preparing for Your Arthroscopy

• Health checks: You will undergo tests to check that you are fit for the procedure. These include blood and urine tests, and heart and lung function tests.
• Your medication: Tell your doctor about all the medicines you are taking, including blood thinners such as warfarin or aspirin, anti-inflammatory painkillers, supplements, and traditional Chinese or herbal medicines, as some of these can affect bleeding. Do not stop any medicine unless your doctor tells you to.
• Allergies and past reactions: Tell our team about any allergies, and about any problems you or your family have had with anaesthesia.
• Anaesthesia: You will be given anaesthesia so that you are comfortable during the procedure. Your anaesthetist will discuss the options with you and explain which is most suitable.
• Fasting: You will be told when to stop eating and drinking before the procedure. Please follow these instructions carefully.
• Illness: Let us know if you have a fever, cough, skin infection or any other illness in the days before your procedure, as it may need to be postponed.
• What to bring: Your doctor’s referral letter, your NRIC (or passport if you are an international patient), previous scan reports or images, and a list of your medications.
• Plan for your recovery: Arrange for someone to take you home and, if possible, stay with you for the first day. If your home has stairs, or a bathroom that is hard to use with a brace or crutches, think about how you will manage in the first few days. Also plan time off work with your employer.

What Happens During an Arthroscopy?

A small incision is created on the side of the joint being examined. The arthroscope will be inserted through this incision to examine the joint. The joint is examined for signs of damage and abnormalities.

The incision is closed using sutures after diagnosis is done. The joint may be supported with a brace after the procedure to provide support and to help you walk better.

How long the procedure takes depends on the joint and on whether any treatment is carried out. Your doctor will give you an idea beforehand.

What Happens After an Arthroscopy?

Immediately After the Procedure

You will rest in the recovery area while the effects of the anaesthesia wear off. You may need to stay in the hospital until you feel well enough to go home. Most patients go home the same day, and you will be given medication to control the pain when you are discharged. Please have someone accompany you home, and do not drive.

At Home

• Keep the wound dry for the first few days after the procedure, and follow your nurse’s advice on dressings and showering.
• Take your pain medication as prescribed so that you are comfortable enough to move around and do your exercises.
• Rest and raise the joint when you can, as advised by your doctor, to help reduce swelling.
• Use your brace or crutches if they were given to you, and follow the instructions on how much weight you can put on the joint.
• Attend your follow-up appointment so that your doctor can check your wound, remove stitches if needed and discuss what was found.

Should you feel excessive pain or experience abnormal swelling, contact your doctor immediately or call our 24-Hour Medical Urgency Clinic.

Regaining strength and movement

Exercises are an important part of your recovery. You will need to strengthen the joint so that you can eventually regain full movement. A physiotherapist can guide you on exercises suited to your joint and your procedure, and our Rehab Centre can support you during your recovery.

How quickly you can return to work, driving, and sports depends on the joint, whether any treatment was done and how you heal. Many people return to desk-based work within days to a couple of weeks, while a return to sports or heavy physical work may take longer. Please check with your doctor before resuming these activities.