Arthroscopy

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Many surgical procedures on large joints can be performed without opening the joint. Instead, a technique called arthroscopy is used. Typically, while the patient is under anesthesia, the surgeon makes a small incision and injects a clear, sterile fluid to make the joint swell for easier viewing. Through another small incision, an arthroscope is inserted. The arthroscope is a lighted tube, with which the surgeon examines the inside of the joint. Sometimes a third incision is used to remove pieces of cartilage or bone that cause pain and inflammation or to repair damaged tissue.

• Tidal lavage is an arthroscopic procedure in which a sterile salt solution is injected into and removed from the joint several times. The patient receives local anesthesia. Tidal lavage often relieves pain and improves joint function for several weeks or months. It is thought that these effects are due to the removal of debris and inflammatory messenger substances in the joint fluid. Another reason for the beneficial effect may be that adhesions in the joint are broken (Ike and Arnold 1992).
• Chondroplasty involves the removal of damaged cartilage from the joint using an arthroscopic procedure. Next, a sample of healthy cartilage is removed and grown in a laboratory culture for roughly one week. The newly grown cartilage cells (chondrocytes), which are believed to prompt the repair of damaged tissue, are then put back into the joint (Brittberg et al 1994; Brittberg, 1999). This procedure may be useful in younger people who are at risk of developing osteoarthritis because of defective joint surfaces.