Other Joints - Procedures

Arthroscopy is a method of viewing a joint, and, if needed, to perform surgery on a joint. An arthroscope consists of a tiny tube, a lens, and a light source.

This procedure is typically performed on the knee, shoulder, elbow, or wrist. The type of anesthesia depends on the particular joint and other factors. A regional anesthetic numbs the affected area, but the patient may remain awake, depending on whether other medications are used. For more extensive surgery, general anesthesia may be used. In this case the patient is asleep and pain-free.

The area is cleaned and a pressure band (tourniquet) may be applied to restrict blood flow. The health care provider then makes a surgical cut into the joint. Sterile fluid is passed through the joint space to provide a better view.

Next, a tool called an arthroscope is inserted into the area. An arthroscope consists of a tiny tube, a lens, and a light source. It allows a surgeon to look for joint damage or disease. The device also allows the surgeon to perform reconstructive procedures on the joint, if needed.

Images of the inside of the joint are displayed on a monitor.

One or two small additional surgical cuts may be needed, in order to use other instruments. These instruments can be used to remove bits of cartilage or bone, take a tissue biopsy, or perform other minor surgery. In addition, ligament reconstruction can be performed using the arthroscope in many cases.

Your doctor may order this test if you have:

• A need for joint surgery
• Damaged meniscus (the piece of cartilage that cushions the knee joint area)
• Joint pain from an injury
• Joint disease
• Lesions or other problems detected by x-rays
• Signs of bone fragments from a fracture
• Signs of a torn ligament
• Unexplainable joint pain

Hip joint replacement is surgery to replace all or part of the hip joint with an artificial device (a prosthesis).

Hip joint replacement is primarily done in people age 60 and older. The operation is usually not recommended for younger people because of the strain they can put on the artificial hip, causing it to fail prematurely.

The reasons for replacing the hip joint include:

• Fractures in the elderly of the neck of the femur (usually requires a hemi-arthroplasty)
• Hip joint tumors
• Severe arthritis pain that limits a person's ability to do the things they want to do

Knee joint replacement is surgery to replace a painful damaged or diseased knee joint with an artificial joint (prosthesis).

Knee joint replacement may be recommended for:

• Arthritis of the knee and decreased knee function caused by arthritis
• Inability to sleep through the night because of knee pain
• Knee pain that hasn't responded to other therapy (including medication, injections, and physical therapy for 6 months or more)
• Knee pain that limits or prevents activities
• Some tumors involving the knee

Ankle replacement is surgery to replace the damaged parts of the three bones that make up the ankle joint. Artificial joint parts (prosthetics) are implanted in place of the old bones. The artificial ankle joints come in different sizes to fit the patient.

Ankle replacement surgery may be performed if the ankle joint has been severely damaged. Causes of damage include:

• Osteoarthritis
• Rheumatoid arthritis  
• Fracture
• Arthritis due to previous ankle surgery

Elbow replacement is surgery to replace the bones that make up the elbow joint with artificial joint parts (prosthetic components).

Elbow replacement surgery is typically performed if the elbow joint is severely damaged and you are experiencing pain or loss of motion. Causes of damage include:

• Osteoarthritis
• Poor result from previous elbow surgery
• Rheumatoid arthritis
• Severely broken bone in the upper or lower arm near the elbow
• Severely damaged or torn tissues in the elbow
• Tumor in or around the elbow