What’s the Difference Between Arthroplasty and Arthroscopy?
Arthroplasty and arthroscopy are two procedures surgeons perform to restore function in your joints.
Arthroplasty and arthroscopy are both common types of surgery used to treat a wide range of conditions in joints such as your:
During arthroplasty, a surgeon replaces a joint with an artificial replacement. They may replace part of your joint or the entire joint, depending on the extent of the damage. It’s estimated that more than 2.34% of adults more than 50 years of age in the United States have had a total hip arthroplasty, also called a “total hip replacement.”
Arthroscopy refers to a minimally invasive procedure in which doctors use a thin tube with special tools called an “arthroscope” to repair damaged parts of a joint. It’s been estimated that more than 1.77 million arthroscopic procedures are performed each year in the United States.
Read on to learn more about these two types of surgery, including when they’re usually performed, benefits, and potential risks.
The purpose of arthroplasty and arthroscopy is to restore function in a joint.
Arthroplasty is generally a more invasive procedure that’s used to treat extensive damage to a joint that hasn’t responded to conservative treatment. Arthroplasty is most common in hip joints and knee joints but can also be performed on other joints, such as:
Conditions treated with arthroplasty include:
- osteoarthritis
- rheumatoid arthritis
- severe fractures
- congenital joint abnormalities
- other conditions that cause pain and stiffness
Arthroscopy is a minimally invasive procedure used to repair damaged tissue in your joint or to diagnose joint problems. One of the most common uses is to repair a torn piece of cartilage, called a “meniscus,” in your knee. About 450,000 arthroscopic meniscus surgeries are performed each year in the United States.
Other conditions treated with arthroscopic surgery include:
- carpal tunnel syndrome
- rotator cuff tears in your shoulder
- shoulder impingement syndrome
- loose pieces of bone or cartilage in joints
- anterior crucial ligament (ACL) tears causing instability in the knee
- wearing of the cartilage in the knee (chondromalacia)
Arthroplasty and arthroscopy can both potentially decrease pain and increase joint function.
Arthroscopy benefits
Compared with arthroplasty, the benefits of arthroscopy include:
- low rates of infection
- faster healing time
- minimal pain after operation
- minimal tissue damage
- lower rates of risks
- less scarring
Arthroplasty benefits
Arthroplasty is generally a more extensive surgery but can offer benefits for people with severe joint damage. These benefits include:
- reduced joint pain
- improvements in quality of life
- increased joint function
- increased independence
- long lasting results
Arthroscopy is sometimes used to perform arthroplasty. For example, in a 2021 study, researchers found evidence that arthroscopic knee arthroplasty may provide better results than traditional knee arthroplasty.
Arthroplasty is generally a more invasive procedure and usually has higher rates of risk.
Arthroscopy risks
Risks of arthroscopic surgery can include:
- infection
- blood clots
- bleeding
- allergic reaction to anesthetic
- ongoing pain
Arthroplasty risks
Risks of arthroplasty can include:
- bleeding
- infection
- blood clots
- problems with the prosthetic
- need for revision surgery
- rarely, nerve injury
You may need arthroscopy after arthroplasty as a revision surgery. The most common reasons you may need arthroscopy after total knee arthroplasty are:
- soft tissue impingement
- knee stiffness
- infection
- removal of cement or other fragments
Here’s a general idea of what you can expect during each procedure.
Arthroscopy procedure
During an arthroscopy, you can expect a procedure like this:
- You’ll be given both local anesthetic to numb the surrounding area and general anesthesia to put you asleep.
- The surgeon will make three small incisions: one for camera and sterile water insertion and two for tool insertion and for water to flow out.
- They’ll insert a long, thin tube called an “arthroscope” so that they can see inside your joint and fix the problem.
- The surgeon will cover your wound with surgical dressings.
Many people can resume their regular activity within days and athletic activity within weeks.
Arthroplasty procedure
During an arthroplasty, you can expect a procedure like this:
- You’ll usually receive a spinal block to numb your lower body and general anesthesia to put you to sleep.
- The surgeon will make an incision over your injured joint and remove the damaged tissue. The amount of tissue they remove depends on whether you’re having a partial or total joint replacement.
- They’ll replace the removed tissue with a prosthesis that mimics the function of your natural joint. The prosthesis may have components made out of materials such as plastic, metal, or ceramics. For example, a total hip replacement involves replacing the top of your femur with a metal ball and the socket of your hip with plastic. Sometimes cement is used to keep a joint in place.
- After the procedure, the surgeon will seal the wounds with stitches.
After a total knee arthroplasty, you can expect to have swelling for 3 to 6 months.
You may be a candidate for arthroscopic surgery if you have a condition, such as a meniscus tear, known to respond well to arthroscopic surgery and:
- have joint instability
- have joint pain
- haven’t benefited from more conservative options
You may be a candidate for arthroplasty if you have:
- severe pain that limits everyday activities
- chronic pain while resting or sleeping
- chronic inflammation that doesn’t improve with rest or medication
- joint abnormalities
- no improvement with conservative treatments such as injections or physical therapy
The price of arthroscopy and arthroplasty vary widely depending on the extent of the surgery and which joint needs to be repaired. Prices can also vary widely between geographic areas.
Arthroscopy tends to be cheaper because it’s less extensive.
In a 2022 study , researchers found that the cost of arthroscopic meniscus repair and physical therapy was $2,010 more over 5 years than physical therapy alone.
In a 2023 study , researchers reported the average cost of total hip arthroplasty as $53,324 and $75,037 for revision surgery across the United States from 2006 to 2015.
Arthroscopy and arthroplasty are usually covered by insurance plans, including Medicare, if they’re deemed medically necessary and if you’ve already tried more conservative treatments. It’s a good idea to check your policy before having surgery.
Medicare reports the average cost to people for arthroscopic meniscus repair at a hospital as $413, including doctor and hospital fees.
Arthroscopy and arthroplasty are considered effective at treating many conditions.
Total knee arthroplasty prostheses last at least 10 years for more than 85% of people.
In a 2017 study , researchers that about 2.62% of people who receive total knee replacement receive revision arthroscopic surgery each year.
In a 2020 study , researchers found an 18% failure rate for people who receive hip arthroscopy.
Doctors recommend trying conservative treatment options before surgery for many joint problems. Alternatives may include:
- rest
- avoiding painful activities
- corticosteroid injections
- physical therapy
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- pain medications
- supportive devices such as crutches
Arthroplasty and arthroscopy are two procedures used to fix problems with your joints. Arthroplasty involves replacing part or all of your affected joint. Arthroscopy involves using a long, thin tube to repair certain structures in your joint or to diagnose problems.
Arthroscopy is generally less invasive with fewer risks, but arthroscopy may make a better option if your joint is extensively damaged.
Last medically reviewed on March 23, 2023
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