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Arthroscopy

Arthroscopy | ACI


Why is Arthroscopy?


Arthroscopy is a surgical procedure orthopaedic surgeons use to visualize, diagnose and treat problems inside a joint. The word arthroscopy comes from two Greek words “arthro” and “ skopein”. The term literally means “to look within a joint”. In an arthroscopic examination, an orthopaedic surgeon makes a small incision in the patient’s skin and then inserts pencil sized instruments(telescope) that contain a small lens and lighting system to magnify and illuminate the structures inside the joint. Light is transmitted through fiber optics to the end of the arthroscope that is inserted into the joint. By attaching, the arthroscopy to a miniature television, camera, and the surgeon is able to see the interior of the joint through this very small incision rather than a large incision needed for surgery.

The television camera attached to the arthroscopy displays the images of inside of the joint on a television screen, allowing the surgeon to look, for example, throughout the knee at cartilage and ligaments, and under the kneecap. The surgeon can determine the amount or type of injury, and then repair or correct the problem, if it is necessary.

Why is Arthroscopy necessary?

Diagnosing joint injuries and disease begins with a thorough medical history, physical examination, and usually x-rays. Additional tests such as an MRI, or CT scan also may be needed. Through the arthroscopy, a final diagnosis is made which may be more accurate than through “open” surgery or from x-rays studies.

Disease and injuries can damage bones, cartilage, ligaments, muscles, and tendons. Some of the most frequent conditions found by arthroscopic examination of joints are: -

INFLAMMATION: Synovitis – inflamed lining in the knee, shoulder, elbow, wrist, or ankle

INJURY(acute and chronic )Shoulder : rotator cuff tendon tears, impingement syndrome, and recurrent dislocations. Knee – meniscal tears, chondromalacia and anterior cruciate ligament tears with instability. Wrist – carpal tunnel syndrome .

LOOSE BODIES OF BONE AND/ OR CARTILAGE : knee, shoulder, elbow, ankle, or wrist

Although the inside of nearly all joints can be viewed with an arthroscopy, six joints are most frequently examined with this instrument. These include the knee, shoulder, elbow, ankle, hip, and wrist. As advances are made by engineers in electronic technology and new techniques are developed by orthopaedic surgeons, other joints may be treated more frequently in the future.



How is Arthroscopy performed?

Arthroscopic surgery, although much easier in terms of recovery than “open” surgery, requires the use of anesthetics and the special equipment in a hospital operating room or outpatient surgical suite. You will be given a general, spinal or a local anesthetic, depending on the joint or suspected problem. A small incision will be made to insert the arthroscopy several other incisions may be made to see other parts of the joint or insert other instruments. When indicated corrective surgery is performed with specially designed instruments that are inserted into the joint through accessory incisions. Initially, arthroscopy was simply a diagnostic tool for planning standard open surgery. With development of better instrumentation and surgical techniques, many conditions can be treated arthroscopically. For instance, most meniscal tears in the knee can be treated successfully with arthroscopic surgery. Some problems associated with arthritis can also be treated. Several disorders are treated with a combination of arthroscopic and standard surgery.

  • Rotator cuff procedure
  • Repair or resection of torn cartilage from knee or shoulder
  • Reconstruction of anterior cruciate ligament in knee
  • Removal of inflamed lining in knee, shoulder, elbow, wrist, ankle
  • Release of carpal tunnel
  • Repair of torn ligaments
  • Removal of loose bone or cartilage in knee, shoulder, elbow, ankle, wrist

After arthroscopic surgery, the small incisions will be covered with a dressing. You will be moved from the operating room to a recovery room. Many patients need little or no pain medication. Before being discharged, you will be given instructions about care for your incisions, what activities you should avoid, and which exercises you should do to aid your recovery. During the follow up visit the surgeon will inspect your incisions, remove sutures, if present and discuss your rehabilitation program.
The amount of surgery required and recovery time will depend on the complexity of your problem. Occasionally, during arthroscopy, the surgeon may discover that the injury or disease cannot be treated adequately with arthroscopy alone. The extensive “open” surgery may be performed while you are still anesthetized or at a later date after you have discussed the findings with your surgeon.

What are the possible complications?

Although uncommon complications do occur occasionally during or following arthroscopy infection ,phlebitis, excessive swelling or bleeding, damage to blood vessels or nerves, and instrument breakage are the most common complications but occur in far less than 1 percent of all arthroscopic procedures.

What are the advantages?


Although arthroscopy surgery has received a lot of public attention because it is used to treat well-known athletes, it is an extremely valuable tool for all orthopedic patients and is generally easier on the patient than “ open” surgery. Most patients have their arthroscopic surgery as outpatients and are home several hours after the surgery.

Recovery after Arthroscopy

The small puncture wounds take few days to heal. The operative dressing can usually be removed the morning after surgery and adhesive strips can be applied to cover the small healing incisions. Although the puncture wounds are small and pain in the joint that underwent arthroscopy is minimal, it takes few weeks for the joint to maximally recover. A specific activity and rehabilitation program may be suggested to speed your recovery and protect future joint function. It is not unusual for patients to go back to work or school or resume daily activities within a few days. Athletes and others who are in good physical condition may in some cases return to athletic activities within few weeks.

 

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