Arthroscopic surgery
Arthroscopic surgery 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" (joint) and
"skopein" (to look). The term literally means "to look within the
joint." In an arthroscopic examination, an orthopaedic surgeon makes a small incision
in the patient's skin and then inserts pencil-sized instruments 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 arthroscope to a miniature television camera, 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 arthroscope displays the image 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.
What is Arthroscopic surgery used for?
Arthroscopic surgery is used to identify, monitor, and diagnose joint injuries and
disease; or to remove bone or cartilage or repair tendons or ligaments. Diagnostic
arthroscopic surgery is performed when medical history, physical exam, x rays, and other
tests such as MRIs or CTs don't provide a definitive diagnosis.
More information about Arthroscopic surgery.
In arthroscopic surgery, an orthopedic surgeon uses an arthroscope, a fiber-optic
instrument, to see the inside of a joint. After making an incision about the size of a
buttonhole in the patient's skin, a sterile sodium chloride solution is injected to
distend the joint. The arthroscope, an instrument the size of a pencil, is then inserted
into the joint. The arthroscope has a lens and a lighting system through which the
structures inside the joint are transmitted to a miniature television camera attached to
the end of the arthroscope. The surgeon uses irrigation and suction to remove blood and
debris from the joint before examining it. Other incisions may be made in order to see
other parts of the joint or to insert additional instruments. Looking at the interior of
the joint on the television screen, the surgeon can then determine the amount or type of
injury and, if necessary, take a biopsy specimen or repair or correct the problem.
Arthroscopic surgery can be used to remove floating bits of cartilage and treat minor
tears and other disorders. When the procedure is finished, the arthroscope is removed and
the joint is irrigated. The site of the incision is bandaged.
Arthroscopic surgery is used to diagnose and treat joint problems, most commonly in the
knee, but also in the shoulder, elbow, ankle, wrist, and hip. Some of the most common
joint problems seen with an arthroscope are:
- Inflammation in the knee, shoulder, elbow, wrist, or ankle
- Injuries to the shoulder (rotator cuff tendon tears, impingement syndrome, and recurrent
dislocations), knee (cartilage tears, wearing down of or injury to the cartilage cushion,
and anterior cruciate ligament tears with instability), and wrist (carpal tunnel syndrome)
- Loose bodies of bone and/or cartilage in the knee, shoulder, elbow, ankle, or wrist.
Corrective arthroscopic surgery is performed with instruments that are inserted through
additional incisions. Arthritis can sometimes be treated with arthroscopic surgery. Some
problems are treated with a combination of arthroscopic and standard surgery.
Also called arthroscopy, the procedure is performed in a hospital or outpatient
surgical facility. The type of anesthesia (local, spinal, or general) and the length of
the procedure depends on the joint operated on and the complexity of the suspected
problem. Arthroscopic surgery rarely takes more than an hour. Most patients who have
arthroscopic surgery are released that same day; some patients stay in the hospital
overnight
Considered the most important orthopedic development in the 20th century, arthroscopic
surgery is widely used. The use of arthroscopic surgery on famous athletes has been well
publicized. It is estimated that 80% of orthopedic surgeons practice arthroscopic surgery.
Arthroscopic surgery was initially a diagnostic tool used prior to open surgery, but as
better instruments and techniques were developed, it began to be used to actually treat a
variety of joint problems. New techniques currently under development are likely to lead
to other joints being treated with arthroscopic surgery in the future. Recently, lasers
were introduced in arthroscopic surgery and other new energy sources are being explored.
Lasers and electromagnetic radiation can repair rather than resect injuries and may be
more cost effective than instruments.
Post Arthroscopic surgery
Immediately after the procedure, the patient will spend several hours in the recovery
room. An ice pack will be put on the joint that was operated on for up to 48 hours after
the procedure. Pain medicine, prescription or non-prescription, will be given. The morning
after the surgery, the dressing can be removed and replaced by adhesive strips. The
patient should call his/her doctor upon experiencing an increase in pain, swelling,
redness, drainage or bleeding at the site of the surgery, signs of infection (headache,
muscle aches, dizziness, fever), or nausea or vomiting.
It takes several days for the puncture wounds to heal, and several weeks for the joint
to fully recover. Many patients can resume their daily activities, including going back to
work, within a few days of the procedure. A rehabilitation program, including physical
therapy, may be suggested to speed recovery and improve the future functioning of the
joint. |
