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Arthroscopy

What is Arthroscopy?

Arthroscopy is derived from the Greek language and simply means "to look within the joint”. It is a type of keyhole surgical procedure, where orthopaedic surgeons use an arthroscope fitted with a camera and a bright light source to visualize, diagnose, and treat conditions of a joint. Arthroscopy is used in the treatment of the problems of following joints:

  • SHOULDER

Rotator Cuff Repair / Frozen Shoulder Release / Stabilization of Recurrent Dislocation. 

Shoulder arthroscopy surgery is a procedure that is performed to repair the tissues inside or around your shoulder joint with the use of a tiny camera and arthroscope to make smaller incisions.

  • KNEE

ACL Reconstruction / PCL & PLC Reconstruction / Meniscectomy / Meniscal Repair. 

Arthroscopic knee surgery is a procedure performed to diagnose and treat knee joint problems. 

  • HIP

Labrum Repair / Arthroscopic Cheilectomy

  • WRIST

Carpal Tunnel Release / Ganglion removal / Scapholunate Ligament Repair.

Wrist arthroscopy surgery is a procedure that utilises a tiny camera and surgical tools to check or repair the wrist tissues inside or around it. 

  • ELBOW

Tennis Elbow / Osteochondritis Dissecans / Loose body removal / Capsulotomy.

  • LOOSE BODY OR INFLAMED SYNOVIUM REMOVAL

Why is the procedure recommended?

An arthroscopic examination is recommended for patients with arthritis and problems with the joints of the hip, knee, wrist, elbow, ankle, etc., that includes inflammation in the lining of the joints, stiffness of the joints, worn-out cartilage, ligament tear, joint scarring, joint damage, or injury, etc. 

How is the procedure performed?

The arthroscopy is performed under local, regional, or general anaesthesia. To expand and enhance the visibility of the joint, it is filled with sterile fluid. Multiple tiny incisions are made on the skin of the joint to introduce arthroscopy and other surgical instruments. Arthroscopy is a pen-sized instrument fitted with a high-definition camera and a bright light so that the structures of the joint can be magnified and illuminated for better viewing quality. Good quality images of the joint are displayed on the monitor that is connected to the arthroscope. These images help the surgeon to view the inside of the joints in detail and determining the extent of damage or injury to the cartilage, ligaments, bone, etc. After the procedure, arthroscopy and other instruments are gently removed and the incisions are closed and dressed. Based on the joints involved, the procedure may take half an hour to 2 hours. The recovery period varies from a few days to a couple of weeks. During the recovery, the patient will be advised a splint, sling, or crutches to support and protect the operated joint.

What are its advantages?

  • Apart from being a valuable diagnostic tool, arthroscopy is also widely used in the treatment of many joint conditions. E.g., Meniscal tears in the joints of the knee.

  • It is a good alternative to ‘open’ surgery.

  • Most arthroscopy procedures are performed in an outpatient setting.

  • Due to small incisions, the scarring is minimal, the risk of infection is low, loss of blood is minimal, and chances of requiring a blood transfusion is low.

  • Less painful and less traumatic for the patient.

  • If the patient is in good physical condition, they may be able to return to their normal activities in a couple of weeks.

What are the benefits?

  • Arthroscopy is a minimally invasive procedure that is used for diagnosing and treating conditions of the joint that affect the ankle, knee, elbow, hip, wrist, etc. For example, meniscal tears in the joints of the knee. 

  • Precision surgery, which means the procedure uses smaller incisions and operates only on the damaged areas compared to the open surgical technique that uses a larger incision.

  • The procedure leads to a lower risk of arthritis in the future.

  • Due to smaller incisions, scarring is minimal, loss of blood is minimal, and thereby, fewer chances of requiring a blood transfusion.

  • The risk of infection is low leading to a speedy recovery and shorter hospital stay.

  • The process has fewer complications, is less painful, less traumatic and is generally easier on the patient than open surgery.

  • It is an outpatient procedure, and the patient will be home on the same day of the surgery.

  • A physically fit individual can start walking right after an arthroscopic procedure and can return to normal activities within a few days.

Risks:

Arthroscopy is generally a safe and effective procedure in treating conditions of the joints. Some complications are reported to occur in less than 1% and include:

  • Damage to the tissue or nerve of the joint surface due to the use of surgical instruments within the joint.

  • Infection of the wound site: Infection in the wound site may occur if not cared for properly.

  • Blood clots: Also called deep vein thrombosis (DVT), blood clots from the vein of the legs may travel to the heart or the lungs which is life-threatening.

  • Excessive swelling or bleeding.

  • Tenderness or discharge from the surgical wound site.

Types of injuries that can be treated:

Our bones, ligaments, cartilage, muscles, tendons, etc., are damaged due to injury or disease and are generally treated using arthroscopic procedures. Some conditions commonly treated include:

  • Inflammation: Due to arthritis or overuse of the joints, the tissues around the joints of the knee, shoulder, elbow, ankle, etc., become inflamed causing redness, severe pain and stiffness. E.g., Synovitis joints.

  • Damage to the joints due to injury (acute or chronic):

    • Anterior cruciate ligament tears

    • Carpal tunnel syndrome in the wrist

    • Chondromalacia (injury of the cartilage in the knee)

    • Rotator cuff tendon tears

    • Repeated dislocation in the shoulder

    • Impingement of the shoulder

    • Meniscal or cartilage tear in the knee

    • Loose fragments or bodies of bone and/or cartilage of the knee, shoulder, elbow, ankle, wrist, etc.

Precautions to be taken after the surgery:

Post-operatively, the dressing over the incision is removed the next day and is covered with adhesive strips to protect the wound site from infection. Keep the wound dressing clean and dry. It may take a few days for these puncture wounds to heal. You may be prescribed certain medications, slings or crutches, exercises, etc., to fasten the healing process and strengthen the joint. An individual who is physically fit will be able to return to normal activities within a few days. Time taken to recovery however varies with every patient depending upon the underlying medical conditions, age, physical fitness, etc. Rest well and avoid strenuous exercises or lifting heavy objects. Follow your doctor’s instructions on moving your limbs.

Frequently Asked Questions:

1. Can I walk right after arthroscopic knee surgery?

You can start walking right after an arthroscopic knee surgery. You may be prescribed certain medications, slings or crutches, exercises, etc., to fasten the healing process and strengthen the joint so that you may walk comfortably. An individual who is physically fit will be able to return to normal activities within a few days. However, it may take some time to recover for individuals with medical conditions, poor physical fitness, etc.

2. Is a full recovery guaranteed?

Full recovery usually depends on the presence of underlying medical conditions, general health, age, physical fitness, etc., of the individual. You may be prescribed certain medications, slings or crutches, exercises, etc., to speed the healing process and strengthen the joint so that you may walk comfortably. A physically fit individual (e.g., an athlete) will fully recover and will be able to walk right after the procedure and return to normal activities within a few days.

3. When can I drive again?

You can safely start driving one week after the procedure only after you stop taking any narcotic pain medications that could induce sleep. You could drive if you feel safe and have full control of your vehicle.

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