Arthroscopy Treatment

WHAT IS ARTHROSCOPIC SURGERY

 

Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed to evaluate or treat many orthopaedic conditions including torn cartilage (known by doctors as “meniscus”), torn surface (articular) cartilage, ACL reconstruction, and trimming damaged cartilage.
The advantage over traditional open surgery is that the joint does not have to be opened up fully. For knee arthroscopy only two small incisions are made, one for the arthroscope and one for the surgical instruments to be used in the knee cavity. This reduces recovery time and may increase the rate of success due to less trauma to the connective tissue. It is especially useful for professional athletes, who frequently injure knee joints and require fast healing time. There is also less scarring, because of the smaller incisions. Irrigation fluid is used to distend the joint and make a surgical space. Sometimes this fluid leaks (extravasates) into the surrounding soft tissue, causing edema.
The surgical instruments are smaller than traditional instruments. Surgeons view the joint area on a video monitor, and can diagnose and repair torn joint tissue, such as ligaments and menisci or cartilage.
It is technically possible to do an arthroscopic examination of almost every joint, most commonly the knee, shoulder, elbow, wrist, ankle, foot, and hip.

 

Arthroscopic surgeries of the knee are done for many reasons, but it is not clear whether it is a more effective for osteoarthritis than more conservative therapies.
A double-blind placebo-controlled study on arthroscopic surgery for osteoarthritis of the knee was published in the New England Journal of Medicine in 2002. In this three-group study, 180 military veterans with osteoarthritis of the knee were randomly assigned to receive arthroscopic débridement with lavage, or arthroscopic lavage alone without debridement (a procedure only imitating the surgical debridement, where superficial incisions to the skin were made to give the appearance that the debridement procedure had been performed). For two years after the surgeries, patients reported their pain levels and were evaluated for joint motion. Neither the patients nor the independent evaluators knew which patients had received which surgery (thus the “double blind” notation). The study reported, “At no point did either of the intervention groups report less pain or better function than the placebo group.” Because there is no confirmed benefit for these surgeries in cases of osteoarthritis of the knee, many payors are reluctant to reimburse surgeons and hospitals for what can be considered a procedure which seems to create the risks of surgery with questionable or no demonstrable benefit.
A 2008 study confirmed that there was no long-term benefit for chronic pain, above medication and physical therapy.

  • Ankle Replacement
  • Knee Replacement
  • Hip Replacement
  • Elbow Replacement
  • Shoulder Replacement

One of the primary reasons for performing arthroscopies is to repair or trim a painful and torn or damaged meniscus. The surgery is known as a arthroscopic partial meniscectomy (APM). Arthroscopic surgery; however, does not appear to result in benefits in adults with mild osteoarthritis who have a meniscal tear.
A torn meniscus is in a majority of cases non-symptomatic. It is unclear if it is cost-effective.

After knee arthroscopy there will be swelling around the knee, which can take anywhere from 7–15 days to completely settle. It is important to wait until there is no swelling before doing any serious exercise or extensive walking, because the knee will not be fully stable; extensive exercise may cause pain and in some cases cause the knee to swell more. The spread of the swell might cause serious problems.

Through a small incision arthroscope can be inserted in the joint, which help to visualize inside the joint on the monitor via camera attached to the arthroscope.
Due to injury, when Anterior or posterior cruciate ligament is torn, knee becomes unstable. Arthroscopically these ligaments can be reconstructed. Arthroscopy is a common surgical procedure in which a joint (arthro-) is viewed (-scopy) using a small camera. Arthroscopy gives doctors a clear view of the inside of the knee. This helps them diagnose and treat knee problems.
Technical advances have led to high definition monitors and high resolution cameras

. These and other improvements have made arthroscopy a very effective tool for treating knee problems. According to the American Orthopaedic Society for Sports Medicine, more than 4 million knee arthroscopies are performed worldwide each year.

Hip arthroscopy refers to the viewing of the interior of the acetabulofemoral (hip) joint through an arthroscope and the treatment of hip pathology through a minimally invasive approach. This technique is sometimes used to help in the treatment of various joint disorders has gained popularity because of the small incisions used and shorter recovery times when compared with conventional surgical techniques (sometimes referred to as “open surgery”). Hip arthroscopy was not feasible until recently, new technology in both the tools used and the ability to distract the hip joint has led to a recent surge in the ability to do hip arthroscopy and the popularity of it.

Shoulder arthroscopy is surgery that uses a tiny camera called an arthroscope to examine or repair the tissues inside or around your shoulder joint. The arthroscope is inserted through a small incision (cut) in your skin.
Description:- The rotator cuff is a group of muscles and tendons that cover your shoulder joint. These muscles and tendons hold your arm in your ball and socket shoulder joint, and they help you move your shoulder in different directions. The tendons in the rotator cuff can tear when they are overused or injured.
Most people receive general anesthesia before this surgery. This means you will be unconscious and unable to feel pain. Or, you may have regional anesthesia. Your arm and shoulder area will be numbed so that you do not feel any pain in this area. If you receive regional anesthesia, you will also be given medicine to make you very sleepy during the operation.

Arthroscopy may be recommended for these shoulder problems:

  • A torn or damaged cartilage ring (labrum) or ligaments
  • Shoulder instability, where the shoulder joint is loose and slides around too much or becomes dislocated (slips out of the ball and socket joint)
  • A torn or damaged biceps tendon
  • A torn rotator cuff
  • A bone spur or inflammation around the rotator cuff
  • Inflammation or damaged lining of the joint. Often this is caused by an illness, such as rheumatoid arthritis.
  • Arthritis of the end of the clavicle (collarbone)
  • Loose tissue need to be removed
  • Shoulder impingement syndrome, to make more room for the shoulder to move around.

In recent years, the elbow is among the small joints that have been explored arthroscopically, with gradual development of safe and effective diagnostic and surgical techniques. The elbow is easily accessed for arthroscopic examination and standard portals have been described. Elbow arthroscopy requires detailed knowledge of the anatomy and the ability to introduce instruments through deep muscle layers in narrow confines near crucial neurovascular structures. With this knowledge and ability, the surgeon should see the benefits of minimal dissection and a more rapid rehabilitation Arthroscopy is a procedure that orthopaedic surgeons use to inspect, diagnose, and repair 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.” During elbow arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your elbow joint. The camera displays pictures on a television screen, and your surgeon uses these images to guide miniature surgical instruments. Because the arthroscope and surgical instruments are thin, your surgeon can use very small incisions (cuts), rather than the larger incision needed for open surgery. This results in less pain for patients, less joint stiffness, and often shortens the time it takes to recover and return to favorite activities.