What is arthroscopic surgery?
Arthroscopic surgery is surgery that includes making small incisions to use a camera to look inside a joint. This is commonly done on joints including the shoulder, the elbow, the wrist, the knee, the hip and the ankle. The doctor who makes the small incision puts a very small camera inside the joint and can see around by making some other tiny incisions where needed. Arthroscopy helps in procedures including cleaning up injuries as well as reconstructing injuries. It is a surgical procedure itself that orthopedic surgeons use to visualize, diagnose and treat problems inside a joint.
In an arthroscopic examination, an orthopedic surgeon makes a small incision in the patient’s skin, and then inserts pencil-sized instruments that contain a small lens and lighting system which magnify and illuminate the structures within the joint. Light is transmitted through fiber optics to the end of the arthroscope that is inserted into the joint. The surgeon will be able to see the interior of the joint through this very small incision rather than having to make a large incision needed for surgery.
The 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. This allows the surgeon to see the cartilage and ligaments. The surgeon can then determine the type of injury and repair and/or correct the problem if necessary.
The doctor would perform the surgery in a hospital and operating room. Post the surgery the individual would be able to go home on the same day itself. The doctor would decide on which type of anaesthesia should be given since it would depend on the joint and what is the suspecting issues as per the surgeon. It can also be a general form of anaesthesia wherein during the surgical procedure you would be sleeping. The doctor can also give the anaesthesia through the spine. They can also look to just numb the region on which the surgery would be performed.
The doctor would insert a special kind of pencil-thin instrument through the small cut or the incision which would be the size of the buttonhole. He would make use of a tool which is also known as the arthroscope which has a camera lens as well as a light. This light would help the doctor to view inside the joints. The camera on this instrument would help in projecting an image of the joint onto the screen.
After which the surgeon would carefully fill up the joint with the sterile fluid so as to widen it which would make it easier for him to view the details. The doctor would view inside the joint, diagnose what the exact issue is and then decide on what type of surgery would be required if any needed. If there is a need for surgery, then the doctor would insert a special tool through the other small incisions which are known as portals.
The doctor would make use of them to cut, grasp, shave or carry out anchor stitching into the bones. If the surgeon feels that there is a need for traditional or open surgery for fixing the issue, then the doctor may carry it out at the same time as with the arthroscopic surgery. After which he would remove the arthroscope as well as any kind of attachments and the wound would be closed by using special kind of tapes or stitches.
Post the completion of the surgery there would be some amount of pain still in the joints for which the doctor can prescribe to make use of certain pain relieving medications. The doctor can also prescribe aspirin or any other medicines so as to prevent the issue of blood clotting. During the phase of recovery, the patient may have to make use of crutches, sling or a splint for support. Mostly in this kind of surgical procedure there is less pain in the joint as well as less stiffness than the open form of surgery.
The recovery phase also takes less amount of time. There would be existence of small puncture wounds wherein the arthroscopic tools have gone into the body. The day post the surgery, the individual can remove those surgical bandages and get them replaced with the small strips for covering the incision. The doctor can also remove the non-dissolvable stitches post a week or two after the surgery.
While the wound takes its own time to heal it is important to keep that part of the body as much dry as possible. This would mean that one should ensure to cover it up with the help of a plastic bag mostly while showering. The doctor would recommend on what activities can be carried out while you are at home and what activities should be avoided. Just after a few days of the surgery you can join back work or go to school. The complete recovery of the joint would normally take around severe weeks and it would take around several months for the entire recovery of the individual.
Diagnosing injuries with arthroscopy
Diagnosing joint injuries and diseases begins with a thorough medical history, physical examination and usually X-rays. Additional tests such as magnetic resonance imaging (MRI) or computed tomography (CT) scan may be needed.
Some of the most frequent conditions found during an arthroscopic examination of joints are:
- Inflammation and acute or chronic injury
- Rotary tendon cuff tears
- Impingement syndrome
- Recurrent dislocations
- Knee meniscal tears
- Anterior cruciate ligament tears
- Carpal tunnel syndrome
Benefits of arthroscopic surgery
Arthroscopic surgery, although much easier in terms of recovery when compared to “open surgery”, still requires the use of anesthetics and the special equipment found in a hospital operating room or outpatient surgical suite. The patient is given general, spinal, or a local anesthetic depending on the joint or suspected problem. A small incision is made to insert the arthroscope. Other incisions may be made during the procedure to see other parts of the joint or to insert other instruments.
Initially, arthroscopy was simply used as a diagnostic tool for planning standard open surgery, but with the development of better instrumentation and surgical techniques, many conditions can now be treated arthroscopically. The amount of surgery required and recovery time will depend on the complexity of the problem. Occasionally, during arthroscopy the surgeon may discover that the injury or disease cannot be treated adequately with arthroscopy.
Arthroscopic surgery is an extremely valuable tool for all orthopedic patients and is generally easier on the patient than open surgery. Furthermore, it is not unusual for patients to have a quicker or easier recovery from arthroscopy, depending on the individual.