Arthroscopy – General Surgery

Introduction – Arthroscopy

Arthroscopy is a most commonly used surgical procedure which helps to diagnose the joint problems and to repair the damage to the joints. It is done on ankles, knees, wrists, elbows and shoulders. Arthroscopy is recommended in patients with joint problems- showing some kind of stiffness or swelling in the joints and where primary imaging tests do not give a definite diagnosis.

Arthroscopy enables an orthopaedic surgeon-

  1. To overview the joint from inside
  2. To treat frozen shoulder
  3. To repair damaged cartilage
  4. To remove fragments of loose bone or cartilage

Procedure-

  • Equipment used in arthroscopy is called an arthroscope, which is nothing but a small and flexible tube. It appears to be just as a drinking straw. This instrument has bundle of fibre optics inside, which function as both a camera and a source of light. Pictures captured by this camera are sent to an eye piece or a video screen- which can be seen by the orthopaedic surgeon.
  • Sometimes, small surgical instruments are inserted through the arthroscope which helps the surgeons during curative procedures of arthroscopy.
  • A small incision is made by the surgeon, next to the joints- from where the arthroscope can be inserted in the joint. Additional small incisions may be taken which might be required for inserting examining probe or surgical instruments.
  • An arthroscopy is performed under general anaesthesia. Sometimes, a local anaesthesia may be used, where the only area being treated is numbed.
  • An arthroscopy is usually performed on an out-patient basis, which means that the person being treated is able to go home on the same day as the surgery.

Indications- 

  1. Diagnostic use-

An arthroscopy can be used to help diagnose a number of joint problems, such as-

       swelling of the joint

       unexplained joint pain

       limited range of movement within the joint

       joint stiffness

       the joint giving way at certain times or ‘popping’ out of position

Preliminary tests for these types of problems usually involve the use of imaging studies as described below-

       X-rays - where high energy waves are used to produce an image of the bones

       computerised tomography (CT) scans - where several X-rays are taken and assembled by a computer to create a more detailed, three-dimensional image of the affected joint

       magnetic resonance imaging (MRI) scans - where strong magnetic fields and radio waves are used to produce detailed scans of the soft tissue of the affected joint

If these tests don’t find anything it may be necessary to take a direct look at the inside of the joint.

An arthroscopy can also be used to measure the level of joint damage resulting from an injury, such as a sports injury, or from underlying conditions that can cause joint damage, such as:

  • osteoarthritis - where, over time, the joint cartilage becomes damaged
  • septic arthritis – where a joint becomes infected
  1. Treatment of joint problems

Surgical instruments can be passed through an arthroscope, making it possible for an arthroscopy to be used to treat a range of joint problems and joint conditions. For example, an arthroscopy can be used to:

       repair damaged cartilage, tendons and ligaments

       remove small sections of bone or cartilage that have broken off and are loose within the joint

       drain away an excess build-up of synovial fluid (fluid that lubricates the joint)

Conditions that can be treated with arthroscopy include:

       Baker’s cyst - where synovial fluid builds up inside a joint, leading to stiffness and swelling

       frozen shoulder - where the shoulder joint becomes compressed, causing stiffness and pain

       synovitis – where the lining of the joint becomes inflamed

       bone spurs – abnormal bone growths that can cause persistent pain

Safety-

An arthroscopy is usually a safe type of surgery and the risk of developing any serious complications is low (less than 1 in a 100). However, possible complications include infection and accidental damage to nerves near the affected joint.

Benefits of arthroscopy-

The benefits of an arthroscopy compared with conventional open surgery include:

  • less post-operative pain
  • a faster recovery time
  • a lower risk of complications

Recovery

  • The time it takes to recover from an arthroscopy differs based on the joint involved and whether it needs to be repaired.
  • It is usually possible for a person to do light, physical activities one to three weeks after having surgery.
  • Full physical activities, such as lifting and sport, can usually be resumed after six to eight weeks.

- Link of interest: General Surgery News on Facebook

This article is not medical advice nor a substitute to professional health advice. Always consult a doctor.

 

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