The knee joint, which appears like a simple hinge-joint, is one of the most complex joints. It consists of the femur (thighbone), tibia (shinbone) and patella (kneecap). The knee is a synovial joint, which means it is lined by synovium. The synovium produces fluid lubricating and nourishing the inside of the joint. Articular cartilage is the smooth surfaces at the end of the femur and tibia. It is the damage to this surface, which causes arthritis.
Arthroscopy is a surgical procedure in which an arthroscope is inserted into a joint. Arthroscopy is a term that comes from two Greek words, arthro-, meaning joint, and -skopein, meaning to examine.
Arthroscopy is performed in a hospital operating room under general anesthetic.
The arthroscope is a small fiber-optic viewing instrument made up of a tiny lens, light source and video camera. The surgical instruments used in arthroscopic surgery are very small (only 3 or 4 mm in diameter), but appear much larger when viewed through an arthroscope.
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.
The surgeon makes two small incisions (about 1/4 of an inch), around the joint area. Each incision is called a portal. These incisions result in very small scars which in many cases are unnoticeable.
In one portal, the arthroscope is inserted to view the knee joint. Along with the arthroscope, a sterile solution is pumped to the joint which expands the knee joint, giving the surgeon a clear view and room to work. The sterile solution is regulated by a drainage needle for the amount of fluid in the joint during the procedure.
With the images from the arthroscope as a guide, the surgeon can look for any pathology or anomaly. The large image on the television screen allows the surgeon to see the joint directly and to determine the extent of the injuries and then to perform the particular surgical procedure if necessary.
The other portal is used for the insertion of surgical instruments. A surgical instrument is used to probe various parts within the joint to determine the extent of the problem. If the surgeon sees an opportunity to treat a problem, a variety of surgical instruments can be inserted through this portal. After treating the problem, the portals (incisions) are closed by suturing or by tape. Arthroscopy is much less traumatic to the muscles, ligaments, and tissues than the traditional method of surgically opening the knee with long incisions (arthrotomy).
Post-operative recovery
Risks specifically related to the surgery.
Risks related to Arthroscopic knee surgery include:
The risks and complications of arthroscopic knee surgery are extremely small. One must however bear in mind that occasionally there is more damage in the knee than was initially thought and that may affect the recovery time. In addition if the cartilage in the knee is partly worn out then arthroscopic surgery has about a 65% chance of improving symptoms in the short to medium term but more definitive surgery may be required in the future. In general arthroscopic surgery does not improve knees that have well established Osteoarthritis.
Shoulder arthroscopy is a surgical procedure in which an arthroscope is inserted into the shoulder joint. The benefits of arthroscopy are smaller incisions, faster healing, a more rapid recovery, and less scarring. Arthroscopic surgical procedures are often performed on an outpatient basis and the patient is able to return home on the same day.
Indications
Arthroscopy may be recommended for shoulder problems such as:
Evaluation and treatment of instability
A torn or damaged cartilage ring (labrum) or biceps tendon
Arthroscope is a small fiber-optic viewing instrument made up of a tiny lens, light source and video camera. The television camera attached to the arthroscope displays the image of the joint on a television screen, allowing the surgeon to look, throughout the shoulder- cartilage, ligaments, and the rotator cuff.
Procedure
The surgeon makes small incisions around the joint area. In one portal, the arthroscope is inserted to view the shoulder joint. Along with the arthroscope, sterile solution is pumped to the joint which expands the shoulder joint, giving the surgeon a clear view and room to work. Other portal is used for the insertion of surgical instruments to probe various parts within the joint to repair the damaged shoulder.
Arthroscopy is much less traumatic to the muscles, ligaments and tissues than the traditional method of surgically opening the shoulder with long incisions (open techniques).
Risks and Complications
Complications of shoulder arthroscopy are infection, bleeding, damage to any nerve or blood vessel or delayed healing after the surgery. In certain cases stiffness of shoulder joint may occur after the surgery.
After the surgery
Following the surgery, your surgeon may recommend you to practice certain measures for better outcomes. Pain medications will be provided, bandage will be given around the operated shoulder which can be removed after 24 hours and dressings can be placed to cover the wounds. Slight swelling of the shoulder may be present after the surgery which is normal. Placing ice-packs on the shoulder for about 20 minutes, 3-4 times a day helps reduce the swelling. You can return to normal activities when you feel comfortable and a follow-up visit should be scheduled 7-10 days after surgery to monitor your progress.
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