ARTHROSCOPY

What is arthroscopy?

Arthroscopy is a surgical procedure that allows an orthopaedic surgeon to look inside a joint, and often diagnose and treat many common problems. The development of fiberoptics allowed delivery of light into the joint. Pencil sized instruments that contain small lenses, allow you to attach a miniature camera and thus see inside a joint with only minimal incisions. The images are projected on a monitor, allowing the surgeon to look, for example, throughout the knee--at the surface cartilage, meniscal cartilages, cruciate ligaments and even under the kneecap. An accurate diagnosis can be made, and the appropriate treatment instituted at the same time!

When is arthroscopy necessary?

Most joint injuries can be diagnosed with a thorough medical history, physical examination, and common x-ray evaluation. Additional studies such as an MRI, or CT scan also may be needed. The arthroscope can often be a more direct way to arrive at the diagnosis, and often provide treatment arthroscopically as well.

Diseases and injuries that can be benefited by the addition of the arthroscope to their care include, but are not limited to:

• Inflammation- removal of inflamed lining (synovium) or synovitis such as seen in arthritis
• Repair of resection of torn knee cartilage
• Loose bodies - removal of loose pieces of bone and/or cartilage
• ACL and PCL reconstruction of the knee
• Rotator Cuff procedures
• Surface Cartilage repair
• Assisting in intra-articular fracture repair
• What are the possible complications?

Although uncommon, problems can occur with arthroscopy. Infection, thrombophlebitis (blood clots), excessive swelling or bleeding, and damage to blood vessels or nerves are rare, occurring in less than 1% of the cases. Instrument breakage is statistically the most common problem, and is not of major significance as long as it is recognized.

What are the advantages?

Although arthroscopic surgery has received alot of press, not all problems can be handled by "the scope". It is an extremely valuable tool, and in general is easier on the patient than "open" procedures. Most patients have their procedure as an outpatient, and are home several hours after the surgery.

Recovery after Arthroscopy

The small puncture wounds take several days to seal, and about a week to heal. The operative dressings can be removed the following day. New dressings can then be applied. You may shower, with indirect water contact on the wound when advised to do so by your doctor. Although the puncture wounds are small and the pain is usually minimal, it takes weeks for the joint to maximally recover. Specific rehabilitation programs will be recommended by your doctor, often in conjunction with the help of registered physical therapist.

It is not unusual for you to be able to return to work or school within a few days. Athletes who have unlimited resources, therapists, trainers, strength and conditioning coaches etc. may return to competition at seemingly remarkable rates. Remember, however, that people who have arthroscopy can have many different diagnoses and preexisting conditions, allowing different recovery rates. Each individual is unique, and even the same diagnosis can behave differently in different people.