What Is Arthroscopy?
An orthopedic surgery which is used to visualize and correct/treat minor defects in any joint is known as arthroscopy. It is both a diagnostic as well as a surgical treatment approach. It is done with the help of an arthroscope. An arthroscope is quite similar to an endoscope in the sense that it is a long surgical instrument with a minute camera to capture and a lens to magnify the joint, attached to one end. This enables the surgeon to visualize the joint space and cavity and work accordingly. It can also be used as an adjunct to the standard surgical procedure used for the correction of defects of joints.
Causes of Joint Diseases :
- Bacterial/viral/fungal infections may cause inflammation in the joints
- Sports injuries in common in athletes
- Genetic disorders leading to impairments in the joints
- Trauma, falls, accidents, injuries
- Inflammation of the synovial membranes leading to arthritis
- Autoimmune conditions in which body tends to produce cells against the host tissues leading to damage and degeneration of the joints.
Signs and Symptoms Of Joint Diseases:
- Pain and tenderness in and around the joint
- Swelling, edema and redness
- Reduced and restricted movements
- Difficulty in walking, performing daily tasks, discomfort while getting up after prolonged sitting
- General body discomfort, lethargy, loss of interest in doing daily chores
Diagnosis Of Joint Diseases:
- Blood and urine sample examinations: ESR erythrocyte sedimentation rate, C-Reactive protein are looked for in blood in cases of arthritis. Urine and blood samples are examined for the presence of excess uric acid indicative of gout.
- Synovial fluid test: A small amount of synovial fluid can also be extracted from the joint space and studied for the presence of any atypical and inflammatory cells.
- Imaging techniques: Xrays are routinely advised for the examination of the bones, bony unions. A CT computed imaging scan can be used to study the parts in details. An ultrasound USG and a MRI magnetic resonance imaging technique will help in the assessment of the tendons, ligaments, joint cavities and the cartilages associated with the joints.
Types of Joint Diseases Requiring Arthroscopy:
The internal structure of 6 joints mainly is viewed with the help of arthroscopy. These joints are:
Diseases and conditions of joints which can be treated by arthroscopy include:
- Rotator cuff surgery: For the correction of rotator cuff tendons and muscles of the shoulder, and arthroscopic approach can be used as an adjunct to the standard surgery in order to visualize the muscle origins and insertions.
- Meniscus repair: This most commonly is done in the knee and shoulder for sealing and bandaging of the torn cartilage pieces.
- Removal of inflamed lining/synovial membrane: A common use of arthroscopy is for removing the inflamed and tender synovial membrane for the correction of arthritic conditions in knee, shoulder, elbow, wrist and ankle.
- Carpel tunnel syndrome: It is used for the intervention into the wrist bones for the correction of the compressed median nerve.
- Removal of loose bone or cartilage in knee, shoulder, elbow, ankle, wrist.
Treatment Procedure for Arthroscopy:
Arthroscopy is considered as a close approach as opposed to the standard open approach for the correction of joint defects. It requires anesthesia and can be done in an outpatient department. Anesthesia can be in the form of local, general or spibal depending upon the type of joint and location of the joint. A small incision is then made at the site of the joint for the insertion of the arthroscope. Earlier when this procedure was only used for the diagnostic purposes, only an arthroscope was used. However, now multiple small surgical instruments can also be inserted. These instruments help in recountouring the rough bony surfaces, aid in the excision of tendons, ligaments or muscles and help in the repair.
The more the complex the problem is, the more elaborative is the surgery and thus the more is the recovery time. As an additional factor, a surgeon may realize that the defect cannot be solely treated with this single approach. At this time, on the surgical table a decision can be made to open the joint completely and treat the cause. In such cases an additional arthroscopy may be needed later to check for the stability of the standard surgery attempted.
Complications And Risk Factors Associated With Arthroscopy:
- Infections, swelling and edema can occur at the site of incision post operatively
- Thrombophlebitis which is engorgement and clotting in the veins can also occur at the site of incisions, can be life threatening in a few cases
- Instrument breakages can occur at the time of insertion
Am I A Good Candidate For Arthroscopy?
Every patient undergoing diseases of the joints in terms of bones, muscles, ligaments, tendons, fascia, bursae is always a candidate for a diagnostic type of arthroscopy. In cases where minor repairs, recountouring, decompression of nerves is required, you become a good candidate for a minimally invasive approach for the surgical type of arthroscopy.
- The procedure helps in the proper visualization of the joint
- Helps in the formation of a correct diagnostic plan
- Since it is a closed type of surgery, can be done in OPD, does not require major hospital stays
- No chance of scarring since the incision made is a very minor one
- More esthetic approach
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