Arthroscopy Surgery:

Joints are beautifully designed to give our bodies freedom of movement. But the wear and tear of an active lifestyle, the normal aging process, disease, or accidental injurty can cause joints to develop problems. No matter what your age, arthroscopy can be a crucial component in the successful diagnosis and treatment of your problem joint.

Advantages and Limitations of Arthroscopy

Once the knee was the sole beneficiary of arthroscopy, but now a variety of joints can enjoy its advantages. With arthroscopy, you surgeon can reach a more accurate diagnosis, prescribe appropriate treatment, and perform many surgical procedures. Because the work is done through small incisions, it is usually a same day procedure and there is less trauma to the tissue, which makes for better healing. But arthroscopy is no the perfect solution for every condition. In addition, full recovery includes a period of healing and rehabilitation which may take a few weeks, or up to one year depending upon your condition.

Understanding arthroscopy

An arthroscope is an instrument that allows you doctor to look directly into the joint that's bother you. Because arthroscopy revealed things never seen before, it was initially used as a superb diagnostic tool.

Eventually, the technique progressed to include surgical procedures.

The arthroscope contains magnifying lenses and glass fibers that beam light into the joint and relay a magnified image to an eyepiece or TV monitor. The arthroscope, fluid tubes and surgical instruments are inserted through tiny incisions called portals. The joint is continuously irrigated to keep the visual field clear and distend the area so the surgeon has room to work.

This distension causes some soreness after arthroscopy, even when it is used only for diagnosis, and not for surgery.

Specially designed surgical instruments are used to remove, repair, or reconstruct the damage tissue. Techniques include trimming tissue, removal of “loose bodies” (fragments of cartilage or bone), suctioning debris, smoothing rough surfaces, and sewing and stapling cartilage and ligaments.

Your arthroscopy experience

Before doing arthroscopy, a complete evaluation is needed to have as accurate a diagnosis as possible. This may include a medical history, physical exam and diagnostic tests. On the basis of these, arthroscopy may then be indicated to confirm the diagnosis. In many cases, your surgeon will be able to correct the problem at the same time as you diagnostic excision.

History

Your doctor may ask you questions such as Where is the pain? Did it begin gradually or suddenly? How were you injured was there swelling soon after.

Physical Exam

Your doctor will manually examine your joint to look for a decreased range of motion, swelling, instability, and signs of muscle atrophy and tenderness.

Diagnostic Tests

Recommended diagnostic tests may include routine or special x-rays, CT scans, bone scans, or MRI's Their results may indicate nonsurgical treatment or arthroscopy.

Indications for Arthroscopy

There are a number of reason why your surgeon may recommend arthroscopy after the orthopedic evaluation. It may also be needed to confirm a diagnosis, or to obtain a diagnosis that was not possible with other means. Arthroscopy may also be indicated when your pain, instability, and inability to use the joint persist despite nonsurgical treatment.

Pre-Op

Your doctor will indicate which preop lab tests you require, such as blood tests, urinalysis, x-ray, and EKG. You will have either local, regional, or general anesthesia, depending upon the joint in which the arthroscopy will be performed and your general physical condition. You will be advised no to eat or drink anything after midnight the night before surgery, and to wash the area well beforehand.

The Procedure

The exact extent and duration of your arthroscopy is unpredictable until the procedure is underway. It may take anywhere from a half hour to several hours.

Post-OP

Recovery Room

A nurse will monitor your progress while the anesthesia wears off and recovery begins. Your joint will be bandage, and possibly elevated, with an ice pack to reduce pain and swelling. You will be encouraged to do certain exercises to improve your circulation and keep the joint mobile.

Home (Hotel) Recovery

Follow your doctor;s instructions about keeping the area elevated above heart level and taking pain medication. You may be instructed to rest and apply an ice pack for the first day. Check with your doctor about when you can take a shower; avoid soaking in a tub or pool. Be sure to continue the recommended exercises.

Follow-up and Rehabilitation

During follow-up appointments, your doctor will inspect the area, remove any stiches, and plan your rehabilitation. You may be shown exercises to do at home, or physical therapy may be recommended. In either case, the goal is to restore your joint to its fullest potential.

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