Arthroscopy: Reasons, Procedure and Benefits

Orthopaedics & Joint Replacement | Posted on 01/19/2022 by RBH

Arthroscopy is a surgical technique in which a tube-like instrument is inserted into a joint to inspect, diagnose, and repair tissues.

Arthroscopy is advised if you have inflammation in a joint, in cases of injury or trauma to a joint, or have damaged a joint due to wear and tear. You can have arthroscopy on any joint. Most often, it’s done on the knee, shoulder, elbow, ankle, hip, or wrist.

Reasons for damage of joints –

• Osteoarthritis is the most common form of arthritis.
• Gout is a type of inflammatory arthritis that occurs in some people with high levels of uric acid in their blood.
• Septic Arthritis – a condition in which a joint becomes infected,
• Viral Arthritis – arthritis due to viral infection
• Rheumatoid Arthritis – RA is a chronic, autoimmune disease
• Spondylarthritis – An inflammatory rheumatic disease
• Systemic Lupus Erythematosus – joint inflammation, especially of the knees, wrists, and finger joints, is common in systemic lupus erythematosus
• Fibromyalgia –  The predominant symptom of fibromyalgia, a chronic pain condition, is widespread muscle tenderness, along with crippling fatigue.
• Hemarthrosis – A bleeding into a joint due to a number of reasons including trauma.

An Overview

Arthroscopic surgery can treat inflammation, torn ligaments and tendons, loose bones or cartilage issues. If you have a joint issue, there is a good chance arthroscopic surgery can diagnose and treat it. While knee and shoulder arthroscopies are the most common surgeries, the procedure can be performed on any joint.

It can be used to treat conditions of knees, shoulders, ankles, elbows, wrists like:

• Tendonitis Bursitis
• Arthritis
• Frozen shoulder
• Cartilage damage
• Bone spurs
• Arthrofibrosis
• Ganglion cysts
• Ligament injury
• Fractures

Arthroscopy Procedure-

Preparation of patient-

Many doctors will recommend a tailored preparation plan, which includes gentle exercises and medications

The patient may need to stop eating up to 12 hours before the procedure, especially if general anaesthesia has to be applied

Positioning and Scope Insertion

• The type of anesthetic used to numb pain will depend on the extent of the arthroscopy.
• A doctor may inject a local anaesthetic to numb the affected joint. In some cases, doctors will use a general anesthetic. In this case, the person will be completely asleep during the procedure
• The procedure starts with a few small cuts in the joint. Surgeons use a pump to push saline solution into the area. This will expand the joint, making it easier for the doctors to view the affected area and operate it with ease
• The patient is placed supine with ability to flex the joint.
• The medical team places a tourniquet (important for safety, but often not inflated).
• The doctors then make anterolateral incision over a soft spot of the joint. Vertical incisions have the advantage of increased superior-inferior mobility of instruments and   horizontal incisions have advantage of increased medial-lateral mobility of instruments.
• Next, the doctors insert a trocar into a capsule
• Advance blade into the capsule with the trocar
• Advance trochar into suprapatellar pouch to strengthen or fix the joint

Benefits of Arthroscopy

While every surgery is different and every person responds to surgery differently, arthroscopic surgery tends to have many advantages over traditional surgery.

• Lesser complications: Since arthroscopy uses tiny incisions instead of large cuts, the chance of infection or other complications is much less.
• Less post-operative pain: No muscles or tendons have to be cut to repair the joint, so pain is usually much more manageable. Fewer cuts also mean that recovery goes much quicker.
• There is less scarring: The minimally invasive nature of arthroscopic surgery means that scarring is kept to a minimum.
• Recovering from arthroscopy is usually quicker than recovering from open surgery.
• Most people leave the hospital on the day of the operation with specific instructions about how to handle recovery. Arthroscopically treated patients tend to heal faster and begin rehabilitation earlier and, subsequently, return to normal activity and work sooner.

General recovery tips include:

• Applying ice packs to the dressing and surrounding area to reduce swelling and pain
• Keeping the leg elevated for several days after surgery
• Resting well and often
• Changing the dressing regularly
• Using crutches and following the doctor’s recommendations about applying weight to the knee.