Arthroscopic Surgery

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Arthroscopic surgery, or more simply arthroscopy, is a surgical procedure in which orthopaedic surgeons visualize, treat, and diagnose problems inside a joint. Far and away the most commonly treated joint by arthroscopic means is the knee joint. It is a very large joint and lends itself beautifully to arthroscopic techniques.

Other large joints which are treated by arthroscopic means are the shoulder, ankle, and the elbow. Arthroscopic surgery of the hip joint has been done by a relatively small number of orthopaedic surgeons. The hip joint, while a very large joint, is very tight and does not permit easy insertion of arthroscopic instruments.

The wrist is a much smaller joint and its treatment by arthroscopic means is much more specialized than the larger joints.

The word arthroscopy comes from two Greek words, arthro (joint) and skopein (to look). Arthroscopy, therefore, literally means to look within the joint.

An arthroscopic examination is performed in the operating room under sterile conditions by an orthopaedic surgeon. General or regional anesthesia is usually used. A small incision is made in the patient's skin, which is called a portal. Instruments are then inserted through the portal, including a small lens and lighting system to magnify and illuminate structures inside the joint. The arthroscope is attached to a miniature television camera enabling the surgeon to see the interior of the joint and display the image on a television screen. The procedure is then guided by the pictures on the screen. Frequently, color print pictures are taken of various findings within the particular joint.

Arthroscopic surgery is only performed after a thorough medical history, physical examination, x-rays, and possibly additional tests such as magnetic resonance imaging (MRI) or CT scan.

Initially, arthroscopy was simply a diagnostic tool for planning standard open surgery. With the development of improved instruments and surgical techniques, many conditions can be treated arthroscopically at this time. One of the most common conditions treated by arthroscopic surgery is a meniscus or cartilage tear in the knee joint.

Frequently loose bodies of bone and/or cartilage in the knee, shoulder, elbow, or ankle can be removed arthroscopically.

When indicated, corrective surgery can be performed with specially designed instruments that are inserted into the joint through accessory incisions.

Some problems associated with arthritis can be treated arthroscopically. Some ligaments in the knee and shoulder can be treated with arthroscopic means.

Arthroscopic surgery is much easier in terms of recovery than "open" surgery.

Although arthroscopic surgery has received much public attention because it is used to treat well known athletes, it is an extremely valuable tool for all orthopaedic patients and in most cases is easier on the patient than open surgery. Most patients have their arthroscopic surgery as outpatients and go home several hours after the surgery. Arthroscopic surgery is the most common procedure that we perform and has been one of the true revolutions in orthopaedic surgery during the later half of the 20th century. We feel fortunate to be able to offer our patients this type of minimally invasive surgery.