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Arthroscopy Procedure & Recovery
Hip arthroscopy for trochanteric bursitis – bursectomy : Arthroscopy procedure can be used to diagnose or treat a range of joint problems. Arthroscopy is a procedure that lets doctors see, and sometimes repair, the inside of a joint. It’s a minimally invasive technique that allows access to the area without making a large incision. In the procedure, a tiny camera is inserted through small cuts. Pencil-thin surgical tools can then be used to remove or repair tissue.
Doctors use the technique to diagnose and treat conditions that affect the knee, shoulder, elbow, hip, ankle, wrist, and other areas. An arthroscopic examination allows the doctor to make a tiny incision in your skin and insert a pencil-sized instrument. The arthroscope has a small lens and lighting system used to illuminate and magnify the joint structures. The doctor can then visualize your joint on a TV monitor.
What does ‘arthroscopy’ mean?
The word ‘arthroscopy’ is derived from two separate Greek words, ‘arthro’ meaning joint, and ‘skopein’ meaning to look in. The term literally means “to look in the joint”.
Arthroscopy is a surgical procedure by which the internal structure of a joint is examined for diagnosis and/or treatment using a tube-like viewing instrument called an arthroscope. Arthroscopy was popularized in the 1960s with the advent of fiberoptic technologies and is now commonplace throughout the world. Typically, it is performed by orthopedic surgeons in an outpatient setting. When performed in the outpatient setting, patients can usually return home on the same day the procedure is completed.
The technique of arthroscopy involves inserting the arthroscope, a small tube that contains optical fibers and lenses, through tiny incisions in the skin into the joint to be examined. The arthroscope is connected to a video camera and the interior of the joint is seen on a television monitor. The size of the arthroscope varies with the size of the joint being examined. For example, the knee is examined with an arthroscope that is approximately 5 millimeters in diameter. There are arthroscopes as small as 0.5 millimeters in diameter to examine small joints such as the wrist.
If procedures are performed in addition to examining the joint with the arthroscope, this is called arthroscopic surgery. There are a number of procedures that are done in this fashion. If a procedure can be done arthroscopically instead of by traditional surgical techniques, it usually causes less tissue trauma, may result in less pain, and may promote a quicker recovery.
For what diseases or conditions is arthroscopy considered?
Arthroscopy can be helpful in the diagnosis and treatment of many noninflammatory, inflammatory, and infectious types of arthritis as well as various injuries within the joint.
Noninflammatory degenerative arthritis, or osteoarthritis, can be seen using the arthroscope as frayed and irregular cartilage. A new procedure for the treatment of younger patients with an isolated injury to the cartilage covering the bone ends within a joint uses a “paste” of the patient’s own cartilage cells. The cells are harvested and grown in the laboratory and are then reimplanted at a later date in the knee with the use of an arthroscope.
In inflammatory arthritis, such as rheumatoid arthritis, some patients with isolated chronic joint swelling can sometimes benefit by arthroscopic removal of the inflamed joint tissue (synovectomy). The tissue lining the joint (synovium) can be biopsied and examined under a microscope to determine the cause of the inflammation and discover infections, such as tuberculosis. Arthroscopy can provide more information in situations which cannot be diagnosed by simply aspirating (withdrawing fluid with a needle) and analyzing the joint fluid.
Common knee joint injuries for which arthroscopy is considered include cartilage tears (meniscus tears), ligament strains and tears, and cartilage deterioration underneath the kneecap (patella). Arthroscopy is commonly used in the evaluation of knees and shoulders but can also be used to examine and treat conditions of the hips, wrist, ankles, feet, spine, and elbows.
Finally, loose tissues, such as chips of bone or cartilage, or foreign objects, such as plant thorns or needles, which become lodged within the joint can be removed with arthroscopy.
Why is arthroscopy necessary?
The orthopedic specialist uses arthroscopy for diagnosis and repair. Some injuries can be diagnosed with x-rays, magnetic resonance imaging (MRI), or computed tomography (CT). Other injuries, however, require further diagnostic techniques. The arthroscope allows the surgeon to make a more accurate final diagnosis and repair the injury at the same time. Some of the common conditions found during arthroscopy include:
- Inflammation – Swelling and redness of the lining of the shoulder, elbow, wrist, knee, or ankle
- Arthroscopy Shoulder – Injury to the rotator cuff tendon, injury to the biceps tendon, impingement syndrome, and recurrent dislocations
- Arthroscopy Knee – Meniscus tears, chondromalacia, and anterior cruciate ligament tears as well as evaluating damage to the joint surfaces
- Arthroscopy Wrist – Torn cartilage or loose bodies
- Loose Bodies of Bone or Cartilage
What are some problems treated with arthroscopy?
The problems treated with arthroscopy include:
- Reconstruction of the anterior cruciate ligament of the knee
- Rotator cuff surgery
- Removal of lose bone or cartilage
- Repair of torn ligaments
- Removal of inflamed synovium lining of the shoulder, knee, elbow, ankle, or wrist
- Repair or removal of a torn meniscus of the knee
What joints are most frequently examined by arthroscopy?
There are six joints that are typically examined with the arthroscope. These include the knee, shoulder, elbow, ankle, hip, and wrist.
How is arthroscopy performed?
Arthroscopic surgery is less traumatic than traditional open surgery. The orthopedic specialist uses general or regional anesthesia, depending on which joint and the extent of the problem. A small, buttonhole sized incision is made on the skin to insert the arthroscope along with several other small incisions around the joint area.
The surgeon inserts the instruments through this incisions and uses the additional incisions to insert specially designed instruments used for repair. When indicated, the surgeon corrects the problem and repairs the damage as necessary. After the procedure, the small incisions are closed with sutures or Steri-strips and covered with a dressing. You will be moved from the operating room to the recovery room. Most arthroscopic procedures are done on an outpatient basis.
Before you are discharged to home, you will be given instructions about how to care for your wounds, what activities to avoid, and which exercises to perform to aid your recovery. The sutures will be removed during your follow-up visit.
What are the possible complications of arthroscopy?
Although complications are rare, they do occasionally occur following arthroscopy. These include blood clots of a vein, infection, excessive swelling, bleeding, damage to blood vessels or nerves, and muscle damage.
What are the advantages of arthroscopy?
Arthroscopic surgery allows quicker recovery time and less pain because less muscle and tissue are disturbed during the procedure, as compared to traditional open surgery. Most patients are treated as outpatients and are home several hours after the operation.
What is recovery like after arthroscopy?
The small incisions take several days to heal. The orthopedic specialist will instruct you as to when the surgical dressing can be removed. The pain in the joint is minimal but may take several weeks to maximally recover. The orthopedic specialist will develop a tailored rehabilitation plan for you to follow. This will depend on the joint that was worked on, the degree and severity of your injury or condition, and your current health status. Most athletes are able to return to their usual athletic activities within a few weeks, and other patients return to normal activities in a short time.
How does arthroscopy feel?
If you are given a general anesthetic, you will be unconscious and not feel anything during your operation. If you receive regional anesthesia, your arm or leg will be numb for several hours. You will not feel anything during the procedure either.
Expect to have some mild soreness and pain following your arthroscopic procedure. The orthopedic specialist will prescribe some pain medicine for you to use, and advise you to apply ice to your joint. This helps reduce pain and swelling. Be sure to keep your bandages clean and dry while the joint heals.
Hip arthroscopy for trochanteric bursitis – bursectomy : Hip arthroscopy can be used to successfully treat trochanteric bursitis of the hip, a fairly common cause of pain on the outside (lateral aspect) of the hip bone (greater trochanter). This video shows an arthroscopic release (incision) of the fascia lata and a bursectomy. By Laith Farjo, M.D., an arthroscopic surgical specialist, in Brighton, Michigan.
Terms related to Arthroscopy
Arthroscopy Knee Surgery
Arthroscopy Recovery Time
Knee Arthroscopy Complications
Knee Arthroscopy Cost