Orthopedics: Arthroscopic Surgery
What is arthroscopy?
Arthroscopy is a surgical procedure that orthopedic surgeons use to visualize, diagnose and treat problems inside a joint. In an arthroscopic examination, an orthopaedic surgeon makes a small incision in the patient's skin and then inserts pencil-sized instruments that contain a small lens and lighting system to magnify and illuminate the structures inside the joint. Light is transmitted through fiber optics to the end of the arthroscope that is inserted into the joint.
By attaching the arthroscope to a miniature television camera, the surgeon is able to see the interior of the joint through this very small incision rather than a large incision needed for surgery. The television camera attached to the arthroscope displays the image of the joint on a television screen, allowing the surgeon to look, for example, throughout the knee. This lets the surgeon see the cartilage, ligaments, and under the kneecap. The surgeon can determine the amount or type of injury and then repair or correct the problem, if it is necessary.
Why is arthroscopy necessary?
Diagnosing joint injuries and disease begins with a thorough medical history, physical examination, and usually X-rays. Additional tests such as magnetic resonance imaging (MRI) or computed tomography (CT) also scan may be needed. Through the arthroscope, a final diagnosis is made, which may be more accurate than through "open" surgery or from X-ray studies.
Disease and injuries can damage bones, cartilage, ligaments, muscles, and tendons. Some of the most frequent conditions found during arthroscopic examinations of joints are:
- Inflammation: For example, synovitis is an inflammation of the lining in the knee, shoulder, elbow, wrist, or ankle
- Acute or Chronic Injury
- Shoulder: Rotator cuff tendon tears, impingement syndrome, and recurrent dislocations
- Knee: Meniscal (cartilage) tears, chondromalacia (wearing or injury of cartilage cushion), and anterior cruciate ligament tears with instability
- Wrist: Carpal tunnel syndrome
- Loose bodies of bone and/or cartilage: for example, knee, shoulder, elbow, ankle, or wrist
Some problems associated with arthritis also can be treated. Several procedures may combine arthroscopic and standard surgery:
- Rotator cuff surgery
- Repair or resection of torn cartilage (meniscus) from knee or shoulder
- Reconstruction of anterior cruciate ligament in knee
- Removal of inflamed lining (synovium) in knee, shoulder, elbow, wrist, ankle
- Release of carpal tunnel
- Repair of torn ligaments
- Removal of loose bone or cartilage in knee, shoulder, elbow, ankle, wrist
Although the inside of nearly all joints can be viewed with an arthroscope, six joints are most frequently examined with this instrument. These include the knee, shoulder, elbow, ankle, hip and wrist. As advances are made in fiberoptic technology and new techniques are developed by orthopaedic surgeons, other joints may be treated more frequently in the future.
**(Text Source: American Academy of Orthopedic Surgeons)