Arthroscopic surgery is a common orthopedic procedure that is used in the diagnosis and treatment of problems inside a joint.
Types of Arthroscopic Surgery:
Arthroscopic surgery could potentially be performed on any joint, and as time passes, more and more different joints are being arthroscopically treated. Common types of arthroscopic surgery include:
- Knee arthroscopy
- Shoulder arthroscopy
- Hip arthroscopy
- Ankle arthroscopy
- Elbow arthroscopy
- Wrist arthroscopy
Knee and shoulder arthroscopy are by far the most common arthroscopic procedures performed. These joints are large enough to manipulate the instruments around, and they are amenable to arthroscopic surgery treatments.
Technically speaking, any joint can have an arthroscopic surgery. However, the practicality and the instrumentation available limit our ability to arthroscope every joint for all types of problems. The most common arthroscopic procedures include repairing cartilage and meniscus problems in the knee and repairing rotator cuff tears in the shoulder.
Performing Arthroscopic Surgery:
When an arthroscopy is performed, a camera is inserted into the joint through a small incision (about one centimeter). The arthroscopic surgery camera is attached to a fiberoptic light source and shows a picture of the inside of the joint on a television monitor. The surgeon uses fluid pumped through the joint to aid in visibility and clear debris from the joint. One or more other incisions are made to insert instruments that can treat a variety of conditions. For example, a shaver can be inserted to trim torn cartilage from a joint.
There are many different types of instruments that help to address different types of problems in different joints. There are cameras that are larger or smaller, different degrees, and provide different images. There are instruments made for individual joints, and even for individual problems with these joints. Performing an arthroscopic surgery in the wrist utilizes very different instruments from an arthroscopic surgery of the hip.
Common Arthroscopic Procedures:
Many joint problems are amenable to arthroscopic surgery. As mentioned above, knee and shoulder conditions are far more often treated arthroscopically than are other joints; some common arthroscopic procedures include:
- Trimming a torn meniscus of the knee2
- Repairing a torn meniscus of the knee
- Treatment of cartilage damage of the knee
- Treatment of shoulder bursitis3
- Repair of the rotator cuff in the shoulder
- Treatment of labral tears in the shoulder
However, not all conditions are best treated with arthroscopic procedures. For example, numerous studies have demonstrated the limited improvement when arthroscopic surgery is performed for treatment of knee arthritis. As with any minimally invasive surgical procedure, the primary objective of adequate treatment of the condition must supersede any desire to perform the procedure through a small incision. If the problem cannot be sufficiently treated arthroscopically, then another surgical approach should be considered.
Safety of Arthroscopic Surgery:
Understand that arthroscopic surgery is a surgical procedure and involves risks. These may include infection, blood clots, nerve injuries, and problems with anesthesia.3 These are serious risks and the decision to undergo arthroscopic surgery should be carefully considered in consultation with your surgeon. That said, arthroscopic surgery is a "less invasive" procedure, and when performed for the right problem it is often very successful.
Some of the common risks after arthroscopic surgery include pain and discomfort following the procedure. Despite the small incisions that are made, there can still be discomfort associated with performing this type of surgery. Additionally, in order to see inside the joint, your doctor will circulate fluid through the arthroscope. This fluid can cause significant swelling around the surgical area. Ask your doctor for more information about arthroscopic surgery, and talk about the possible risks of undergoing the procedure.
Recovery from Arthroscopy:
One of the tremendous advantages of arthroscopic surgery is the ability to limit damage to the soft-tissues surrounding the joint. Not only are incisions small, but there is minimal damage to muscle, ligaments, and all of the structures that surround the joint. In addition, the trauma to the joint, and the bleeding, swelling, and inflammation, is all minimized. Patients can generally begin range-of-motion and strengthening exercises sooner than with open surgical procedures. However, some procedures may still require limitations even when performed arthroscopically; therefore, check with your surgeon before beginning any post-surgical therapy program.
Despite the fact that recovery is often faster with an arthroscopic procedure, there are limitations to how much activity you should do and how quickly. Arthroscopy is traumatic to your body, and if not properly treated there can be an increase in pain, stiffness, and swelling. Gradually increasing activity levels can help to ensure that these problems do not occur. In addition, having a physical therapist or athletic trainer guide you rehabilitation is often a critical step in ensuring the right pace of recovery.