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 Arthroscopy

Arthroscopy is derived from two words, Arthro = Joint, Scopy = Looking into, thus arthroscopy is a modality of minimal intervention surgery where the surgeon by help of very fine telescope is able to look into the joint to pick up any abnormality which is causing problem to the patient. Not only one can pickup but is able to rectify and cure most of the problems at the same time.

The Arthroscopy as  modality has picked up  and is In vogue due to the fact that patient has a very short stay in the hospital, morbidity(pain and discomfort) after the surgery is very low, very small cut on the skin is made, the esthetics of the part is maintained, patient is able to regain activity very quickly. Not only that there are certain problem deep inside the joint or in certain areas of joint that are actually not easily approached by open method but are better accessed and dealt efficiently by arthroscopy.

The surgery is performed with the help of a very fine telescope(Arthroscope) which is introduced into the joint by a very tiny  punter  of  4mm in the skin called “viewing portal”. The telescope has a light post which carries the light from external  light source via fiber optic cable into the joint thus illuminating the structure in front of the telescope. The images of these structure are picked up by the telescope which has very sophiscated   lens  system which transmits them to the eye piece. The eye piece than passes these images to a very powerful 3 chip camera system which in turn projects these on to the screen of a TV monitor which are visualized by the operating surgeon and can be dealt easily. The total procedure images can be stored as movie on to a disc or as still image for future reference and also can be kept  as a record.

Procedure in the joint is facilitated by a fluid in the joint like Normal saline. It not only inflates the joint and make things clearer but also help in maneuverability of the telescope in the joint. One more portal is than made called “Instrument port” by which various instruments are inserted into the joint to check the integrity of various structures and to  perform very specialized procedures arthroscopically.

Surgeon uses the telescope in a very planned manner all over the joint to be able to inspect every area of the joint. To facilitate examination of the joint the arthroscopist uses a very specialized instrument called “Examination Hook” (which is like extension of surgeons finger)  is used to pull on the structures to find out if they are intact or are torn or have any other pathology. The Hook also helps in measurement of the problem by the markings on it. Further there are very specialized forceps which help to take biopsy and also help in various procedures like menisectomy,  ACL reconstruction,  chondral injury, PCL reconstruction,  Stabilization of Shoulder, rotator cuff repair etc. Now further new and technological advancement have made available very specialized instruments and systems that allows surgeon to be able to tackle 60-70% of joint pathologies arthroscopically with excellent results without patient undergoing  big ordeals of open surgery.

Patient  undergoing arthroscopy are generally brought in as DAY-CARE  where in the patient is admitted in the hospital same day in morning and after the procedure are mostly discharged the same day. As there is very little interference with body systems as well as the joint tissues the patient not only goes home the same day but is also able to start regaining body functions by same evening or max by next day morning and are able to get back to work in few days.

Joints where 70-80% of the problems can now be addressed by Arthroscopic surgery are KNEE, SHOULDER, ELBOW, WRIST, ANKLE. The other joints that can be arthroscoped and treat lot of pathologies are HIP joint, Small  joints of hand and feet,  spine.

Not only joints that are amenable to arthroscopy but many of body spaces where pathologies can be very efficiently dealt by scopy like Bone cyst, carpel tunnel at wrist, compartment syndrome, thorax also nerve entrapment at various body areas.

Arthroscopy is procedure for all who wish to regain function and physical activity quickly with spending minimum time at the hospital.

Studies show that when the ACL is torn approximately 50% of patients also tear their meniscus at the same time. If a part of the meniscus is torn, it can cause a significant amount of pain. The lateral meniscus is more commonly injured than the medial meniscus. Some tears in the meniscus can heal themselves, others may require surgical treatment to help them heal, and some Arthroscopy tears create fragments that need to be removed.

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