Arthroscopic Surgery: Minimally Invasive Solutions For Joint Problems

Overview

Arthroscopy is a procedure wherein an orthopaedic surgeon uses a fibre-optic camera to diagnose and treat problems in the joints. Orthopaedic surgeons specialise in conditions affecting our musculoskeletal system that usually trigger pain, instability or some other dysfunction. In this procedure, the surgeon will insert an arthroscope – a narrow, long tube fitted with a video camera and light on one end – via a small incision. The view inside your joint is then flashed onto a high-definition video screen.

Through arthroscopy, surgeons can see inside the joint without needing to make a large incision. Some forms of joint damage can also be repaired through arthroscopy, as pencil-like surgical instruments are inserted through other small incisions.

The procedure is used for various joint problems, generally those affecting the knees, elbow, shoulder, ankle, hip, hand and wrist. Conditions treated with arthroscopy could include damaged or torn cartilage, loose bone fragments, inflamed joint linings, scarring within joints and torn ligaments. The procedure could be used if X-rays or other imaging tools fail to provide proper answers. Arthroscopy could also be an option for damaged tendons, ligaments or cartilage wherein you get no relief from nonsurgical methods like braces or splints, medications or steroid injections, physiotherapy and rest.

The Benefits of Arthroscopy

Being a minimally invasive procedure, it is only done through small incisions. In comparison to an open surgery, it ensures faster recovery, less pain plus limited blood loss and scarring.

The Possibility of Complications

Since it is a relatively safe procedure, complications are uncommon. In rare cases, some problems may arise such as:

• Tissue or nerve damage: The movement and placement of instruments inside the joint could damage its structures.
• Infection: Although invasive surgery of any type has an infection risk, it is far lower in arthroscopy, unlike open surgeries.
• Blood clots: On rare occasions, a surgery lasting longer than one hour could raise the risk of blood clot formation in the lungs or legs.
• Allergic reaction: In rare instances, an allergic reaction to anaesthesia may occur.

How to Prepare for the Procedure

The precise preparations depend on which joint the surgeon is examining or repairing. The typical pre-procedure guidelines cover:

• Avoiding specific medicines: The surgical team may advise you to avoid taking any medications or dietary supplements that enhance the risk of bleeding.
• Fasting: Depending on the kind of anaesthesia to be administered, consumption of solid foods may need to be discontinued eight hours before the procedure begins.
• Wearing loose clothing: Loose, comfortable clothing is ideal. For instance, if you are undergoing knee arthroscopy, shorts will be most convenient to wear once the procedure is done.

Before the procedure, a surgical team member will insert an intravenous tube into the hand or forearm vein to inject a sedative. This will help you stay calm and feel less anxious.

During the Procedure

The specific anaesthesia used will differ according to the procedure.

• Local anaesthesia: In this type of anaesthesia, numbing agents will be injected below your skin to block sensation within a limited area, e.g., the knee. Although awake during this procedure, at the most you will merely feel some pressure or sensation of movement within your joint.
• Regional anaesthesia: The most common form of regional anaesthesia is given via a small needle inserted between two of your lumbar vertebrae in the spine. While this will numb the lower half of your body, you will be awake.
• General anaesthesia: Depending on the duration of the operation, it may be deemed better if you are unconscious during the surgery. Therefore, general anaesthesia will be administered through your vein.

As per the procedure to be undertaken, you will be placed in the best position, either on your back or on the side. The limb to be examined or repaired could be put in a positioning device. To decrease any blood loss and increase visibility inside your joint, a bandage may be used. Another technique to enhance the internal view of the joint may require filling it with some sterile fluid and expanding the area surrounding the joint.

A small incision is then made for the surgeon’s viewing device. More small incisions at different areas around the joint will permit the insertion of surgical tools, which are required to cut, grasp, grind and ensure suction for the joint repair. Typically, the incisions are small enough for closure with narrow, sterile strips of adhesive tape or only with one or two stitches.

After the Operation

Once the arthroscopy is over, you will be wheeled to a separate recovery room. You will remain here for a few hours before being allowed to go home.

The aftercare procedure could include:

• Medications: Medicines will be prescribed to relieve the pain and inflammation.
• R.I.C.E.: This acronym refers to Rest, Ice, Compress and Elevate. Your joint will need R.I.C.E. treatment for some days since these steps can help reduce the pain and swelling.
• Protection: The use of temporary splints (slings or crutches) for protection and comfort may be required.
• Exercise: The medical team may prescribe physiotherapy and rehabilitation. This will help strengthen your muscles and improve the functioning of the joint.

When Should You Call the Doctor?

A call to your doctor may be necessary in certain circumstances. For example, if you develop a fever, find no relief from pain even with medicines, notice swelling and a change in skin colour, have some tingling sensation or new numbness, experience drainage from the incision site, feel extreme pain or see bleeding from the incision site, have nausea, vomiting, signs of infection like redness at the incision site or fever.

Recovery and Outlook

The surgeon will review and share the treatment results with you on the day the surgery is done. Recovery from arthroscopic surgery is much faster than an open surgery where large incisions are required. Though complete recovery will take some months, depending on the procedure you underwent, a return to work could be possible within a few days.

Nonetheless, the recovery process can vary between different patients. For some, a longer recovery and rehabilitation period is essential. The surgeon could recommend physiotherapy to speed up recovery, improve your muscle strength and prevent any future injuries. The surgical team will check your progress during follow-up visits. During this time, any potential problems can be addressed.

It must be emphasized that arthroscopy is a comparatively safe and effective way to examine and treat joint, muscle, tendon and ligament problems. However, you need to visit the best orthopaedic care centre or hospital to ensure the best treatment outcomes without unwanted complications.