Arthroscopic surgery is a minimally invasive procedure performed using an arthroscope through small button-hole like keyhole skin incisions. An arthroscope is a pen-like telescopic camera which is used to look-into a joint to diagnose and treat joint pathologies. The diameter of a standard arthroscopy is 4 mm for large joints and 2.7 mm for small joints. An arthroscope can be used to treat all major joints.
There are many joint conditions which need surgery. Injuries like ligament tears, cartilage injuries, meniscus tears, small bony joint fractures and pathologies like chronic synovitis, plica syndromes, ligament releases for instability, benign tumors and inflammatory arthritis and loose body extraction are best managed arthroscopically.
Arthroscopic surgery is performed under regional anesthesia as a day care procedure. The joint to be arthroscoped is cleaned and prepped. Small button-hole like skin incision is made on the joint surface and the 4 mm arthroscope is introduced into the joint. The joint is insufflated with normal saline fluid and small hand instruments are passed through another incision. The camera in the arthroscope projects the joint images and video on a screen. The diagnostic procedure is carried out first followed by the definitive therapeutic surgical procedure. Once the surgery is concluded, skin wounds are closed using one or two stitches and compression dressing is applied. Patient usually starts weight bearing and walking on the leg using crutches by evening. Stitches are removed in 10 days after the surgery. Patients are usually put on rehabilitation exercises for few months.
Most surgeries which were earlier done using large incisions as an open procedure are fortunately being done arthroscopically now. The large incisions would cause more muscle damage, more bleeding, increase operating time, anesthesia time, and hospital cost, and subsequently resulted in more joint stiffness, ugly scarring and arthritis. Technological advances in implants and devices have paved the way for arthroscopic surgeries which avoids all these complications. Therefore, arthroscopic surgery is faster, safer and has less scarring, it lowers operating time and anesthesia requirement, resulting in early discharge, less hospitalization and lower cost of treatment.
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