What is Arthroscopic Surgery?
Arthroscopic Surgery is a procedure Dr Bhimani can use on a patient by patient basis depending upon the patient’s medical circumstances, to visualize, diagnose, and treat problems inside a joint.
Arthroscopic surgical procedures are usually performed on an outpatient basis and the patient is able to return home on the same day as the procedure. If a procedure can be done arthroscopically instead of by traditional surgical methods, it can cause less trauma, may result in less pain, and may promote a quicker recovery for the patient.
In an arthroscopic examination, Dr Bhimani makes a small incision in the patient's skin and then inserts a small tube that contains optical fibers and lenses. 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, Dr Bhimani is able to see the interior of the joint through this very small incision rather than a large incision needed for traditional surgical methods.
The television camera attached to the arthroscope displays the image of the joint on a television screen, allowing Dr Bhimani to look, for example, throughout the knee or hip. Dr Bhimani can then see the cartilage, ligaments, and under the kneecap to determine the amount or type of injury and can sometimes repair or correct the problem.
However there are many instances when arthroscopic surgery would be insufficient to treat the problems a patient is experiencing and more traditional surgical options such as a joint replacement may be required.
Dr Bhimani will always discuss the non-surgical and surgical options available to you, and which option he believes is most suitable in order to obtain the best long term result given your diagnosis, pain and loss of normal function.
Why is Arthroscopy necessary?
An arthroscope may be recommended even if the condition causing you pain has already been diagnosed or to help find a diagnosis.
Diagnosing joint injuries and disease begins with a thorough medical history, physical examination, and usually X-rays. Additional tests such as an MRI or CT scan also may be required. A final diagnosis may be more accurate following an arthroscope to assist your surgeon to treat the issue, whether during an arthroscope or more traditional surgical options.
What are the conditions that can be treated by Arthroscopy?
On a case by case basis, as determined by Dr Bhimani, arthroscopy can be helpful in the diagnosis and treatment of many non-inflammatory, inflammatory, and infectious types of arthritis as well as various injuries within the joint.
Non-inflammatory degenerative arthritis, or osteoarthritis, can be seen using the arthroscope as frayed and irregular cartilage. In inflammatory arthritis, such as rheumatoid arthritis, some patients with isolated chronic joint swelling can sometimes benefit by arthroscopic removal of the inflamed joint tissue (synovectomy).
Arthroscopy is commonly used in the evaluation of knees but can also be used to examine and treat conditions of the hips.
Common knee joint injuries for which arthroscopy is considered include cartilage tears (meniscus tears), ligament strains and tears, and cartilage deterioration underneath the kneecap (patella).
Lastly, loose tissues, such as chips of bone or cartilage, or foreign objects, such as plant thorns or needles, which become lodged within the joint, can be removed via arthroscopy.
How is arthroscopy performed?
Arthroscopic surgery, although much easier in terms of recovery than ‘open’ surgery, still requires the use of anaesthetics and the special equipment in a hospital operating room or outpatient surgical suite. You will be given a general, spinal, or a local anaesthetic, depending on the joint or suspected problem.
A small incision (about the size of a buttonhole) will be made to insert the arthroscope while other incisions may be made to see other parts of the joint or insert other instruments.
Corrective surgery is performed with specially designed instruments that are inserted into the joint through accessory incisions. Initially, arthroscopy was simply a diagnostic tool for planning standard open surgery. With development of better instrumentation and surgical techniques, many conditions can be treated arthroscopically.
For instance, many meniscal tears in the knee can be treated successfully with arthroscopic surgery. The surgeon inserts miniature scissors to trim a torn meniscus.
After arthroscopic surgery, the small incisions will be covered with a dressing. You will be moved from the operating room to a recovery room. Many patients need little or no pain medications.
Before being discharged, you will be given instructions about care for your incisions, what activities you should avoid, and which exercises you should do to aid your recovery. During the follow-up visit, Dr Bhimani will inspect your incisions; remove sutures, if present; and discuss your rehabilitation program.
The amount of surgery required and recovery time will depend on the complexity of your problem. Occasionally, during arthroscopy, Dr Bhimani may discover that the injury or disease cannot be treated adequately with arthroscopy alone.
What are the possible complications?
While uncommon, complications do occasionally occur during or following arthroscopy. Infection, phlebitis (blood clots of a vein), excessive swelling or bleeding, damage to blood vessels or nerves, and instrument breakage are the most common complications, but occur in far less than 1 percent of all arthroscopic procedures.
What are the advantages of arthroscopy?
Most patients have their arthroscopic surgery as outpatients and are home several hours after the surgery as it usually causes less trauma, may result in less pain, and may promote a quicker recovery for the patient than traditional surgical methods.
What is recovery like after arthroscopy?
The small puncture wounds take several days to heal. The operative dressing can usually be removed the morning after surgery and adhesive strips can be applied to cover the small healing incisions.
Although the puncture wounds are small and pain in the joint that underwent arthroscopy is minimal, it takes several weeks for the joint to maximally recover. A specific activity and rehabilitation program will be suggested to speed your recover and protect future joint function.
It is not unusual for patients to go back to work or school or resume daily activities within a few days. However people who have arthroscopy will have many different diagnoses and pre-existing conditions, so each patient's arthroscopic surgery is unique to that person and as such recovery time will reflect this.