The modern world offers patients with severe illnesses more modern treatments. Surgical operations have long stepped far forward, and today there are few pathologies of the musculoskeletal system that could not be alleviated with the help of such procedures.
Many are interested in what arthroscopy is, how dangerous such an operation is, and in what situations it is worth performing. Let's consider all these questions in more detail. But first, it’s worth a closer look at what this procedure is.
What is arthroscopy
This procedure is a surgical intervention that allows you to more accurately diagnose the condition of certain groups of joints of the human body. Arthroscopy is considered one of the least invasive operations. The fact is that during its holding only a few holes are made, the length of which does not exceed 3-5 mm.
Thanks to this operation, arthroscopy of joints is very popular today. Nevertheless, this is not a new method, but a technology that has been around for many years.
When the procedure first started
For the first time, joint arthroscopy was announced in the early 20th century. In 1912, a Danish surgeon spoke at a congress of doctors and presented his developments. His name was Severin Norrentoft. However, in those days, endoscopic devices were not yet so developed, doctors simply did not use the optics that are available today. Therefore, they forgot about the development, until later in the 30s of the 20th century a Swedish politician, and part-time doctor, by the name of Eugen Bircher, wrote a work that details what knee arthroscopy is and what this procedure can help many patients . The doctor proved that with the help of an endoscope he can diagnose the type of rupture and other tissue damage. However, at that time he still resorted to open surgery.
Nevertheless, it was Bircher who became the author of the contrast approach to arthroscopy. Despite this, a talented physician quite quickly abandoned his medical career. Later, his work was studied by a Japanese surgeon named Masaki Watanabe. Based on the data he created a more modern arthroscope, which has much in common with modern instruments.
In the early 30s of the twentieth century, the medical community was completely interested in this procedure. This provoked the creation of a special arthroscopic apparatus equipped with a very thin tube, the diameter of which was only 4 mm. After that, what arthroscopy was learned around the world and began to successfully use this diagnostic method.
Features of the procedure
Arthroscopy operation is a tiny incision in the skin, due to which it becomes possible to get to the damaged joint and take the desired sample of its tissues located on the inside. Since the Japanese specialist was the first to seriously describe this procedure, it was Dr. Watanabe’s patients who became successful experiments in this area.
At first, he operated exclusively on athletes. But later the procedure began to be used by traumatologists as well as doctors who deal with problems of joint mobility. The procedure today helps patients who are faced with pathologies of this type.
Using a sample taken during joint arthroscopy, it becomes possible to analyze the patient's condition. After this, you can carry out the procedure to restore or replace damaged tissues and bones with artificial elements.
Varieties
This procedure is of several types. As a rule, it differs depending on the area of the venue. For example, there is an operation arthroscopy of the knee joint. A similar procedure is performed in case of rupture of the anterior and posterior cruciate ligament. It is also carried out in case of serious damage to the meniscus. In this case, after arthroscopy, reconstruction of the affected parts is performed. As a rule, transplants of a natural type are used for this. For example, the doctor takes the necessary material from the hip. But artificial parts can also be used. Arthroscopy of the knee has helped many to return to their usual lives and start walking again.
There is also a procedure that is performed on the shoulder joint. It is most in demand among athletes who often damage this particular part of the body. Most of them suffer from dislocations and unstable work of the shoulder joint. The rotational cuff also suffers. In this case, arthroscopy of the shoulder joint becomes a powerful diagnostic procedure.
In addition, there is arthroscopy of the elbow joint. In this case, most often it is not about treatment, but rather about a diagnostic measure. A similar procedure is performed if the patient complains of poor mobility and joint pain.
There are also two more varieties of surgery. Slightly less than those described above, operations are performed on the hip joint. This unpopularity of this procedure is due to the fact that an operation of this type requires highly qualified specialists. If the procedure is carried out correctly, then doctors will be able to assess the condition of the bone material of the femoral part of the patient, which allows you to adjust the treatment.
One of the simplest and most gentle procedures is considered ankle arthroscopy. However, to such operations, despite their apparent simplicity, there are most contraindications. Therefore, it is worth considering in more detail to whom such procedures are recommended, and who should refrain from them.
Indications for arthroscopy
Today, this procedure is increasingly used not only for diagnosis, but also for the treatment of pathologies. For example, arthroscopy can be a way out in a situation where other non-invasive treatment methods have not yielded significant results. Also, such an event may be required if the diagnostician or surgeon needs more accurate and reliable data on the patient's condition.
Arthroscopy can be useful if the patient suffers from:
- Damage to articular cartilage or meniscus.
- Osteochondrosis of the dissecting type.
- Rupture of the cruciate ligaments.
- Dislocation in the patella.
- Free bodies penetrated into the joint.
- The first symptoms of synovitis.
If we talk about the benefits of diagnostic measures, then arthroscopy helps to get the most clear picture with:
- Dislocation of the shoulder.
- Adhesive capsule or with occurrence of periarthritis of the shoulder-shoulder type.
- Pathologies occurring in the tendons of the biceps.
- Damage to the shoulder cuff.
- An unstable condition of the joints.
- Identification of the first signs of arthrosis of the deforming type.
Arthroscopy research
This procedure was most popular for problems in the elbow joints. As a rule, arthroscopy is performed if the patient suffers from:
- Contractures.
- Arthrosis of the deforming type.
- The appearance of free bodies in the elbow joint.
There are also a number of indications for arthroscopy of the hip joint . For example, a similar procedure is performed if a patient is diagnosed with chondromatosis, a deforming type of arthrosis, or damage that affects the joint lips.
The ankle procedure is performed in situations where patients suffer from contracture, deforming arthrosis, intraarticular fractures, dissecting osteochondritis, and many other problems.
Thus, we can say that this operation is effective in the diagnosis, treatment and prevention of many pathologies. However, this does not mean that arthroscopy can always be performed.
Contraindications to the procedure
Despite the fact that this procedure is considered relatively safe, it is far from being performed in all situations. For example, it is contraindicated in ankylosis. Also, doctors do not recommend performing arthroscopy if the patient was diagnosed with an abnormality in the development of affected joints.
It is worth abandoning such surgical interventions if a person is overweight.
Description of procedure
Long before the procedure is completed, it is important to consult with a specialist several times and carry out preparatory activities. A full examination of the body is mandatory, so that after arthroscopy of the knee or other joint, one does not have to face complications caused by additional pathologies that occur simultaneously with the main lesion.
If we talk about the operation itself, then it is performed using general anesthesia. Local anesthesia in such situations is not enough. This is because the effect of the drug may not be enough for the entire procedure, which will lead to a not very pleasant surprise for both the patient and the surgeon.
For the procedure I use an arthroscopic probe, the arthroscope itself, a trocar (necessary to create small holes) and a cannula made of metal.
The operation itself lasts about 1-3 hours. After arthroscopy of the knee, elbow, or other joint, the surgeon should have access to the area being examined. As a rule, at the time of the initial examination after the procedure, the patient is still sleeping. If the operation was performed on the knee, then it must be fixed at an angle of 90 degrees. A special holder is used for this.
Sometimes it becomes necessary to use a tourniquet.
Operation result
Thanks to this procedure, the surgeon has the opportunity to perform a large number of manipulations with the affected area. He gets a clear picture of the condition of the joint from the inside. However, this is far from the only plus of such an operation. For example, a specialist can immediately remove the meniscus, suture, take the right material for a subsequent biopsy. During the procedure, surgeons often remove chondromatous bodies, perform restorations, and much more.
If after arthroscopy of the knee joint the patient has undergone a recovery course, then it is most likely that the pain in this area will disappear. However, many patients note a decrease in swelling and an increase in the amplitude of movements. Thanks to this, we can say that arthroscopy helps to return a person to normal life.
What complications can you face?
If we talk about the risks that the doctor should warn about, then it is worth noting that sometimes after such a procedure, patients are diagnosed with synovitis, bacterial or infectious lesions. During the operation, a specialist may accidentally cause injury. Sometimes arthroscopy breaks instruments.
Blood clots may form in the articular cavities. There were cases when, during the procedure, patients were affected by case syndrome. This is a condition characterized by squeezing fluid in tissues or nerves.
Arthroscopy: reviews, pros and cons
If you consider the opinion of patients who have undergone this procedure, then many note an improvement in condition. For example, people who suffered from chronic or chronic injuries, deforming arthrosis and other pathologies say that thanks to the procedure they managed to achieve long-term remission.
Also, many note that this surgical intervention can be called sparing, since during the procedure the joint does not open completely. Due to this, more tissue is saved, and rehabilitation after surgery takes much less time. In addition, it is fair to say that with arthroscopy, the risk of getting an infection is much lower than with standard procedures.
Also, many patients note a wonderful cosmetic effect. Since only a few tiny incisions are made, there are no noticeable scars and scars on the human body. Arthroscopy does not require a large number of sutures. Therefore, this procedure is especially popular among women.
However, it is worth paying attention to one important point. Some patients note that a special irrigation fluid is used during this procedure. It divides the surfaces of the joints in order to improve the visibility of the joint from the inside. If in performing these manipulations an inexperienced specialist makes a mistake, then there is a risk that the irrigation fluid will penetrate the soft tissues. Because of this, a rather large hematoma, edema, and even hemorrhage can appear on a sore spot. Of course, such defects will last much longer.
Also, patients who underwent arthroscopy recommend that they carefully read the contraindications to such procedures. There are frequent cases when commissures formed between the surfaces of the joints. This quite severely limits mobility after the operation. Therefore, for some people, recovery can take much longer. Others note that the full motor function has not returned.
Rehabilitation Features
Despite the fact that this procedure can hardly be called a full-fledged operation, it still requires increased attention. If we talk about the duration and complexity of rehabilitation, arthroscopy is considered to be rather sparing, but much will depend on the age, state of health of the patient and many other factors. As a rule, the maximum stay in the walls of the hospital is no more than 1 month. But usually rehabilitation takes much less time. For example, after meniscus arthroscopy, patients can go home only a few hours after the procedure.
The situation is a little different when it comes to complete rehabilitation. It can take up to 4 months. However, compliance with several conditions will help speed up the healing process. For example, it is recommended that you think about the prevention of infectious diseases long before surgery. To do this, it is worth consulting with a specialist, he can prescribe antibiotics that are allowed to be taken in such situations.
Another way to speed up rehabilitation is to be at rest the first time after surgery. In this case, the operated limb must be securely fixed.
Of course, it is necessary to monitor the quality of food, not to be in the drafts and to limit their motor activity. It is also worth considering what the patient is wearing. Preference should be given to knitwear. Elastic bandages should be applied to the operated limb for the first few weeks. During the first weeks you can not take hot baths. Also, do not allow hypothermia.