What is arthroscopic surgery?
It is keyhole surgery where a small telescope the size of a small pencil is inserted into the joint through small punctures in the joint and the telescope is hooked up to a video monitor enabling the surgeon to see the inside of the joint in a magnified manner and to operate inside with special instruments without making a cut over the joint.
Can arthroscopy be done as day surgery?
It is most often done as day surgery and the patients generally do not have to spend more than a few hours in the hospital.
Would I have arthroscopy under general or local anaesthetic?
It is mostly done under General anaesthetic , but if the chest or heart condition prevents administration of a safe general anaesthetic, then it can be done under local anaesthetic also.
Which joints are suitable for arthroscopic surgery?
The joint most suited to arthroscopic surgery is the knee. However the shoulder. elbow ,wrist and ankle are increasingly being treated by arthroscopic surgery.
What are the possible complications of arthroscopic surgery?
Generally, keyhole surgery is quite safe. There is a very small chance of infection . In such a case, the joint may feel swollen and hot and you may be running a fever. Though infection is very rare, if you suspect it, you must report to your doctor immediately.
Sometimes, a minor twig of a cutaneous nerve supplying the skin may get damaged in the process of putting in the telescope. This may leave a small patch of numbness around the puncture site, which generally improves over a few months, but may be permanent at times.
Occasionally, if the operative procedure is long, and if a tourniquet is being used to stem the blood flow into the joint, then, the nerves passing across the tourniquet may be compressed and cause temporary numbness or weakness in muscles of the limb. This usually settles down in a few days, but may occasionally take few weeks to resolve.
There may be minor bleeding inside the joint after the operation leading to swelling of the joint. This is normal and should not cause any problems. If however there has been considerable blood collection inside the joint, than the collection may need to be aspirated by a needle, which is done under a local anaesthetic.
What types of surgery can be undertaken through the arthroscope?
The most common surgery is for torn meniscal cartilages. This procedure is better done through the arthroscope and patients can go out of the hospital after a few hours walking full weight bearing. In addition, removal of loose bodies, and smoothening procedures (chondroplasty) on roughened joint surfaces can be done very well through the arthroscope. In the recent years, reconstruction of the anterior cruciate ligament has been undertaken very successfully by the keyhole technique using the arthroscope.
In the shoulder, again removal of loose bodies and chondroplasty operations and also subacromial decompression (shaving of the undersurface of the acromion to decompress the supraspinatus tendon of the shoulder) are done very well.
In the elbow, removal of loose bodies and chondroplasty are done whereas, in the wrist, it can be used to diagnose causes of wrist pain and tidy up torn cartilages.
When can I go back to work?
This will depend on the operation being done. Generally after a knee arthroscopy you can go back to work in about one week. You may need physiotherapy which will be arranged on an outpatient basis and you will be regularly followed up in the clinic till your condition stabilises.