Think of all the sportspersons you know of, from Sachin Tendulkar to Raphael Nadal, who seem to keep getting injured and are in the news for undergoing surgery. If you were wondering how they go through surgery and yet get back to playing so quickly, it is arthroscopic surgery (or arthroscopy) that makes it possible.
Arthroscopy is a minimally invasive procedure where an arthroscope (a type of endoscope which is an instrument which allows the surgeon to see into the body while performing a procedure) is inserted into joints through small incisions and used to carry out surgery mostly on the knee and shoulder joints. This afford many advantages to the patient such as a huge reduction in pain (since the incisions are so small), rapid recovery and minimal scarring.
Here at Sita Bhateja Speciality Hospital, we offer some of the very best arthroscopic procedures, conducted by highly respected and skilled surgeons. While arthroscopy can be used to treat various ailments, some of the most common and crucial procedures are as follows.
1. Diagnostic and Anterior Cruciate Ligament Reconstruction (ACLR) and Posterior Cruciate Ligament reconstruction (PCLR)
Globally, one of the most common of knee injuries is to the anterior cruciate ligament. It can occur while playing sports or even simply during the ordinary activities of day-to-day like such as walking or climbing stairs. It is even more common in our part of the world since Asians are more prone to it due to various anatomical reasons.
It is caused by an ‘insufficiency’ of the anterior cruciate ligament. Which basically means there just isn’t enough of the ligament, which in turn leads to an instability in the knee. Patients will find their knee unable to hold up under pressure and simply buckling or giving way while doing something as simple as walking. While some may shrug it off thinking it to be just ‘one of those days’ or phases, it is essential that it be checked out by a physician. Prolonged instability of this kind can lead to further complications in other parts of the knee and, as the name suggests, ‘reconstruction’ of the ligament is highly recommended, particularly in younger patients. In this arthroscopic procedure the surgeon uses bone-patella tendon or hamstring tendons to reconstruct the anterior cruciate ligament. After the procedure, the patient will require proper rehabilitation (as advised by the doctor and physiotherapist) and will eventually regain full use of the knee.
2. Meniscus procedures
The menisci are cartilaginous tissues in the knee which act as shock absorbers between the upper and lower leg. Preserving the meniscus is very important in order to prevent early degeneration of the joint (arthritis). But, they are subject to tear partially or fully (usually during sporting activities). Arthroscopy provides a long-term solution and in fact partial or complete menisectomies are fairly common procedures. Meniscal repairs are carried out with special equipment and instruments and are very successful.
3. Loose Body removal
Loose bodies can be formed in the knee, following diseases of the sinovium or cartilage injuries. They wander around the joint causing complications, discomfort and pain. They should be removed to prevent long-term deterioration of the joint.
1. Stabilisation procedures
The shoulder is a special joint which has greater mobility and more stability depending on the integrity of the capsule. The capsule is made up of thick connective tissue, contains fluid and separates the joint from the rest of the body. Tearing of the capsule from the bone can result in repeated dislocations of the shoulder joint. Apart from the pain caused, it can result in overall deterioration of the quality of life of the patient, not to mention acute embarrassment (it can happen during the most mundane activities). This can be very effectively addressed through arthroscopic procedures where the capsule is re-attached to the bone using metal or bio-absorbable anchors. With arthroscopy, patients recover faster and re-attain full, pre-surgical range of motion in the joint.
2. Rotator cuff procedures/repairs and Subacromian Decompression (SAD)
The rotator cuff is a group of muscles and tendons surrounding the shoulder joint and tears in this can occur due to degeneration or aging of the muscles. This may present itself as pain in the night and an inability to lift one’s arm above the shoulder level. If the condition cannot be treated non-surgically, arthroscopy is a viable and effective option. The rotator cuff can be repaired arthroscopically using suture anchors after which healing takes several weeks. With the proper rehabilitation, patient can get back to normal activity. Subacromian deompression (SAD) is another procedure which is carried out on the same region, where the rotator cuff tendon is pinched between the head of the humerus and the undersurface of the acromion. Arthroscopically, bone is removed from the underside of the acromion until the tendons are free to move unheeded by bone.
3. Frozen shoulder
Frozen shoulder is a common affliction seen in people above thirty-five years of age. Symptoms are stiffness in the shoulder joint, pain and discomfort. Most frozen shoulders get well through conservative treatment. It is only when there is no response to such treatment, arthroscopy can help and is recommended.