Arthroscopy is a procedure that is used in surgeries of bone joints that allows the surgeon to see the problems or damage inside the joint. In arthroscopy, surgeons make some small incisions and use the arthroscope to visualize the inside of the joint. In open surgeries, usually, large incisions are needed to perform the procedure which can delay the recovery period. In open surgeries, there are more complications and risks to manage even after the procedure. In arthroscopic surgery, small incisions allow the fast recovery, less pain after the procedure, short stays in the hospital, and little risk of severe complications after the surgical procedure. The arthroscopic procedure is also used for diagnostic procedures to determine the disease occurring in the joint. Arthroscopy is commonly performed on almost all joints of the human body including the knee, shoulder, hip, ankle, elbow, and wrist. Sometimes during arthroscopic surgery, complications occur and surgeons need to perform open surgery to manage these complications. So, arthroscopic surgery may not be suitable for every patient with joint disease. Despite the safety of the arthroscopic surgical procedure, it still carries some risks and complications that should be managed with time otherwise revision surgery is required to manage these complications.
The types of arthroscopic surgeries according to the joint under surgical treatment are:
Arthroscopic Knee Surgery
The arthroscopic surgery in the knee joint is performed to treat various conditions. Some of these conditions are:
- Meniscectomy: Removal of a damaged or torn connective tissue in the knee.
- Meniscus Repair: Repairing of partially torn meniscus by using sutures.
- Anterior, Posterior, medial, and lateral Cruciate Ligament (ACL, PCL, MCL, LCL) Reconstruction: Reconstructing of the damaged ligaments of the knee present in front, back, or those present on the sides by using grafts.
- Patellar Realignment: Realignment of the kneecap to correct instability or pain. Microfracture: It involves the creation of small fractures to promote the growth of new cartilage in damaged areas.
- Synovectomy: Removal of swelled synovial tissue in degenerative conditions of the joints.
Arthroscopic Shoulder Surgery
The arthroscopic surgery performed on the shoulder joint is:
- Rotator Cuff Repair: Repairing a damaged rotator cuff tendon.
- Subacromial Decompression: Removing bone spurs to create more space for the muscles of the shoulder.
- Bankart Repair: Repairing shoulder instability or dislocation.
- Capsular Release: Releasing tight or constricted joint capsules to improve range of motion.
Arthroscopic Hip Surgery
The types of arthroscopic hip surgical procedures are:
- Hip Labral Repair: Repairing tears or damage to the labrum in the hip joint.
- Hip Impingement Surgery: Removing or reshaping bone to reduce friction in the hip joint.
- Synovectomy: Removal of swollen synovium in degenerative joint diseases.
Arthroscopic Ankle Surgery
- Ankle Impingement Surgery: Removing bone spurs or inflamed tissue that irritates nerves.
- Ankle Synovectomy: Removal of inflamed synovium in degenerative joint disease.
- Loose Body Removal: Removing loose bone or cartilage fragments from the ankle joint.
Arthroscopic Elbow Surgery
- Elbow Debridement: Cleaning the joint and removing damaged tissue in cases of trauma.
- Tennis Elbow Release: Releasing the tendon to alleviate pain.
- Elbow Synovectomy: Removal of swollen synovium.
Procedure of arthroscopic surgery
Here is a general outline of the steps involved in an arthroscopic surgery:
Anesthesia
The anesthesia is administered to prevent irritation and pain during the procedure. Sometimes regional anesthesia may also be used which only numbs the area under surgical procedure.
Arthroscopic inspection
Small incisions that are not greater than half an inch, are made around the affected joint to insert the arthroscope and special types of surgical instruments. The arthroscope is a small camera that allows the surgeon to visualize the inside of the joint on a computer screen.
Removal of damaged tissue:
The damaged tissues in the joint or any loose tissue, bone, or other dead tissues are removed that may be causing pain or limiting the healing process. These are carefully removed using surgical instruments.
Surgical Interventions
Depending on the type of disease, the surgeon may perform various arthroscopic procedures to treat the underlying problem. Common interventions include:
- Repairing or resecting torn ligaments or tendonsย
- Removing damaged cartilage or loose bodies
- Smoothing or reshaping rough bone surfacesย
- Synovectomyย
- Microfractureย
- Grafting procedures
Closure
Once the surgery is performed, the surgeon closes the incisions with sutures. Sterile dressings to prevent infection and a supportive sling are then applied.
Post-operative care:
After the surgery, the patient is taken to the recovery room for proper management and care. Pain medication, blood thinner medications, and instructions for physical therapy are provided.
Cost of arthroscopic surgery in India
The cost of arthroscopic surgery in India ranges from 1000 USD to 1500 USD. The cost can vary according to the facilities of the hospital and the skill of a surgeon to perform a surgery. The cost can also vary according to the complications of each patient.
Arthroscopic Surgery : 1066 USD - 1420 USD
Knee Arthroscopy : 5329 USD - 7108 USD
Arthroscopic Meniscectomy : 951 USD - 1207 USD
Wrist Arthroplasty : 2664 USD - 3552 USD
Symptoms and Risk factors
Here are some common indications for arthroscopy across various joints:
- Meniscus tear
- ACL tearย
- PCL tearย
- MCL tearย
- LCL tearย
- Synovitis
- Loose bodiesย
- Cartilage damageย
- Patellar disordersย
- Rotator cuff tearย
- Labral tearย
- Shoulder impingementย
- Recurrent shoulder dislocationย
- Biceps tendon disordersย
- AC joint disordersย
- Ankle impingementย
- Tennis elbowย
- Carpal tunnel releaseย
Risk factors of arthroscopy treatment
Like any surgical procedure, there are certain risk factors associated with arthroscopic surgery. Here are some of the risk factors:
Bleeding
In surgery, there is a risk of excessive bleeding if not managed properly. A proper closure after the surgery is necessary to avoid any bleeding.
Infection
Surgeries are always the major risk factor to catch any infection. The infection can spread to the whole body if proper medications are not used.
Blood clots
Blood clots can be formed in the legs and also can travel to major organs in the body like the brain, heart, and lungs where they can cause some serious complications and even death.
Damage to nerves and blood vessels
There is a small possibility of damaging nerves or blood vessels in the area under surgery. This can lead to numbness, weakness, pain, or other complications in the affected side of the leg.
Excessive Swelling
ย Some patients may experience more swelling than usually happens. The swelling can affect the recovery process.
Failure to resolve the problem
In some cases, arthroscopy may not resolve the problem or damage to the joint. It may further need additional surgical treatments in the future.
