The modern world offers patients with serious illnesses more modern methods of treatment. Surgical operations have long gone far ahead, 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 should be performed. Let's consider all these questions in more detail. But first, you should take 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 in the human body. Arthroscopy is considered one of the least invasive surgeries. The fact is that during its implementation only a few holes are made, the length of which does not exceed 3-5 mm.
Thanks to this, the operation of arthroscopy of the joints is now very popular. However, this is not a new method, but a technology that has been around for many years.
Whenfor the first time the procedure was started
For the first time, arthroscopy of the joints was announced at the beginning of the 20th century. In 1912, a Danish surgeon spoke at a congress of doctors and presented his developments. His name was Severin Nordentoft. However, in those days, endoscopic devices were not yet so developed, doctors simply did not use the optics that are available today. Therefore, the development was forgotten until later in the 30s of the 20th century, a Swedish politician, and part-time physician, named Eugen Bircher wrote a work that details what knee arthroscopy is and that this procedure can help many patients. The physician proved that with the help of an endoscope he can diagnose the type of rupture and other tissue damage. However, he still resorted to open surgery at the time.
Nevertheless, it was Bircher who became the author of the contrast approach to arthroscopy. Despite this, a talented physician quickly abandoned his medical career. Later, his work was studied by a Japanese surgeon named Masaki Watanabe. Based on the data obtained, he created a more modern arthroscope, which has much in common with modern devices.
In the early 1930s, the medical community became fully 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, they learned all over the world and began to successfully use this diagnostic method.
Features of the procedure
Arthroscopy operation is a tiny incision in the skin, thanks 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 still helps patients who are faced with this type of pathology.
With the help of a sample taken during joint arthroscopy, it becomes possible to analyze the patient's condition. After that, you can carry out a procedure to restore or replace damaged tissues and bones with artificial elements.
Varieties
This procedure can be of several types. As a rule, it differs depending on the venue. For example, there is an operation called arthroscopy of the knee joint. A similar procedure is performed in case of rupture of the anterior and posterior cruciate ligaments. It is also performed in case of serious damage to the meniscus. In this case, after arthroscopy, reconstruction of the affected parts is performed. As a rule, grafts of a natural type are used for this. For example, the doctor takes the necessary material from the thigh. But artificial parts can also be used. Knee arthroscopy has helped many people get back to normal life and start again.walk.
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 rotator cuff also suffers. In this case, shoulder arthroscopy 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 about a diagnostic measure. A similar procedure is performed if the patient complains of poor mobility and joint pain.
There are also two more types of operation. Slightly less often than those described above, operations on the hip joint are performed. Such unpopularity of this procedure is due to the fact that this type of operation requires highly qualified specialists. If the procedure is carried out correctly, then doctors get the opportunity to assess the condition of the patient's femoral bone material, which allows you to adjust the treatment.
One of the simplest and most gentle procedures is ankle arthroscopy. However, such operations, despite their apparent simplicity, there are the most contraindications. Therefore, it is worth considering in more detail who is recommended such procedures, 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 may be an option when other non-invasive treatments have failed to produce significant results. Also, such an event may be required if a diagnostician or surgeon needs more accurate and reliable data on the patient's condition.
Arthroscopy may be useful if the patient suffers from:
- Injuries to the articular cartilage or meniscus.
- Dissecting osteochondrosis.
- Acruciate ligament tear.
- Dislocations in the area of the patella.
- Loose bodies penetrating the joint.
- First symptoms of synovitis.
If we talk about the benefits of diagnostic measures, then arthroscopy helps to get the clearest picture when:
- Dislocated shoulder.
- Adhesive capsulitis or humeroscapular periarthritis.
- Pathologies occurring in the tendons of the biceps.
- Injury to the shoulder cuff.
- Unstable joints.
- Identification of the first signs of deforming arthrosis.
Research with arthroscopy
This procedure is most popular for problems in the elbow joints. Typically, arthroscopy is performed if the patient suffers from:
- Contractures.
- Arthrosis of the deforming type.
- Appearance of free bodies in the elbow joint.
There are also a number of indications for hip arthroscopy. For example, such a procedure is carried out ifthe patient was diagnosed with chondromatosis, a deforming type of arthrosis, or damage affecting the articular lips.
The ankle procedure is performed in situations where patients suffer from contractures, deforming arthrosis, intra-articular fractures, osteochondritis dissecans 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 not worth performing in all situations. For example, it is contraindicated in ankylosis. Also, doctors do not recommend performing arthroscopy if the patient has been diagnosed with an abnormality in the development of the affected joints.
Such surgery should be avoided if the person is overweight.
Procedure description
Long before the procedure, it is important to consult with a specialist several times and carry out preparatory measures. A complete 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 similar situationsnot enough. This is due to the fact that 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 (needed to create small holes) and metal cannulas.
The operation itself lasts about 1-3 hours. After arthroscopy of the knee, elbow, or other joint, the surgeon must have access to the area being examined. As a rule, at the time of the initial examination after the procedure, the patient is still asleep. If the operation was performed on the knee, then it must be fixed at an angle of 90 degrees. For this, a special holder is used.
Sometimes it becomes necessary to use a tourniquet.
Result of operation
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 state of the joint from the inside. However, this is far from the only advantage of such an operation. For example, a specialist can immediately remove the meniscus, suture, take the necessary material for a subsequent biopsy. During the procedure, surgeons often remove chondromatous bodies, perform refixation, and more.
If the patient underwent a course of recovery after arthroscopy of the knee joint, then it is most likely that the pain in this area will disappear. At the same time, many patients note a decrease in swelling and an increase in the amplitudemovements. Thanks to this, we can say that arthroscopy helps to return a person to normal life.
Complications you may face
If we talk about the risks that the doctor should warn about, it is worth noting that sometimes after such a procedure, patients are diagnosed with synovitis, bacterial or infectious lesions. During the operation, the specialist may accidentally cause injury. Sometimes instruments break during arthroscopy.
Blood clots can form in the joint cavities. There were cases when during the procedure, patients were affected by sheath syndrome. This is a condition that is characterized by squeezing of fluid in tissues or nerves.
Arthroscopy: reviews, pros and cons
If we consider the opinion of patients who have undergone this procedure, many note an improvement in their condition. For example, people who have suffered from chronic or chronic injuries, deforming arthrosis and other pathologies say that thanks to the procedure they were able to achieve a long-term remission.
Also, many people note that this surgical intervention can be called sparing, since the joint does not fully open during the procedure. Thanks to this, more tissue is preserved, and rehabilitation after surgery takes significantly less time. In addition, it is fair to say that with arthroscopy, the risk of infection is much lower than with standard procedures.
Also, many patients note an excellent cosmetic effect. Since only a few tinyincisions, there are no noticeable scars and scars on the human body. Arthroscopy does not require a large number of stitches. Therefore, this procedure is especially popular with 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 separates the surfaces of the joints in order to improve the visibility of the joint from the inside. If an inexperienced specialist makes a mistake when performing these manipulations, then there is a risk that the irrigation fluid will penetrate into the soft tissues. Because of this, a rather large hematoma, swelling and even hemorrhage may appear on the sore spot. Of course, such defects will take much longer to pass.
Also, patients who have undergone arthroscopy are advised to carefully read the contraindications to such procedures. It is not uncommon for adhesions to form between the surfaces of the joints. This severely limits mobility after the operation. Therefore, recovery may take much longer for some people. Others note that the full motor function has not returned.
Features of rehabilitation
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 quite gentle, but much will depend on the age, he alth of the patient and many other factors. Typically the maximumthe duration of stay in the hospital is no more than 1 month. But usually rehabilitation takes much less time. For example, after meniscus arthroscopy, patients can go home just a few hours after the procedure.
The situation is a little different when it comes to full rehabilitation. It can take up to 4 months. However, following a few conditions will help speed up the healing process. For example, it is recommended to think about the prevention of infectious diseases long before performing a surgical intervention. To do this, you should consult with a specialist, he can prescribe antibiotics that can be taken in such situations.
Another way to speed up rehabilitation is to be at rest for the first time after surgery. In this case, the operated limb must be securely fixed.
Of course, you need to monitor the quality of food, not be in drafts and limit your physical activity. It is also worth considering what the patient is wearing. Preference should be given to knitwear. For the first few weeks, elastic bandages should be applied to the operated limb. Hot baths should not be taken during the first weeks. Also, do not allow hypothermia.
