| An introduction to arthroscopic surgery of the | | | | arthroscopic surgery. Shoulder replacement is not yet |
| shoulder | | | | possible arthroscopically, but with minimally invasive |
| 'Arthros' means joint in Greek. The arthroscope is an | | | | orthopaedic surgery catching up, that may not be far |
| instrument used by orthopaedic surgeons to look into | | | | off. It is certainly possible to introduce prosthesis for |
| joints. It is about 8- 10 inches long and is as thick as | | | | fracture fixation through key hole incisions and the |
| a pencil. There is a fibre optic lens system which | | | | same may be extended to joint replacement as well. |
| transmits light from a cold light source outside and | | | | Arthroscopy can be diagnostic to confirm or make |
| relays the interior image to a medical television | | | | the diagnosis. X -rays do not reveal soft tissue |
| monitor. In other words the arthroscope serves as a | | | | pathology and many patients are frustrated when |
| camera device to look into structures inside a joint. It | | | | their orthopaedic surgeon dismisses their pain as of |
| is possible to diagnose pathological conditions not | | | | no significance just because the X-ray is normal. MRI |
| seen on X rays and sometimes even on MRI scans. | | | | and ultra sound are useful non invasive investigations |
| Who needs arthroscopy?a) Rotator cuff tears, partial | | | | but is operator dependent and need good musculo |
| and completeb) Recurrent dislocationsc) Frozen | | | | skeletal radiologists to interpret them. |
| shoulder and adhesive capsulitisd) Calcium depositione) | | | | Rotator cuff disease, instability, impingement due to |
| Loose bodiesf) Osteoarthritis | | | | bony outgrowths from the clavicle or the acromio |
| Advantages | | | | clavicular joint can be trimmed arthroscopically. |
| As there are no formal large incisions, post operative | | | | Infections can be drained. Recalcitrant calcium |
| pain is minimal. Since muscles and tissues are not | | | | deposits can be needled and a frozen shoulder can |
| removed from their origins on bone, again the | | | | be released arthroscopically. SLAP lesions are |
| amount of inflammation is minimal. Recovery can be | | | | debrided and reconstructed by this method through |
| faster as it is not necessary for muscles to heal back. | | | | small key hole incisions. |
| Cosmetically the procedure is very satisfying. There | | | | How is the procedure done? |
| are no mental scars of open surgery. Return to sport | | | | Arthroscopic surgery is an elective or planned |
| or work is faster, hospital stays are shorter and | | | | surgery. It is done under general anaesthesia. It is |
| hence bills are smaller. However arthroscopic | | | | done as a day case which means that you may be |
| equipment is expensive to hire or possess and the | | | | discharged the same day (Day care or surgery). The |
| surgeon has to recover the cost of dispensable items | | | | instrument is introduced into the joint through small |
| like shavers, suture anchors. This is offset by | | | | incisions about half centimeter long. Other instruments |
| enormous patient satisfaction. | | | | are also introduced and maneuvered to achieve the |
| Arthroscopic surgery by its simple nature provides an | | | | therapeutic goal. |
| opportunity to the orthopaedic surgeon to examine | | | | Advantages |
| the interior of a joint. After Knee arthroscopy, the | | | | As there are no formal large incisions, post operative |
| shoulder is the joint which is suited for arthroscopic | | | | pain is minimal. Since muscles and tissues are not |
| surgery. Other joints are the ankle, wrist and elbow. | | | | removed from their origins on bone, again the |
| Indians and Asians in the Gulf get only short spells of | | | | amount of inflammation is minimal. Recovery can be |
| leave to spend with their near and dear ones. They | | | | faster as it is not necessary for muscles to heal back. |
| would benefit from undergoing Arthroscopic shoulder | | | | Cosmetically the procedure is very satisfying. There |
| surgery for shoulder pain as the recovery is shorter. | | | | are no mental scars of open surgery. Return to sport |
| The conditions treated by open surgery earlier are | | | | or work is faster, hospital stays are shorter and |
| now treatable by arthroscopic surgery with | | | | hence bills are smaller. However arthroscopic |
| remarkable success. Some hitherto unknown | | | | equipment is expensive to hire or possess and the |
| conditions have been diagnosed after the advent of | | | | surgeon has to recover the cost of dispensable items |
| arthroscopic surgery. | | | | like shavers, suture anchors. This is offset by |
| Any painful or unstable condition of the shoulder | | | | enormous patient satisfaction. |
| except end stage arthritis can be treated by | | | | |