Arthroscopic surgery is an orthopedic surgical (minimally invasive) technique used to visualize, diagnose and treat intra-articular disease. An arthroscope is an endoscope, a surgical instrument used to visualize lesions in the joint. It has the external appearance of a pencil, 5-6 mm thick in diameter, and a small opening of less than 1 cm in the skin allows the arthroscope to be placed into the joint. A miniature camera is attached to the back of the arthroscope, which allows us to take a look inside the joint and detect the lesion directly and accurately. Also, the surgery can be performed under arthroscopic observation immediately after the lesion is detected, without the need for an additional large incision. Compared to open surgery, it is less invasive, less painful, easier to restore joint movement, shorter bed time, and smaller skin scars. These are all advantages of arthroscopic surgery. The advantages of minimally invasive surgery are not only that the skin incision is small, the postoperative pain is relatively mild, and the skin scar is small in terms of aesthetic impact, but more importantly, the joint function can be restored sooner after surgery and the joint can be moved to the ground earlier. Arthroscopy is suitable for knee, ankle, shoulder, elbow and wrist joints. Damage to cartilage structures, synovial membrane, cartilage discs, ligaments and joint surfaces within the joint cannot be detected on x-ray, but can be seen at a glance under arthroscopy.
The delicacy of arthroscopic surgery refers not only to the delicacy of the surgical instruments, but also to the delicacy of the cutting operation. It is the ability to preserve the physiologically functional tissue structures intact and to limit the trauma to the joint to a minimum. Arthroscopic surgery should not be considered as a minor surgery, as it requires meticulous manual skills, experience and patience to avoid additional trauma. If the same procedure is done with the joint open, the surgery may be faster. However, the patient’s future interest is to choose a troublesome procedure now, and the greatest post-operative benefit is to the patient himself.
I. What is arthroscopic surgery
Arthroscopic surgery is an orthopedic surgical technique for the observation, diagnosis and treatment of intra-articular disease. An arthroscope is an endoscope, a surgical instrument used to visualize lesions within the joint. It has the external appearance of a pencil, 4-6 mm thick in diameter, and a small opening of less than 1 cm in the skin allows the arthroscope to be placed into the joint. We attach a miniature camera to the back of the arthroscope, which can take a look inside the joint and directly and accurately detect the lesion.
The Joint Center of People’s Hospital has been using arthroscopy for examination and treatment of joint diseases since 1993, and has performed more than 2,000 examinations and procedures. We have accumulated a lot of experience in examining the knee, ankle, shoulder, elbow and wrist joints. In the knee joint, we can not only examine the joint, but also operate under arthroscopic observation immediately after the lesion is detected, without the need for an additional large incision. Compared to open surgery, it is less invasive, less painful, easier to restore joint movement, shorter bed rest, and less skin scarring. These are the advantages of arthroscopic surgery.
Second, those diseases should be treated by arthroscopic surgery
Arthroscopy is suitable for knee, ankle, shoulder, elbow and wrist joints. Damage to cartilage structures, synovial membrane, cartilage discs, ligaments and articular surfaces within the joint cannot be detected on x-ray, but can be seen at a glance under arthroscopy.
The following is a brief overview of arthroscopic surgery of the knee joint.
1. Meniscal injury: This is the most resident cause of knee pain and interlocking. Arthroscopy allows a clear view of the meniscal damage and allows a decision to be made on whether to perform a partial, subtotal or total resection. Juvenile meniscus repair and disc meniscoplasty can only be performed arthroscopically.
2. Free body: The importance of arthroscopic surgery is not only to remove the free body through a small incision, but more importantly to find the cause of the free body formation and to treat the identified cause. To prevent the re-formation of free body.
3, Synovitis: Arthroscopic synovectomy is suitable for the early stage of synovitis, the postoperative pain is much lighter compared with open joint surgery, the chance of joint adhesions is also less, and the joint activity function is recovered quickly. Even if the synovitis recurs in the future, the operation can be repeated.
4.Osteoarthritis: It is suitable for medium-term osteoarthritis, especially those with joint jamming and strangulation. Through arthroscopy, the damage to the joint surface and cartilage can be clearly seen. By trimming the cartilage surface, removing the damaged meniscus, taking out the free body, grinding the bone flab that prevents joint movement, for the patellofemoral joint is too tight. In patients with obvious squatting pain, the pain can be relieved to a certain extent by releasing the lateral patellar support band.
5, cartilage fracture, synovial crease syndrome, fat pad extrusion syndrome and patellar subluxation: many sprain conditions of the joint are not always meniscal injuries. Rather, there are cartilage fractures, synovial crepitus syndrome, fat pad compression syndrome and patellar subluxation, which are often difficult to identify based on the physician’s experience with palpation and x-ray examination. However, dynamic examination under the arthroscope, the diagnosis is accurate, and can make the corresponding day treatment.
6, anterior cruciate ligament injury: not uncommon in sports injuries, and often combined with other injuries to the internal cruciate ligament of the knee. Arthroscopic reconstruction of the anterior cruciate ligament encounter of the knee when dealing with other lesions within the joint cross, is an important development in arthroscopic surgical techniques in the last year 10 years.
Arthroscopic surgery of other joints with good results, such as: synovium of the ankle joint, joint free bodies and traumatic arthritis. Synovitis of the shoulder joint. Glenoid labral tears, subacromial extrusion syndrome and joint free bodies, synovitis and free bodies of the elbow joint. Synovitis of the wrist joint, microscopic reduction of fractures. Fixation and complex resection of deltoid cartilage, etc.
Third, what are the advantages of arthroscopic surgery
The main advantages of arthroscopic surgery are shown in: 1. Arthroscopy is a minimally invasive surgery, 2. Through arthroscopy, it is possible to dynamically observe how the lesions in the joints, which produce symptoms when moving within the joints, and 3. The surgery is delicate.
The advantages of minimally invasive surgery are not only the small skin incision, relatively light postoperative pain, small skin scars to aesthetic impact, but more importantly, the ability to restore joint function faster after surgery and to move off the ground earlier. This reduces some of the complications that are very common after joint surgery, such as joint adhesions and muscle atrophy. Phlebitis. Blood clots and wound infections, etc.
It is important to observe the joint dynamically. In fact, many joint diseases have been recognized by the medical community only after arthroscopy, especially mechanical disorders of the joint and sudden pain and loss of force when the joint moves to a certain position, often due to impact with the diseased intra-articular structures when the joint moves to this position. It must be observed dynamically to be detected. In contrast, the cause of the lesion cannot be detected after the joint is opened.
The refinement of arthroscopic surgery refers not only to the refinement of the surgical instruments, but also to the refinement of the cutting operation. The physiologically functional tissues are preserved intact and the trauma to the joint is limited to a minimum.
Because of these advantages, arthroscopic surgery requires excellent special surgical equipment. It is performed by experienced surgeons and can take a long time.