What is Arthroscopy or Arthroscopic Surgery?
Arthroscopy is a minimally invasive surgical procedure for the diagnosis of joint problems. The procedure is performed using a specialised instrument called an arthroscope. The instrument is a probe fitted with a camera. Only a small incision is needed to introduce the probe. Once inside the joints, the camera gives real time picture of the joints. This helps the surgeon to evaluate and assess the damage to reach a proper diagnosis.
Arthroscopic surgery is a surgical procedure to treat joint disorders. The surgery is done by using small probe shaped instruments. The probes have an arthroscope with a camera, surgical tips and drainage tubes. These are inserted through small incisions around the joints. These incisions some time resemble a keyhole and hence arthroscopic surgery is also referred to as keyhole surgery.
The joints that are frequently examined using an arthroscope are knee, shoulder, elbow, ankle, hip and wrist. As advances are made in the field and new techniques are developed, other joints may be treated more frequently in the future.
Arthroscopy may be performed under general, spinal or epidural anaesthesia or a regional block. Once the anaesthesia is achieved the procedure is started. The arthroscope is inserted into the joint through a small incision. Instruments for the manipulation of structures of the joint are inserted through other incisions.
Additional instruments for surgical repairs are inserted into the joint through other small incisions in the joint. These instruments can be used to cut, remove and suture the damaged tissues according to the condition to be treated. An arthroscope helps to minimise post-surgical trauma and complications.
Types of Arthroscopic Surgeries
1. Arthroscopic knee surgery
Arthroscopic knee surgery is done for the following conditions
• Removal or repair of a torn meniscus
• Surgical correction of a torn anterior cruciate ligament
• Surgical removal of inflamed synovial tissue
• Surgical trimming of damaged articular cartilage
• Surgical removal of loose fragments of bone or cartilage
• Treatment of patella (knee cap) problems
• Treatment of knee sepsis (infection)
2. Arthroscopic shoulder surgery
Common arthroscopic shoulder surgery procedures include:
• Rotator cuff repair
• Bone spur removal
• Removal or repair of the labrum
• Repair of ligaments
• Removal of inflamed tissue or loose cartilage
• Repair for recurrent shoulder dislocation
3. Arthroscopic Hip Surgery
Conditions treated best with arthroscopic hip surgery are
• Femoroacetabular impingement (FAI)
• Dysplasia of the hip joint
• Snapping hip syndromes
• Removal of loose bodies
• Hip joint infection
4. Arthroscopic Elbow Surgery
Common arthroscopic elbow surgery procedures include:
• Treatment of tennis elbow (lateral epicondylitis)
• Removal of loose bodies
• Release of scar tissue to improve range of motion
• Treatment of osteoarthritis of elbow
• Treatment of rheumatoid arthritis (inflammatory arthritis)
• Treatment of osteochondritis dissecans (seen in throwers or gymnasts)
5. Arthroscopic Ankle surgery
• Ankle arthritis
• Ankle fracture.
• Ankle instability
• Anterior ankle impingement ( athlete’s ankle or footballer’s ankle)
• Arthrofibrosis: Infection:
• Osteochondral defect (OCD):
• Posterior ankle impingement:
6. Arthroscopic Wrist Surgery
Arthroscopic surgery can be used to treat a number of conditions of the wrist like
• Chronic wrist pain
• Wrist fractures-
• Ganglion cysts.
• Ligament/TFCC tears.
• Carpal tunnel release
Complications of arthroscopic surgery
Being a minimally invasive surgery, post operative complications after arthroscopic surgery are less as compared to open surgery. Some of the postoperative complications after arthroscopic surgery are:
• Blood clots in the joints
• Stiffness in the joints
• Accumulation of blood in the joints
• Pain in the joints
Recovery after arthroscopic surgery:
Arthroscopic surgical incisions will be small and will be in the range of 5mm.The incisions will be covered with separate bandages. A drain may be placed in one of the incisions to remove the fluids accumulating in the surgical site. After surgery the patient will be shifted to the recovery room for a couple of hours for observation. The patient will then be shifted to the room. Discharge from the hospital will happen the next day.
Once at home, the patient needs to follow certain guidelines for faster recovery. They include:
• Keeping the surgical wound sterile
• Application of icepacks to prevent swelling
• Keeping the surgical area elevated from the rest of the body
• Taking medicines on time as prescribed
Arthroscopic surgery in India
Arthroscopy and arthroscopic surgeries are done in all major hospitals in India. Orthopaedic surgeons specialised in the field routinely perform these surgeries with pin point precision. This has helped to spread the fame of these hospitals and surgeons all over the world. This is evident from the ever increasing number of international patients coming to these hospitals.
Here is an approximate cost estimate of various arthroscopic procedures in India. One should note that the costs can change on a hospital to hospital basis and patient to patient basis.
Cost of arthroscopic joint surgery in India is approximately between 5,500 to 6,500 USD