Sai Institute of Sports Injury & Anthroscopy

MRI or CT scan also may be needed. Joint structures which are not visible in X-rays are seen in MRI. Through the arthroscopy, a final diagnosis is made which is more accurate than through open surgery of from X-ray studies.

Diagnostic Tests

Any of the tests below may be used before arthroscopy. These tests help pinpoint your injury and suggest treatment. They may also help your doctor to know where to focus the arthroscopy.


X - Ray	MRI Scan

How is Arthroscopic surgery performed ?

Arthroscopic surgery may be performed under general, spinal or local anaesthesia, depending on the joint or suspected problem. A small incision (about 1 cm long) is made to insert the arthroscopy. Several other incisions may be made to see other parts of the joint or to insert other instruments. When indicated, corrective surgery is performed with specially designed instruments which are inserted into the joint through other incisions. Occasionally, during arthroscopy, the surgeon may discover that the injury or disease cannot be treated adequately with arthroscopy alone. The extensive open surgery may be performed while patient is anaesthetized or at a later date after discussing the findings with the patient.

KNEE JOINT

Knee anatomy
Cartilage is a soft cap covering the bone ends which forms the joint. Menisci are present in between the bone ends and acts as a shock absorber. Ligament connects the bone ends and provides stability to the joint. Whole joint is enclosed by synovial membrane lined sac.

Some of the procedures that may be performed arthroscopically include

Removal or repair of torn meniscus (knee cushion)

Reconstruction of the anterior cruciate ligament of the knee with Patellar tendon or Hamstring tendons.

Reconstruction of posterior cruciate ligament of the knee.

Removal of inflamed lining (synovium) of the knee.

Repair of ligament avulsions.

Removal of loose bodies (bone or cartilage) from the joint.

Septic arthritis

Arthrolysis for stiff joints.

Renival of Torn Meniscus	Meniscal Repair

Ligament Reconstruction

With Patellar Tendon	With Hanstrings

Cartilage Surgery

Cartilage from non-weight bearing area in transferred to weight bearing cartilage defect area, by endoscopic and open methods. This operation is performed in the age group of less than 45 years, preventing the knee from developing Early Osteoarthritis. Knee cartilage injuries are often associated with ligament tears, meniscal tears and they don't have healing capacity like bone, which has got inherent nature to unite after the fracture. These injuries it not treated, will progress to osteoarthritis at early age only, among the active people. Advantages of this method are fast recovery, one stage procedure, costs far less when compared to, two-staged operation of chondrocyte culture & implantation method which is not available in India presently.

Cartilage transfer for cartilage defects.

Shoulder Joint

Shoulder
Some of the procedures that may be performed arthroscopically include:

	Sub acromion decompression for rotator cuff tear & impingement syndrome
	Rotator cuff repair
	Frozen shoulder (Stiff Shoulder)
	Acromioclavicular joint problems
	Labral lesions
	Shoulder stabilization for dislocation

Recovery after Arthroscopy
Postoperatively, the small incisions are covered with a small dressing. Postoperative pain and recovery depend on the problems for which arthroscopy is performed and type of surgery involved. Many arthroscopic procedures can be performed as "day cases", with patient being discharged the next day. Arthroscopy is only the first step to getting your joint back to normal. You have a key role in the next step: Rehabilitation. Longer rehabilitation will be required following some procedures (e.g. cruciate ligament reconstruction and shoulder surgeries).

Remember, that people who have arthroscopy can have many different diseases and preexisting conditions, so each patient's arthroscopic surgery is unique to that person. Good out come depends not only on surgery, but also on patient compliance in post operative rehabilitation and pre-existing conditions.

Shoulder Anatomy

What are the advantages?
Advantages of arthroscopy over open surgery are:

Patient recovery and rehabilitation is faster,
Small incisions,
Minimal postoperative pain,
Less complications,
Stay is short,
Early return to work and cost effective.

Feeling fine once again
It comforting to know that there is help for your shoulder and knee problem. Your doctor's arthroscopic skills and your rehabilitation efforts can help you get back in action. Recovery from arthroscopy is less painful than recovery from open surgery. That means you may be able to return sooner to all the things you enjoy most.

What are the possible complications ?
These can occur in less than 1% of the procedures. Uncommon complications do occur occasionally, during or following arthroscopy such as infection, phlebitis (blood clots of vein), excessive swelling or injury to nerve.