Arthroscopy at large joints
Arthroscopic surgery is a procedure in which the internal structures of a joint can be examined and cured with surgical instruments inserted into the joint through small incisions of a length of about 5-10 mm. Arthroscopic equipment consists of an arthroscope and small-diameter instruments that allow the surgeon to probe, cut, stitch or remove tissue inside the joint. The arthroscope is a rigid tube with a diameter of 4 mm and has a light guide fiber and magnifying lenses. An image from an arthroscope connected to a television camera and a source of cold light is projected onto a monitor.
Knee arthroscopy
Arthroscopy of the knee joint is a modern minimally invasive operative method of visual examination of the internal structures of the joint and the contents of the articular cavity, as well as therapeutic effects on them using thin optical and mechanical devices.
The knee joint is filled with a sterile fluid to ensure good visibility. The surgeon, moving the arthroscope in the articular cavity, can examine all the structures of the joint and evaluate them on the monitor screen. Thin surgical instruments with a diameter of 2-3 mm are inserted into the joint through separate incisions in order to remove damaged areas of cartilage, meniscuses, inflamed synovial membrane or perform reconstructive operations on damaged internal structures of the joint.
A minor injury to the joint capsule, in contrast to the traditional arthrotomy (incision), promotes rapid rehabilitation, restoration of movements in the knee joint and support ability of the limb. Many patients do not need pain medication and return home the next day after surgery.
The prognosis after arthroscopy depends on what was discovered and done during the operation. If pronounced signs of arthrosis were identified, the doctor may recommend changes in physical activity, for example, to exclude running, jumping. After resection of a damaged meniscus, the patient usually returns to the previous level of physical and athletic activity; it must be remembered that heavy loads on the knee joint after removing a part of the meniscus can lead to the development of arthrosis after many years.
The term of recovery depends on many factors, namely, how extensive the changes in the joint were, and what was done during the operation. Remember that a person who has undergone arthroscopic intervention can have many different diagnoses and previous conditions, so that each arthroscopic operation is unique for each individual person.
It should be remembered that excessive stress on the joint in the first days after arthroscopy (walking, returning to work, exercise) can cause swelling and pain, delay recovery, and increase the risk of postoperative complications. It takes at least one week for the patient to sit behind the wheel of a car. Most people can return to sedentary work a week after surgery, but patients who have to walk a lot at work need a longer period of time. Activity expands gradually in accordance with pain and the presence of edema in the joint. Usually, the level of everyday household activity is achieved in 4-6 weeks, but it should take 2-3 months before the patient can do physical work and sports without pain. The more pronounced the phenomenon of arthrosis, the more time it takes to recover.
Shoulder arthroscopy
Arthroscopy of the shoulder joint is a modern minimally invasive surgical method of visual examination of the internal structures of the joint and the contents of the articular cavity, as well as the therapeutic effect on them using thin optical and mechanical devices.
The shoulder joint is filled with a sterile fluid to ensure good visibility. The surgeon, moving the arthroscope in the articular cavity, can examine all the structures of the joint and evaluate them on the monitor screen. Thin surgical instruments with a diameter of 2-3 mm are inserted into the joint through separate incisions in order to remove damaged areas of the cartilage, inflamed synovial membrane or perform reconstructive operations on the damaged internal structures of the joint.
A minor injury to the joint capsule, unlike traditional arthrotomy (incision), promotes rapid rehabilitation. Many patients do not need pain medication and return home the next day after surgery.
The prognosis after arthroscopy depends on what was discovered and done during the operation. If reconstructive interventions were performed using anchor clamps (surgery to restore the rotator cuff or the articular lip and shoulder-shoulder ligaments), the doctor may recommend long-term immobilization of the operated joint (up to 4-6 weeks) and a change in physical activity over the next few months. To prevent the development of persistent contractures (stiffness and limitation of joint movements), daily gymnastics should be performed to develop joint movements and strengthen the periarticular muscles before surgery, and in the postoperative period to follow the rehabilitation program prescribed by the attending physician.
The term of recovery depends on many factors, namely, how extensive the changes in the joint were, and what was done during the operation. Remember that a person who has undergone arthroscopic intervention can have many different diagnoses and previous conditions, so that each arthroscopic operation is unique for each individual person.
It should be remembered that excessive stress on the joint in the first days after arthroscopy (active movements in the operated joint) can cause swelling and pain, repeated damage to the reconstructed intra-articular structures, delay recovery, and increase the risk of postoperative complications. Most people can return to sedentary work one week after surgery, but patients who have to perform active movements at work in the operated joint may require longer rehabilitation. Activity expands gradually in accordance with the recommendations of the attending physician, pain and swelling in the joint.
Hip arthroscopy
Hip arthroscopy refers to minimally invasive operations. It allows for the examination and treatment of joints in the area of the articulation of the femoral and iliac bones and the elimination of pathologies. Most often performed for the correction of femoroacetabular impingement. Femoroacetabular impingement is one of the main causes of pain and movement restrictions in the hip joint.
During the operation, the hip joint is filled with a sterile fluid to ensure good visibility. The surgeon, moving the arthroscope in the articular cavity, can examine all the structures of the joint and evaluate them on the monitor screen. Thin surgical instruments with a diameter of 2-3 mm are inserted into the joint through separate incisions in order to remove damaged areas of the cartilage, inflamed synovial membrane or perform reconstructive operations on the damaged internal structures of the joint.
A minor injury to the joint capsule, unlike traditional arthrotomy (incision), promotes rapid rehabilitation.
The prognosis after arthroscopy depends on the volume of the operation and the existing diagnosis. A few days after surgery, patients are allowed to sit down. In this position, they feel more comfortable, because when flexed in the hip joint, its capsule relaxes. As a rule, on the second day, patients are allowed to get out of bed on their own and move using crutches, but it is important that the load on the operated joint is limited. Such actions are aimed at preventing thrombosis, as well as improving blood circulation in the muscles. On the 3-4th day it is necessary to start developing the joint with the help of light exercise. The complex of exercises for rehabilitation is developed by the doctor individually, since it must take into account many factors – a type of pathology, the amount of surgery, age, general condition of the patient, etc. For a month after the operation, it is necessary to avoid sudden movements, as well as to monitor their feelings.
It should be remembered that excessive stress on the joint in the first days after arthroscopy (active movements in the operated joint) can cause swelling and pain, repeated damage to the reconstructed intra-articular structures, delay recovery, and increase the risk of postoperative complications.
Possible complications
After atroscopic interventions, sometimes complications do occur. Their frequency is less than 1% of all arthroscopic operations. Possible postoperative problems include:
- infection;
- thrombophlebitis;
- thrombosis and thromboembolism (formation of blood clots in the veins and blockage of the pulmonary vein with blood clots);
- significant accumulation of blood in the joint.