Arthroscopy

Arthroscopy (also called arthroscopic or keyhole surgery) is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed during ACL reconstruction. Arthroscopy (also called arthroscopic or keyhole surgery) is a minimally invasive surgical procedure on a joint in which an examination and sometimes treatment of damage is performed using an arthroscope, an endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed during ACL reconstruction. The advantage over traditional open surgery is that the joint does not have to be opened up fully. For knee arthroscopy only two small incisions are made, one for the arthroscope and one for the surgical instruments to be used in the knee cavity. This reduces recovery time and may increase the rate of success due to less trauma to the connective tissue. It has gained popularity due to evidence of faster recovery times with less scarring, because of the smaller incisions. Irrigation fluid (most commonly 'normal' saline) is used to distend the joint and make a surgical space. The surgical instruments are smaller than traditional instruments. Surgeons view the joint area on a video monitor, and can diagnose and repair torn joint tissue, such as ligaments. It is technically possible to do an arthroscopic examination of almost every joint, but is most commonly used for the knee, shoulder, elbow, wrist, ankle, foot, and hip. Knee arthroscopy, or arthroscopic knee surgery, is a surgery that uses arthroscopic techniques. People who undergo this surgery for 'wear and tear' joint pain, including osteoarthritis and meniscal tears, usually have high hopes for the results, but from time to time the result is not satisfactory. Nevertheless, it is worth trying, as it does not worsen the damage. It has, in many cases, replaced the classic open surgery (arthrotomy) that was performed in the past. Arthroscopic knee surgery is one of the most common orthopaedic procedures, performed approximately 2 million times worldwide each year. The procedures are more commonly performed to treat meniscus injury and to perform anterior cruciate ligament reconstruction. While knee arthroscopy is commonly used for partial meniscectomy (trimming a torn meniscus) on middle aged to older adults with knee pain, the claimed positive results seem to lack scientific evidence. During an average knee arthroscopy, a small fiberoptic camera (the arthroscope) is inserted into the joint through a small incision, about 4 mm (1/8 inch) long. More incisions might be performed in order to visually check other parts of the knee and to insert the miniature instruments that are used to perform surgical procedures. The BMJ Rapid Recommendations group makes a strong recommendation against arthroscopy for osteoarthritis on the basis that there is high quality evidence that there is no lasting benefit and less than 15% of people have a small short-term benefit. There are rare but serious adverse effects that can occur, including venous thromboembolism, infections, and nerve damage The BMJ Rapid Recommendation includes infographics and shared decision making tools to facilitate a conversation between doctors and patients about the risks and benefits of arthroscopic surgery. Two major trials of arthroscopic surgery for osteoarthritis of the knee found no benefit for these surgeries. Many medical insurance providers are now reluctant to reimburse surgeons and hospitals for what can be considered a procedure which seems to create the risks of surgery with questionable or no demonstrable benefit. However this is still a widely adopted treatment for a range of conditions associated with osteoarthritis, including labral tears, femoroacetabular impingement, osteochondritis dissecans.