Arthroscopy is a procedure that uses an arthro-scope (a viewing tube with a tiny videocamera at its tip) to examine, diagnose, and treat joint problems. The procedure is usually done on the knee joint, but it can be performed on other joints, such as the shoulder, elbow, ankle, hip, and wrist. For arthroscopic surgery, the surgeon makes a small incision and inserts the arthro-scope directly into the joint. The procedure can be observed on a video monitor and videotaped. Surgical instruments are inserted into the joint through other small incisions. Any loose bone, cartilage, or other material in the joint also can be removed. A biopsy (removal of a small piece of tissue from the joint for examination under a microscope) can be easily performed during arthroscopy.
Arthroscopic surgery is performed to examine and repair the following:
• torn rotator cuff (the muscles and tendons surrounding the shoulder joint)
• torn meniscus (a crescent-shaped disk of cartilage found in the knee joint)
• torn or damaged ligaments
• torn cartilage
• inflamed tendon sheaths
General, local, or spinal anesthesia is used, depending on the joint. Most people do not require strong pain medication afterward and can usually resume light normal activities within a few days. However, after arthroscopic knee surgery, a person must wear a knee brace and have physical therapy on the joint for several weeks or months to promote healing and prevent further injury.
Either meniscus in the knee can be torn during sharp, rapid, twisting motions. The incidence of this type of injury rises with age and participation in sports that require quick, reactive movements, such as basketball, downhill skiing, and soccer. Certain knee motions cause a popping sensation, sometimes accompanied by swelling, warmth, and instability in the joint. Treatment for torn cartilage is similar to treatment for a torn ligament (see page 316). A torn meniscus is often repaired using arthroscopy (see box on previous page).
Tendinitis (see page 306) can occur in the front of your knee below the patella (kneecap) or in the back of the knee at the popliteal tendon. As with ligament injury, tendinitis is treated with RICE (see page 65) and nonsteroidal antiinflammatory medication such as aspirin or ibuprofen. Rehabilitative exercise programs can begin when the swelling is gone. Because corticosteroid injections can rupture knee tendons, they are rarely, and very carefully, given. Surgical repair of a severely ruptured tendon may be necessary.
Bursitis (see page 305) of the knee commonly occurs on the inside of the knee and on the front of the kneecap. Treatment is similar to that for the ligament and tendon injuries described above. Osteoarthritis (see page 308) is a common cause of pain and inflammation in the knees. In severe cases, surgery to replace the damaged knee joints (see Joint Replacement, page 310) may be necessary.
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