Surgery

Arthroscopy is a surgical procedure where endoscopic instruments are inserted by puncture of a joint capsule into its cavity. Inner surface of the joint is examined with a camera for diagnostic purposes; if necessary, some therapeutic procedures can be performed as part of arthroscopy.

At CDC MEDSI you can undergo arthroscopy performed by experienced specialists, using modern equipment and with fast rehabilitation after the intervention.

Types of manipulation

Arthroscopic procedure may involve two types of manipulations

• Diagnostic
• Therapeutic

Usually, they are combined with each other in a single intervention.

Diagnostic part of arthroscopy allows to:

• Assess the condition of synovial capsule of the joint from the inside
• Investigate the position of internal components of the joint (discs, menisci, synovial bursae)
• Identify the causes of movement blocking or restrictions
• Determine the volume and properties of synovial fluid, collect it to study the composition

Therapeutic part of arthroscopy:

• Reconstruction and stabilization of damaged and altered joint tissues (ligaments, articular cartilage, menisci, articular lip)
• Modeling of articular cartilage
• Restoration of joint internal components integrity by stitching
• Recovery of damaged ligaments
• Removal of necrotic joint components
• Creation of microfractures to restore the cartilage (microfracturing by Stedman)
• Joint cavity lavage with antibiotic solution or other medicine composition
• Removal of cysts
• Dissection of internal adhesions in the joint

Arthroscopic intervention is indicated for:

• Damage and diseases of articular discs, menisci
• Articular cartilage damage, including the need for plastics
• Defects and protrusions of cartilage
• Ligament damage
• Gout, Reiter’s disease, reactive arthritis and other specific knee joint diseases
• Chondromalacia
• Deforming osteoarthritis
• Aseptic necrosis
• Diseases of the synovial membrane of the joint
• Intra-articular body presence

In some cases, a timely therapeutic arthroscopy allows to avoid open joint surgery. Usually, the technique is used to examine large joints: knee, ankle, shoulder, elbow, etc.

Preparation for the procedure

Prior to arthroscopy, a number of mandatory preliminary procedures are prescribed to clarify the patient’s condition and prevent complications:

• Complete blood count
• Urinalysis
• Metabolic panel
• Blood clotting
• Blood type and Rh factor
• HIV and viral hepatitis tests
• Radiography
• ECG
• Consultation of orthopedist

If necessary, the volume of preparatory activities can be expanded as recommended by the doctor.

Arthroscopy is performed under the condition of stable well-being of the patient. The procedure should be postponed if the person has flu or ARVI, exacerbation or worsening of a chronic disease. Before the intervention, it is necessary to refuse from food and liquid intake for 6-7 hours. If any additional preparatory measures are needed, the doctor will inform the patient.

How the procedure is performed

The patient should be anesthetized, the type and method anesthesia are chosen by the doctor. Then, the skin above the surface of the examined joint is treated with an antiseptic, and surgical access to the joint is performed: miniature incisions are made that open the joint capsule and do not damage the surrounding important structures (ligaments, muscles).

The arthroscope elements are introduced into the joint cavity: light source, camera, manipulators. All instruments are small in size. To improve visibility, the joint cavity is filled with a sterile solution for the entire duration of the procedure. When necessary manipulations are finished, the instruments are removed and sutures are placed on the surgical wounds.

The patient is transferred to postanesthesia care unit, and then to general ward.

Rehabilitation

Rehabilitation after arthroscopy takes a short time and starts on the first day after surgery.

• Immediately after the procedure, a pressure bandage is applied to the examined area to avoid bleeding into the joint cavity and surrounding tissues
• For the same purpose, and to reduce postoperative edema, cold is applied to the extremity which is fixed in elevated position
• After stabilization of the patient’s condition, he/she is discharged from the hospital, and further recovery takes place at home
• For several days after the intervention, the patient may take anesthetics and antibiotics as recommendation by the doctor
• Next day after arthroscopy, movements in the operated joint are allowed. Also, the doctor will recommend a set of exercises for faster recovery

Duration of rehabilitation depends on what type of intervention was performed in the joint cavity. In most cases, it is possible to fully load the joint including playing sports 3-4 weeks after the procedure.

Advantages of arthroscopy at MEDSI

• Modern equipment with an extended set of manipulators, that allow to perform a wide range of medical procedures on the joint and to avoid open surgical interventions
• High-class specialists who constantly improve their qualifications with continuous practice and additional training, including international level experts
• Compliance with the principles of fast-track surgery: early discharge and activation of the patient, accelerated recovery after the procedure. Absence of cosmetic defects on the skin after arthroscopy (or almost imperceptible traces of incisions)
• Competence Center for Traumatology and Orthopedics is available in Clinical Diagnostic Center MEDSI, where diagnosis and treatment of diseases and injuries are performed with the use of modern techniques

Price

To learn more about arthroscopy or to make an appointment with an orthopedic traumatologist, call: +7 (495) 780-77-54.