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Joint injuries most often affect people practicing sports, but damage can also occur during ordinary activities. Arthroscopy is an endoscopic procedure that allows for effective diagnosis and evaluation of an injury, as well as for performing a surgical procedure with the use of minimally invasive tools.
Arthroscopy – what is it?
Arthroscopy is a minimally invasive technique of diagnosing and treating joints, involving the examination of their interior. Its primary purpose is to examine the damaged joint and, if necessary, also perform a medical treatment. In addition, the procedure allows the collection of material for histopathological or bacteriological examination. Does it hurt? Arthroscopy is performed under regional or general anesthesia, so pain during the procedure is not felt.
Arthroscopy is an endoscopic examination. It is performed in the conditions of an operating room. The surgeon cuts small holes in the skin near the joint and places an arthroscope, i.e. a drain, in them. Arthroscopy in this phase allows you to fully see the structure of the joint by introducing a saline solution. The surgeon examines the synovium, articular cartilage, muscles and ligaments. This is where diagnostic arthroscopy ends.
If necessary, surgery is started on the damaged joint. This part is an operative arthroscopy, during which the doctor introduces small surgical instruments, thanks to which he can reconstruct the ligament, remove free bodies from the joint, rinse the joint, smooth the joint cartilage or remove synovial hyperplasia.
See also: «Orthopedics – what diseases does it treat?»
Arthroscopy – types
The most common type of this procedure is ACL arthroscopy, i.e. arthroscopic reconstruction of the anterior cruciate ligament. It constitutes as much as 50 percent. all arthroscopic procedures. A ligament may rupture during sports or normal daily activities. Knee arthroscopy usually involves ligament reconstruction with the use of the patient’s own tendons, artificial tendons or a tissue graft.
In addition, arthroscopic procedures include:
- hip arthroscopy,
- ankle arthroscopy,
- elbow arthroscopy,
- hip arthroscopy,
- hand (wrist) arthroscopy.
Arthroscopy – indications
Arthroscopy is performed in the case of:
- various types of joint injuries,
- intra-articular fractures,
- instability of movements around the joint,
- the appearance of foreign bodies in the pond,
- degenerative changes,
- rheumatoid arthritis,
- tumors within the joints,
- damage to articular cartilage or ligaments.
In the case of each procedure, there are circumstances that preclude or hinder its performance. Contraindications to the arthroscopy procedure will be:
- skin inflammation within the operated joint,
- blood coagulation disorders,
- general poor health of the patient,
- allergy to substances contained in the anesthetic.
Arthroscopy – how long does it take?
Arthroscopic surgery is a simple surgical technique and qualifies for one-day surgery. It is usually associated with admission to hospital in the morning. The duration of arthroscopy ranges from several dozen minutes to about 2 hours. After the procedure, the patient leaves the hospital on the same day or the next morning, unless the attending physician decides otherwise and extends the stay for a few more days.
Arthroscopy – how to prepare?
Before determining the date of arthroscopy, the doctor performing the procedure orders a diagnostic ultrasound, magnetic resonance imaging or X-ray of the joint to diagnose the problem. In addition, he should give guidelines on how to prepare for arthroscopy, and possibly recommend:
- refraining from taking medications that inhibit blood clotting (e.g. ibuprofen, aspirin, naproxen or other narcotic drugs),
- taking medications to prepare for arthroscopy – here the patient should indicate whether he is allergic to any substances,
- abstaining from alcohol consumption – tell the doctor how much alcohol has been consumed by the patient in the last two weeks,
- refraining from smoking (smoking prolongs the healing process of wounds and the disappearance of edema).
On the day of the procedure, the patient should arrive at the hospital in the morning on an empty stomach. It is recommended that the last meal be eaten 6-12 hours before the planned arthroscopy. He may, however, take medications that the patient usually takes for other ailments, if the doctor advised so during the consultation.
Information about the menstruation will also be important for the doctor performing the procedure. Arthroscopy is associated with some blood loss, so an additional factor may adversely affect the course of the procedure. It happens that the doctor decides to perform arthroscopy despite menstruation, but most often it is a contraindication, and the procedure is postponed to another date.
Also read: «Hospitalization in Poland – how many Poles go to hospital and for what reasons?»
Arthroscopy – tests before surgery
Arthroscopy is a minimally invasive procedure, but requires a thorough health check. Two weeks before the procedure, basic additional tests should be performed:
- ECG,
- blood count,
- blood glucose test,
- blood group test,
- liver tests,
- urinalysis
- on the level of electrolytes,
- coagulation system analysis,
- Chest X-ray with description.
However, when it comes to arthroscopy and jaundice vaccinations, it should be remembered that an important vaccination against hepatitis B is absolutely necessary for the procedure. In addition, you should inform your doctor about the possible coexistence of other diseases, including the heart, kidneys, liver, lungs or nervous system.
Arthroscopy – rehabilitation and convalescence
Pain after arthroscopy is much less noticeable than after traditional surgery. Nevertheless, there are typical reactions in the body after surgery, so a recovery period is essential.
Depending on the type of arthroscopy performed and its course, the doctor recommends appropriate ways to relieve the area of the operated joint, rehabilitation exercises and the approximate date when the patient will be able to return to physical activity. There may be times when you need to immobilize the joint after arthroscopy.
For several days immediately after arthroscopy, the patient takes painkillers and anticoagulants. During this time, it is recommended to limit physical activity to the absolute minimum and avoid sudden movements.
Rehabilitation after arthroscopy takes place on the next day and is supervised by a specialist. The doctor usually recommends:
- massages,
- pilates,
- physical therapy (electrostimulation of muscles),
- cryotherapy (improves circulation, relieves pain and affects faster regeneration of the joint).
The most common arthroscopy is arthroscopy of the knee joint. Both in this case and in the case of convalescence after hip surgery, the doctor recommends moving with the elbow crutches, and the physiotherapist gives tips on how to use them properly. It also tells you how much pressure you can put your foot on the ground at a given point in the recovery period. Full load is possible approximately one week after the procedure. However, walking without crutches after knee arthroscopy will be possible only after 2-3 weeks.
Arthroscopy – home exercises
In addition to rehabilitation, the rehabilitator will recommend simple exercises after arthroscopy. Each case will require a different set of exercises, but the most common ones will be stretching exercises, isometric exercises (using the strength of tight muscles), and active exercises (where physical exertion causes muscle activity).
For example, exercises after knee arthroscopy will be based on slowly straightening the leg at the knee, lifting and holding it above the floor, or moving the heel to the side. However, before the patient undertakes any physical activity, it should be agreed with a specialist.
Arthroscopy and blood donation
According to the recommendations of the Regional Blood Donation Centers, people after endoscopic procedures, including arthroscopy, should refrain from donating blood for 6 months after the procedure. After this time, it will be completely safe to donate blood.
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