The Chaim Sheba Medical Center
The hospital of Israel
The Department of International Medicine
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Arthroscopy

A procedure known as arthroscopy or arthroscopic surgery is a minimally invasive surgery, which is allowing to carry out a visual analysis of the joints, as well as to treat joint components that are localized in the inner cavity of the joint.
A special type of endoscope, which is called the arthroscope is a main apparatus used for such operations. During surgery, it is placed into operable joint through a small incision. This kind of operations are very effective and its benefits are superior to the traditional, open surgery procedures.

Arthroscopy is often used to establish a correct diagnosis, as well as for certain types of treatment of joint diseases and defects. For the first time, these technologies have been used in Japanese hospitals in the early 1920s. Then, arthroscopic surgery practiced by only by a limited number of specialists and, fairly recently, arthroscopy became increasingly popular for imaging, diagnosis and treatment of joint diseases. Nowadays, this procedure became simply an indispensable technology for the treatment of a variety of intraarticular disease, which provides modern surgeons not only to save patients from pain and discomfort, but practically get patients back into the old way of life and physical activity.

Usually, arthroscopic surgery performed on the knee joint, but in case of emergency, the aids of the arthroscope can be used in operations on shoulder, ankle and even on the elbow joint.

The procedure itself is usually performed under local or general anesthesia, sometimes with the use of sedatives. The introduction of arthroscope into the joint occurred through three micro-incision of about 5 mm. One incision is used to place device itself with a light source, a miniature optical devices – a special cameras with an ability to transmit the image on the display. Another incision is used to introduce the main micro-surgical tools to perform all the necessary manipulations aimed at restoring ligaments, removal of the fluid, tissues, and so on. The third section is used to introduce a special saline solution into the joint cavity. This is necessary in order to increase the volume of the articular cavity and facilitate the inspection, diagnosis, manipulation and other necessary actions.

Upon completion of this operation, all devices and instruments are removed from the joint cavity, the physiological solution is pumped out (in case of a need, a special fluid with anti-inflammatory or anti-infective drugs could also be introduced into the joint), incisions are antiseptically treated, covered with sterile adhesive bandages, and stitched. The whole joint is wrapped with a special elastic bandage .

Usually, arthroscopic surgery of the knee is most commonly used to get rid of various problems with the meniscus. Arthroscopy allows to a surgeon to:

  • remove part of the meniscus, or perhaps make the damaged part of the meniscus, and implement restoration of knee ligaments,
  • reconstruct articular cartilage in the event of physical damage
  • remove various foreign bodies, adheres and folds
  • perform arthrolysis and arthroplasty
  • make the necessary types of synovectomy
  • stabilize the knee joint, and much more.

Also, such procedures can take samples of tissues or fluids at different local areas of the joint for bacteriological, chemical and other types of analysis.

There are cases when arthroscopic surgery determines the causes and helps to rid of joint diseases that is bringing discomfort, swelling, pain, joint instability, and so on. Indeed, in such situations, sometimes a simple visual inspection is not enough. Therefore, arthroscopy is often accompanied by such additional tests as MRI, X-rays, CT scans, and others diagnostic procedures which help complete the picture, the correct diagnosis and avoid the inconsistency of the data.

Of course, the main advantage of arthroscopic operations is their extremely high efficiency due to visualization and diagnosis of structural problems inside of the joint. Other advantages are very short periods of recovery after such a procedure, which usually last from one to three weeks, and the ability to conduct the procedure in the ambulatory, without a long hospital stay.
Since this operation is minimally invasive, post-op recovery is fast , the small incisions made during the procedure heal quickly, while leaving little visible scars or marks on the skin.

Arthroscopic operations can be carried out only after a thorough examination of the expert, as well as - in the absence of major constriction for such surgery. For example, arthroscopy does not recommended for the patients with severe cardiovascular system diseases, nervous system, as well as considerably weakened general state of health. Also, arthroscopy is contraindicated to those who are suspected of having tuberculosis of bones, infectious or septic joint disease, osteomyelitis, arthritis, siringomeliya, joint contractures, ankylosis and a number of other joint problems.

Arthroscopy is performed in many clinics around the world and have become fairly routine procedure for diagnosis and treatment of joint problems. This procedure has a very small risk of complications and undesirable side effects that occur in very rare cases. Typically, most of these complications occurs when the procedure is carried out by beginners and not very experienced surgeon.

In most cases, after the arthroscopic procedures, patients recovered and returned to his/her routine way of life and physical activity relatively quickly. However, for the first time is very important to follow certain guidelines and restrictions to assure a quick and without complications recovery. For example, it is necessary to avoid bending the knees, not to squat or kneel.
The best way to rest is considered to slightly elevate joint and lower leg to ease a blood circulation. Also, it is advisable to perform special exercises that will help restore mobility. If there is puffiness, swelling and other visible abnormalities, you can use any type of cooling compresses 4-5 times a day for 15-20 minutes.

Arthroscopic surgery is widely used to ease the condition of patients with problems of the joints. In particular, such procedures are often performed to drain the synovial fluid from the glenoid cavity, which contains harmful substances, particles of mucin, cartilage and so on.

Typically, such a procedure quickly helped the patient; it reduces the pain, give patient greater freedom of movement and greater use of problematic leg. Also, this procedure is improving the overall condition of the joint which will last for several years.

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The Chaim Sheba
Medical Center
The hospital of Israel
Hospital address: Derech Sheba 2, Tel-Hashomer, Ramat-Gan, Israel.