Artroskopi is a surgical procedure performed with make an incision the size of a keyhole to insert a tool called artroskop. This procedure aims to diagnose and treat a number of joint disorders.
An arthroscope is a small tube equipped with a flashlight and camera. This tool serves to capture an image of the joint and display the image on the monitor screen. From the screen above, the doctor can find out the type of injury the patient has and determine the appropriate treatment.
Arthroscopic procedures are usually performed to examine and treat joint disorders in the shoulder, elbow, hip, wrist, ankle, and knee. Some of the joint disorders that can be diagnosed and treated with arthroscopy are:
- Frozen shoulder
- Carpal tunnel syndrome
- Jaw joint disorders (tempomandibular disorder)
- A tear in the cartilage in the shoulder (labral tears)
- Inflammation of the shoulder joint (bursitis)
- Shoulder pain syndrome (shoulder impingement syndrome)
- A tear in the muscles and tendons in the shoulder (rotator cufftendon tears)
- Damage to cartilage in the kneecap (chondromalacia)
- A tear in the cartilage in the knee (meniscal tears)
- Anterior knee ligament injury (ACL tears)
In addition to the above conditions, arthroscopy can also be used to remove loose pieces of bone or cartilage and aspirate fluid deposits within the joint.
Please note, arthroscopy should not be performed on patients suffering from the following conditions:
- Severe osteoarthritis
- Infection of the soft tissue around the joint
- Impaired blood flow, especially in the pelvis and legs
There are several things that patients should know before undergoing arthroscopy, namely:
- People with heart failure, emphysema, high blood pressure, and diabetes should tell their doctor about their condition before undergoing arthroscopy.
- Patients who are over 50 years old and have a history of heart or lung problems should have an EKG and chest X-ray before undergoing arthroscopy.
- Patients who are suffering from soft tissue infections, degenerative joint disease, bone fragility, overweight, and blood clotting disorders are not recommended to undergo arthroscopy.
Before starting an arthroscopic procedure, the patient needs to know the following:
- The orthopedic doctor may ask the patient to stop taking certain medications. Therefore, tell your doctor which medicines, herbal products, or supplements you are currently taking.
- Depending on the type of anesthetic to be administered, the doctor may ask the patient not to eat solid foods for 8 hours before the arthroscopy.
- Patients are not advised to drive alone after arthroscopy. Therefore, ask friends or family to accompany and take you home after the arthroscopy is finished.
- Patients are advised to wear loose and comfortable clothing to make it easier to put them back on after the arthroscopy.
In addition to the things above, the doctor will also perform a number of examinations to ensure that arthroscopy is the right procedure for the patient. These inspections include:
- Blood tests, including white blood cell counts, blood tests rheumatoid factor, C-reactive protein test, and erythrocyte sedimentation rate test
- Scan by X-ray, ultrasound, CT scan, or MRI
The arthroscopic procedure begins with the injection of local, regional, or general anesthetic, according to the patient's condition. After the anesthetic works, the patient will be positioned in such a way, depending on the part of the joint to be operated on.
After that, the skin area on the part of the body that will be operated on is cleaned with antibiotic liquid. Next, the doctor will make a keyhole-sized incision in the patient's skin for the arthroscope to enter. The doctor may also make several incisions to insert other surgical tools or instruments.
The doctor can see an image of the joint captured by the arthroscope on the monitor screen. While monitoring the problematic joint, the doctor can also perform actions, such as removing or repairing damaged tissues in the joint area. Generally, the arthroscopic procedure lasts 30 minutes to 2 hours.
After the procedure is complete, the doctor will close the incision and transfer the patient to the recovery room. The patient may feel pain in the operated joint. To relieve the pain felt by the patient, the doctor will give pain medication.
After undergoing arthroscopy, the patient will be advised to:
- Using splints or crutches for a while
- Avoid strenuous physical activity for a few weeks
- Performing rehabilitation therapy as well as regular check-ups with the doctor
- Applying R.I.C.E (rest, ice, compress, and elevate), which is resting the joint, compressing the joint with ice wrapped in a cloth or towel, bandaging the joint, and elevating the joint area higher than the position of the heart when sitting or lying down to relieve swelling and pain.
Arthroscopy is a safe procedure. However, in some cases, this procedure can cause complications such as:
- Bleeding in the joints
- Joint infection (septic arthritis)
- Damage to the joint and surrounding tissues due to the use of surgical instruments during arthroscopic procedures
- Blood clots in the legs (DVT)
- Pulmonary embolism, which is blockage of blood vessels in the lungs due to blood clots that are separated from other areas