Advances in Arthroscopic Surgery

Knee and shoulder injuries once signaled the end of exercise for many athletes and weekend warriors.  Today, however, active individuals are getting back in the game quickly, thanks to new advances in arthroscopic surgery.

In these procedures, a surgeon inserts a thin, tubular instrument (arthroscope) through a small incision to obtain a clear view of the inside of the joint.  Fiber optic cameras on the end of the scope transmit images onto a TV monitor, which the surgeon then uses as a guide to deliver other instruments to the site and repair the damage.

Whereas traditional, "open" joint surgeries require larger incisions, arthroscopic incisions are barely the size of a penny, thus making recovery times faster and less painful, notes Christopher C. Annunziata, MD, an orthopedic surgeon at Virginia Hospital Center.  The arthroscopes used for knee repairs are roughly four millimeters in diameter, while scopes used on smaller joints, such as wrists and ankles, are even tinier.  Because many arthroscopic procedures can often be performed under local or regional anesthesia, patients tend to enjoy fewer complications and shorter hospital stays.  In fact, most surgery is available on an outpatient basis.

Since its rise to popularity in the 1970s, arthroscopy has become an important treatment for sports injuries such as torn cartilage and/or ligaments in the knee, as well as rotator cuff damage in the shoulder.  More than 600,000 arthroscopic procedures are performed annually in the US, of which about 85% are knee surgeries and 10% are shoulder surgeries.  Arthroscopy can also be used to repair some hip, ankle, elbow and wrist traumas.  Surgery is generally indicated only when other remedies such as physical therapy or medication are not working.

Acute joint or muscle injuries should always be treated immediately with cold compresses (not heat, which will increase swelling).  If pain lasts more than a week and is accompanied by sleep loss or diminished range of motion, consult a doctor.