Science and technology has made tremendous progress in recent times, but the pace of development of Medical Sciences leaves other disciplines far behind. This science is taking full advantage of the latest scientific inventions and discoveries. Latest diagnostic and therapeutic treatment options are being made available for the common people almost everyday. Notable examples are: Cardiac Surgery, Cardiac Pacemaker, Lithotripsy, to break kidney stones without surgery, CT Scanning, MRI Scanning, Organ Transplantation, Replantation of severed body parts with the help of Microsurgery, Endoscopic Surgery, Joint Replacement and many more.
Arthroscopic Surgery is a new addition to this growing list. The word Arthroscope comes from Greek root, arthro for joint and scope, meaning to view. The arthroscope consists of a tube, an optical system of magnifying lenses, and a fiberoptic light source. Other instruments required for this surgery are Motorized Shaver, a special Video Camera with Monitor, Flexible Fiberoptic Light Source, Fluid Irrigation Pump and various Hand Instruments. The surgery itself is least invasive and usually minor, and therefore, the surgery done with the help of the Arthroscope is considered a Minimally Invasive Surgery.
The History
The development of Arthroscopic Surgery has taken place in the last two decades mainly. Dr. Watanabe of Japan developed first practical arthroscope named Watanabe No. 21. Many surgeons of North America used this arthroscope shortly thereafter.
There was a flood of experiments and publications based on this revolutionary instrument, instantly. Other accessory equipment for this surgical modality like Motorized Cartilage Shaver, special Video Camera, Flexible Fiber-optic Light Source and special Hand Instruments were developed thereafter. Dr. O’Connor, Developer of Arthroscopic Surgery, Dr. Lanny Johnson and internationally acclaimed surgeon of Indian origin, Dr. Dinesh Patel, Chief, Dept. of Arthroscopic Surgery, Harvard Medical School, Boston helped in the development of these specialized instruments in United States.
A magnified view of the interior of the joint is obtained by the use of a Video Camera and the monitor. This magnification helps in carrying out microsurgery with utmost precision. A video recording of the procedure is done and made available to the patient so that other surgeons may know about the condition of the joint and the details of the procedure performed. Motorized Shaver helps in speedy and accurate repair of the torn or diseased cartilage padding or cushion for the joint or meniscus a C shaped, pad like structure inside the knee joint.
The Indications
The arthroscopic surgery is indicated for the following conditions:
Meniscus Repair or Meniscectomy. Meniscus is a C shaped pad like structure inside the knee joint which gets torn after a twist or a jerk on the knee or a direct injury close to the knee joint. The knee gets swollen and painful. Recurrent episodes of swelling and locking inability to straighten the knee fully take place and the patient is apprehensive of falling down while walking downstairs. The arthroscopic method to treat this condition is very successful and conventional techniques lead to arthritis and joint instability later.
Clearing of degenerated and torn tissues in Degenerative Arthritis
Synovectomy, removal of inflamed inner lining of the joint for patients of Rheumatoid Arthritis who suffer from swelling and pain of knee unresponsive to usual medications.
Removal of Loose Bodies which could be fleshy or bony
Removal of Foreign Bodies pieces of glass, iron or wood in the joint
Reconstruction of the Cruciate Ligament of the knee, this ligament is a very powerful restraint of the knee joint which keeps the knee from abnormal and dangerous mobility. Arthroscopic Reconstruction is the gold standard for this problem and improper treatment could lead to early arthritis of the knee joint with devastating effects on the patients life style. This ligament is torn when too much twisting strain is put on the knee joint and within few hours, the joint is all swollen as blood accumulates quickly within the joint. The patient usually feels a pop or cracking sound too in the joint, when this ligament gives way. The patient feels insecure while walking and feels that his/her knee joint may give way. It is imperative that this condition is diagnosed and treated urgently and effectively.
Diagnostic Procedure to document joint status before planning any major open surgery on the joint.
Besides knee joint many diseases affecting other joints like shoulder, ankle, wrist, elbow and hip, could also be taken care of with the help of Arthroscopic Surgery very effectively.
Although some problems still require larger incisions, most joint injuries can now be treated with the help of the arthroscopic surgery. An exciting and revolutionary new area in which research work is going on is Autogenous Chondrocyte Transplantation which may prove to be a blessing for the patients of Arthritis. In this technique, normal cartilage cells are taken from a site and arthroscopically transplanted on the diseased joint surface, which is deficient in the cartilage cells. This process may potentially reverse the aging effects on the joint. Laser Knife is also being used to tackle some problems at select centers.