‘Arthros’ means joint in Greek. The arthroscope is an instrument used by orthopaedic surgeons to look into joints. It is about 8- 10 inches long and is as thick as a pencil. There is a fibre optic lens system which transmits light from a cold light source outside and relays the interior image to a medical television monitor. In other words the arthroscope serves as a camera device to look into structures inside a joint. It is possible to diagnose pathological conditions not seen on X rays and sometimes even on MRI scans.
Who needs arthroscopy?
a) Rotator cuff tears, partial and complete
b) Recurrent dislocations
c) Frozen shoulder and adhesive capsulitis
d) Calcium deposition
e) Loose bodies
f) Osteoarthritis
Advantages
As there are no formal large incisions, post operative pain is minimal. Since muscles and tissues are not removed from their origins on bone, again the amount of inflammation is minimal. Recovery can be faster as it is not necessary for muscles to heal back. Cosmetically the procedure is very satisfying. There are no mental scars of open surgery. Return to sport or work is faster, hospital stays are shorter and hence bills are smaller. However arthroscopic equipment is expensive to hire or possess and the surgeon has to recover the cost of dispensable items like shavers, suture anchors. This is offset by enormous patient satisfaction.
Arthroscopic surgery by its simple nature provides an opportunity to the orthopaedic surgeon to examine the interior of a joint. After Knee arthroscopy, the shoulder is the joint which is suited for arthroscopic surgery. Other joints are the ankle, wrist and elbow. Indians and Asians in the Gulf get only short spells of leave to spend with their near and dear ones. They would benefit from undergoing Arthroscopic shoulder surgery for shoulder pain as the recovery is shorter.
The conditions treated by open surgery earlier are now treatable by arthroscopic surgery with remarkable success. Some hitherto unknown conditions have been diagnosed after the advent of arthroscopic surgery. Any painful or unstable condition of the shoulder except end stage arthritis can be treated by arthroscopic surgery. Shoulder replacement is not yet possible arthroscopically, but with minimally invasive orthopaedic surgery catching up, that may not be far off. It is certainly possible to introduce prosthesis for fracture fixation through key hole incisions and the same may be extended to joint replacement as well.