Arthroscopy – A Less Invasive Option for the Orthopaedic Surgeon
Joint pain, and the loss of mobility that frequently accompanies it, is now a growing problem in today’s society. Throughout most of the years since effective treatment of the various causes of this condition became possible, it was mainly encountered in older subjects – typically those of age 60 years or more, and significantly more common, as well as more severe in female subjects than in males. While injuries, frequently those arising from sporting activities, account for quite a number of cases, most of them are the result of a condition known as osteoarthritis (OA). Arthroscopy by an orthopaedic surgeon is frequently carried out to determine the precise cause of the joint pain, in order to decide upon the most effective intervention.
Today, the incidence of OA is clearly on the increase. Some of that increase can be accounted for by the fact that people are now living significantly longer in societies where healthcare is readily accessible and well developed. However, there is also a parallel trend for subjects to display the symptoms of osteoarthritis at an earlier age than was previously the case, with a growing number of subjects becoming symptomatic during their fourth and fifth decades, or even earlier. It has been mooted that the increased incidence in younger subjects is linked to the greater frequency of obesity.
Where X-rays may fail to do so, arthroscopy will often provide the surgeon with a clear picture of the cause of joint pain. It could, for example, be due to an accumulation of tiny fragments of bone or cartilage resulting from an injury received on the rugby field or soccer pitch. This would give rise to a grinding action accompanied by pain when, for example, flexing a knee joint. An accumulation of fluid with visible swelling around the joint could give rise to similar symptoms.
To confirm these findings in the absence of radiographic evidence, arthroscopy is the diagnostic tool of choice. The surgeon inserts a thin tube known as an endoscope through a tiny incision in the region of the joint. The tube has a camera attached to the leading end, which relays images via a fibre-optic cable to an eyepiece or a screen where it can then be viewed by the specialist. Given the clear view of the internal structure of the joint, a firm diagnosis can be made.
Should any of the tell-tale fragments or accumulated fluid mentioned earlier appear to be the root of the pain, he or she may then extend the diagnostic procedure and proceed to treat the cause, thus saving the patient the inconvenience and delay of scheduling a second procedure for some later date.
On other occasions, the damage detected may be due to osteoarthritis, and it may be sufficiently severe to warrant a partial or even total joint replacement. This will not be possible with arthroscopy and, instead, the surgeon will need to conduct the more radical orthopaedic procedure known as arthroplasty.
Depending upon the extent of the damage and the joint which is affected, the precise treatment needed will vary. In case of a knee, for instance, the specialist will first conduct preliminary repairs to the damage affecting the articulating surfaces, and prepare them to receive the required prosthetic components. Once complete, this step is then followed by fitting both the tibia and the femur with tailored prostheses, usually metal or a tough ceramic, and designed to engage with one another and to restore free movement.
Arthroscopy and arthroplasty, conducted by an experienced surgeon have proved to be highly successful procedures, and are essential steps in the diagnosis and correction of persistent, severe joint pain, swelling and stiffness. Based on an established reputation for exceptional success, many South Africans and even overseas patients are now being referred to Pretoria Hip Knee & Shoulder Surgeons for arthroscopy and other advanced orthopaedic procedures.