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Walking, dressing, and cooking are a few examples of daily activities
which require the free motion of fluid-filled joints. These synovial
joints enclose the bone ends, which are covered by a special protective
material called articular cartilage. The joint cavity is surrounded
by a joint capsule and holds the synovial fluid which lubricates
the articular cartilage. Movement and activity are essential for
healthy cartilage, joints, and synovial fluid exchange.
Accident, injury, disease, or the normal aging process may cause
joint problems. These may affect the bone, articular cartilage,
or the soft tissues (such as ligaments, tendons, and the synovial
membrane) surrounding the joints. Injury commonly tears ligaments
and damages cartilage. Torn cartilage such as a meniscus in the
knee may lead to persistent pain and clicking. A
sprained ankle may result in bone or cartilage chips or loose
bodies, which also cause pain.
These changes can be sources of joint pain which may result in
stiffening, swelling, and inflammation. With the development of
a surgical device called an arthroscope, joint problems may now
be diagnosed and often treated without large incisions or extended
hospital stays. These techniques were originally developed for
the knee, but now many synovial joints benefit from this minimally
invasive procedure including: the shoulder, elbow, wrist, finger,
hip, ankle, and the joint of the lower jaw.
Arthroscopy was originally used to look directly into a joint
to diagnose soft-tissue damage and disease states that could not
be seen on an x-ray. With the development of new instruments,
your surgeon can now repair and remove damaged tissue, clearing
the way for smooth joint movement.
Your orthopaedic surgeon will evaluate your joint condition using
examination skills, x-ray and sometimes MRI, and preoperative blood
tests. Small surgical instruments are passed
into the joint space through a small incision. While viewing the
inside of the joint on a video monitor, the surgeon can inspect,
remove, repair, or reconstruct damaged parts of the joint.
A small bandage and paper tapes are used to close
the incisions. Unlike traditional joint surgery in which the entire
joint capsule is opened, arthroscopic procedures heal relatively
quickly with less scarring. Your recovery depends on your general
health and condition and the extent of diagnostic or surgical
treatment.
During this period of recovery and rehabilitation you will first
control inflammation and swelling with rest and ice. You will
regain range of motion and gradually restore muscle strength with
a gradual increase in activity and joint specific exercises. The
application of ice packs for 20 minutes at a time, especially
after exercise, will decrease pain and swelling. Wraps or compression
bandages, carefully applied, also reduce joint swelling, as does
elevation of the affected joint above the level of your heart
during rest.
Initially you should not do any vigorous physical activity. Your
personal exercise program will be developed with your physician
and physical therapist to enable you to return to normal activity
as soon as possible.
Arthroscopy as a method for diagnosing and treating synovial joint
problems allows for minimal disturbance of normal joint and muscle
anatomy. Swelling and scarring may be reduced compared with traditional
surgical procedures.
Your rehabilitation and recovery after the procedure depends on
the type and extent of joint surgery performed. Continuing exercises
at home for several months after surgery will help you regain
your strength and muscle balance. An active lifestyle that includes such activities as water exercises, walking, or biking is essential in maintaining joint flexibility. Physical activity, good nutrition, and follow-up care are the keys to maintaining your health and well-being. |
