With the Advent of Science & the optics in Medical Profession any Joint can be visualised & reconstructed in the body using Arthroscope with its extensive use in the Knee & Shoulder Joints.
With the increase in the high energy sports ( Sports Injuries) & the Road Trafficking with high speed vehicles the ligament injuries and their reconstruction & repair has become a day to day activity in the high demand joints such as Knee & Shoulders.
Ligament injuries and cartilage defects neglected in the initial stages, pose a problem later. Ligament tears such as ACL tear: PCL MCL/LCL injury mainly cause instability patients are troubled with daily activities including jogging, climbing stairs. brisk movements. exercise sporting both for recreation & professional. MRIs help in diagnosing the level of injury, grading of the ligament tear and need for the repair.Ligament reconstructions are minimally invasive arthroscopic surgeries. Where in the entire knee joint is addressed with 2 to 3 portals. The diagnostic scopy is done and the status of the meniscus, cartilage and ligaments are noted, Meniscal repair can be done with special implants such as fast fix, meniscal cinch, etc. For complex tears partial/subtotal meniscectomy is advised.
For most ligament reconstructions. Grafts commonly used are hamstrings tendons(semitendinosis and Gracilis)Other Grafts are Bone Tendone Bone Graft from Patella and Quadriceps tendon. The graft is secured with ultra-button/tightrope at the thigh end and bio screws at the tibial-end. For short individuals, using tight ropes holding the graft with graftlink technique is used. With the advent of the instrumentation and new techniques in surgeries,surgical time was reduced to a great extent which reduces the chances of infection and pain post surgery and rehabilitation has been shortened and almost pain free. Patients are discharged in 36-48 hours, walk with a walker within 4-6 hours post-surgery can be non dependent in 2-4 weeks time, back to office in 4-6 week’s time, back to low energy recreational activity in 3-6 months and high energy sports in 6-9 months period.
1. Very small incisions needed for surgery.
2. Less pain for patients.
3. Less joint stiffness.
4. Relieves painful symptoms of many problems that damage the cartilage surfaces and other soft tissues surrounding the joint.
5. Shortens the time it takes to recover and return to favorite activities.
The widespread use of technology has brought in a gigantic transformation in the field of medical sciences and healthcare. Technology has even made it possible for doctors to treat their patients in a virtual environment. The many inceptions that took birth in the surgical field have supplemented to the benefits of the patients. One such origination that constituted to the knee related surgeries is the Arthroscopic Surgery. The knee arthroscopy is a minimally invasive surgical technique, that allows orthopedic surgeons to assess the injury (joint) and repair any injuries without needing to fully open the joint.
Most commonly due to twisting inuries ,most commonly patient presents with
If the meniscus tears,it needs to be addressed properly because patient has increased risk of developing early arthritis.
5-20% of Knee ligamentous injuries due to direct blow when knee is in flexion/Hyperextension injury usually combined with ACL injuries.
Grade - I & II can we treated conservatively
III - Bony avulsion - To be operated PCL Repair/Reconstruction
Mined PLC injury diagnosis is a common cause of ACL reconstruction fracture
Complete PLC lesions rarely heal with conservative management and most often treated surgically
Most common liagamentous injury of knee 40% due to direct blow to lateral knee with valgus force
Grade - I & II can we treated conservative manager
III - Repair/Reconstruction
Shoulder arthroscopy is a surgical procedure used to visualize, diagnose, and treat various problems inside the shoulder joint and in the space surrounding the rotator cuff. This is done through small incisions that allow the insertion of specialized instruments
Most common shoulder problems, including bursitis, tendonitis, arthritis, impingement, rotator cuff tears, labral tears and shoulder instability
Ankle Arthroscopy can be useful in treating a variety of intra articular disorders. Availability of modern instruments and ankle distraction techniques has allowed surgeons to treat the disorder arthroscopically
With this technique, patient can get back to activities in 3 - 6 weeks and avoids immobilisation for prolonged period, with low risk of soft tissue complications and less trauma.
Advantages:
Patient will be able to walk from second day of surgery.
Minimal pain, minimal scar.
Minimal wound healing complications compared to traditional method.
Reduce incidence of Re - rupture and sural nerve injury.
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