Arthroscopic surgery. Prices, reviews, ratings
Arthroscopic surgery has been known to mankind since 1919. Almost a century ago, the first arthroscopic operation on the knee joint was performed. Japan is considered the birthplace of this field of practical medicine.
Arthroscopic surgery has been known to mankind since 1919. Almost a century ago, the first arthroscopic operation on the knee joint was performed. Japan is considered the birthplace of this field of practical medicine.
General information
Arthroscopy is a method of minimally invasive examination and treatment of joint pathologies. The manipulations are performed using an arthroscope, a special optical device. It includes a system of lenses placed in a metal case, a light cable, and a lens. A video camera is connected to the device, from which the signal is sent to the monitor.
Process
We will consider the sequence of actions using the example of surgical manipulations on the knee.
- Before the procedure, the patient is given anesthesia, local or general. Each of them has its own advantages and disadvantages, anesthesia is always selected individually.
- The patient is placed on his back. After the anesthetic is administered, the lower leg and thigh are wrapped with a rubber bandage to ensure blood flow from the area where the procedure will be performed. After some time, a tourniquet is applied to the thigh. The patient's leg is firmly fixed.
- To begin the examination, a 0.5 cm long incision is made at a distance of 0.5 cm from the patellar ligament, closer to the outer edge. The skin, subcutaneous tissue and the lining of the joint capsule are cut with a scalpel. Then, for further penetration, a trocar is used - an attachment that makes it possible to insert the arthroscope body. Sometimes only the upper skin is cut with a scalpel, and the trocar does all the rest of the work. For different purposes, devices of different thickness are used.
- The device is gradually advanced under the patella.
- As the device body advances, the knee is extended.
- The trocar is removed and an arthroscope is inserted in its place.
- A thin vessel is connected to the system, through which saline is supplied.
- An irrigation cannula is inserted on the other side of the patella, 1 cm from its upper pole. A drainage tube is connected to it, through which saline flows into a specially prepared vessel. Free movement of the solution inside the examined section provides a good image due to better contrast.
- The signal from the device's video camera is transmitted to the monitor, and the doctor can examine the internal structure of the bone joint by simply moving the instrument.
If abnormalities are detected during diagnostic procedures and surgical intervention is required, it can be performed with devices inserted using an arthroscope, or open surgery can be performed immediately while the patient is under anesthesia.
For example, meniscus damage can be repaired with arthroscopic instruments. Torn and defective parts are removed with nippers inserted in a minimally invasive manner. The meniscus is repositioned by applying pressure to the pinched part with an optical probe. Small thin scraps of organic tissue are processed with a shaver - a system of an external and internal tube, in which the first tube is stationary, and the second rotates, "shaving" the damaged areas with a sharp end. They can be removed along with the flow of fluid passing through the joint. Larger pieces of tissue are removed through holes made for the introduction of the device.
Two or three stitches and a sterile bandage are applied to the incisions.
The rehabilitation period after minimally invasive procedures lasts much less than after open ones: wounds heal within a few days, and full recovery occurs in about a month.
Indications
Arthroscopy is widely used in orthopedics for the diagnosis and elimination of pathologies. It is used for ruptures of cartilage, meniscus and ligaments. Arthroscopes are used to perform therapy on the wrist, elbow, shoulder, ankle, knee and hip joints of bones.
Contraindications
Minimally invasive surgery is contraindicated in the presence of purulent-inflammatory processes and fibrous adhesion of bones in the problem area.
Complications
Adverse effects are observed in only 1% of operated patients. The most likely complications are as follows:
- puncture site infection;
- tissue damage by surgical instruments;
- internal hemorrhages and blood clots;
- nerve damage;
- thromboembolism;
- limited movement, etc.
Prices and clinics
Arthroscopic surgeries are performed by orthopedic surgeons - specialists in surgery on the musculoskeletal system. A preliminary examination and referral for surgery is performed by the attending orthopedic physician. The schedule of consultations and the cost of doctor's appointments can be found on the medical portal .
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