Arthroscopy | definition of arthroscopy by Medical dictionary Arthroscopy | definition of arthroscopy by Medical dictionary Definition Arthroscopy is the examination of a joint, specifically, the inside structures. The procedure is performed by inserting a specifically designed illuminated device into the joint through a small incision. This instrument is called an arthroscope. The procedure of arthroscopy is primarily associated with the process of diagnosis. However, when actual repair is performed, the procedure is called arthroscopic surgery . Purpose Arthroscopy is used primarily by doctors who specialize in treating disorders of the bones and Arthroscopy is primarily used to help diagnose joint problems. This procedure, most commonly associated with knee and shoulder problems, allows accurate examination and diagnosis of damaged joint ligaments, surfaces, and other related joint structures. The illustration above indicates the most common entry sites, or portals, in knee arthroscopy. (Illustration by Electronic Illustrators Group.) related structures (orthopedics) to help diagnose joint problems. Once described as essential for those who primarily care for athletic injuries, arthroscopy is now a technique commonly used by orthopedic surgeons for the treatment of patients of all ages.

This procedure is most commonly used to diagnose knee and shoulder problems, although the elbow, hip, wrist, and ankle may also be examined with an arthroscope. A joint is a complex system. Within a joint, ligaments attach bones to other bones, tendons attach muscles to bones, cartilage lines and helps protect the ends of bones, and a special fluid (synovial fluid) cushions and lubricates the structures. Looking inside the joint allows the doctors to see exactly which structures are damaged. Arthroscopy also permits earlier diagnosis of many types of joint problems which had been difficult to detect in previous years. Precautions Most arthroscopic procedures today are performed in same-day surgery centers where the patient is admitted just before surgery. A few hours following the procedure, the patient is allowed to return home, although usually someone else must drive. Depending on the type of anesthesia used, the patient may be told not to eat for several hours before arriving. Before the procedure, the anesthesiologist will ask if the patient has any known allergies to local or general anesthetics. Airway obstruction is always possible in any patient who receives a general anesthesia. Because of this, oxygen, suction, and monitoring equipment must be available.

The patient's cardiac status should always be monitored in the event that any cardiac abnormalities arise during the arthroscopy. Description The arthroscope is an instrument used to look directly into the joint. It contains magnifying lenses and glass-coated fibers that send concentrated light into the joint. A camera attached to the arthroscope allows the surgeon to see a clear image of the joint. This image is then transferred to a monitor located in the operating room at the time of the arthroscopy. This video technology is also important for documentation of the arthroscopic procedure. For example, if the surgeon decides after the arthroscopic examination that a conventional approach to surgically expose or "open" the joint (arthrotomy) must be used, a good photographic record will be useful when the surgeon returns to execute the final surgical plan. The procedure requires the surgeon to make several small incisions (portals) through the skin's surface into the joint. Through one or two of the portals, a large-bore needle, called a cannula, is attached to tubing and inserted into the joint. The joint is inflated with a sterile saline solution to expand the joint and ensure clear arthroscopic viewing.

Often, following a recent traumatic injury to a joint, the joint's natural fluid may be cloudy, making interior viewing of the joint difficult. In this condition, a constant flow of the saline solution is necessary. This inflow of saline solution may be through the cannula with the outflow through the arthroscope, or the positions may be reversed. The arthroscope is placed through one of the portals to view and evaluate the condition of the joint. Preparation Before an arthroscopy can take place, the surgeon completes a thorough medical history and evaluation. Important for the accuracy of this diagnostic procedure, a medical history and evaluation may discover other disorders of the joint or body parts, proving the procedure unnecessary. This is always an important preliminary step, because pain can often be referred to a joint from another area of the body. Anatomical models and pictures are useful aids to explain to the patient the proposed arthroscopy and what the surgeon may be looking at specifically. Proper draping of the body part is important to prevent contamination from instruments used in arthroscopy, such as the camera, light cords, and inflow and outflow drains placed in the portals.

Draping packs used in arthroscopy include disposable paper gowns and drapes with adhesive backing. The surgeon may also place a tourniquet above the joint to temporarily block blood flow to the area during the arthroscopic exam. General or local anesthesia may be used during arthroscopy. Local anesthesia is usually used because it reduces the risk of lung and heart complications and allows the patient to go home sooner. The local anesthetic may be injected in small amounts in multiple locations in skin and joint tissues in a process called infiltration. In other cases, the anesthetic is injected into the spinal cord or a main nerve supplying the area. This process is called a "block," and it blocks all sensation below the main trunk of the nerve. For example, a femoral block anesthetizes the leg from the thigh down (its name comes from femur, the thighbone). Most patients are comfortable once the skin, muscles, and other tissues around the joint are numbed by the anesthetic; however, some patients are also given a sedative if they express anxiety about the procedure. (It's important for the patient to remain still during the arthroscopic examination.) Key terms Hemarthrosis — A condition of blood within a joint.

Pulmonary embolus — Blockage of an artery of the lung by foreign matter such as fat, tumor, tissue, or a clot originating from a vein. Thrombophlebitis — Inflamation of a vein with the formation of a thrombus or clot. General anesthesia, in which the patient becomes unconcious, may be used if the procedure may be unusually complicated or painful. For example, people who have relatively "tight" joints may be candidates for general anesthesia because the procedure may take longer and cause more discomfort. Aftercare The portals are closed by small tape strips or stitches and covered with dressings and a bandage. The patient spends a short amount of time in the recovery room after arthroscopy. Most patients can go home after about an hour in the recovery room. Pain medication may be prescribed for a short period; however, many patients find various over-the-counter pain relievers sufficient. Following the surgical procedure, the patient needs to be aware of the signs of infection, which include redness, warmth, excessive pain, and swelling. The risk of infection increases if the incisions become wet too early following surgery.

Because of this, it is good practice to cover the joint with plastic (for example, a plastic bag) while showering after arthroscopy. The use of crutches is commonplace after arthroscopy, with progression to independent walking on an "as tolerated" basis by the patient. Generally, a rehabilitation program, supervised by a physical therapist, follows shortly after the arthroscopy to help the patient regain mobility and strength of the affected joint and limb. Risks The incidence of complications is low compared to the high number of arthroscopic procedures performed every year. Possible complications include infection, swelling, damage to the tissues in the joint, blood clots in the leg veins ( thrombophlebitis ), leakage of blood into the joint (hemarthrosis), blood clots that move to the lung (pulmonary embolus), and injury to the nerves around the joint. Normal results The goal of arthroscopy is to diagnose a joint problem causing pain and/or restrictions in normal joint function. For example, arthroscopy can be a useful tool in locating a tear in the joint surface of the knee or locating a torn ligament of the shoulder.

Arthroscopic examination is often followed by arthroscopic surgery performed to repair the problem with appropriate arthroscopic tools. The final result is to decrease pain, increase joint mobility, and thereby improve the overall quality of the patient's activities of daily living. Abnormal results Less optimal results that may require further treatment include adhesive capsulitis. In this condition, the joint capsule that naturally forms around the joint becomes thickened, forming adhesions . This results in a stiff and less mobile joint. This problem is frequently corrected by manipulation and mobilization of the joint with the patient placed under general anesthesia. Resources /ar·thros·copy/ (ahr-thros´kah-pe) examination of the interior of a joint with an arthroscope. arthroscopy (är-thrŏs′kə-pē) n. pl. arthrosco·pies Examination of the interior of a joint, such as the knee, using a type of endoscope that is inserted into the joint through a small incision. ar′thro·scope′ (är′thrə-skōp′) n. ar′thro·scop′ic (-skŏp′ĭk) adj. ar′thro·scop′ic·al·ly adv.

arthroscopy [ärthros′kəpē] Etymology: Gk, arthron + skopein, to watch the examination of the interior of a joint, performed by inserting a specially designed endoscope through a small incision. The procedure, used chiefly in knee problems, permits biopsy of cartilage or synovium, diagnosis of a torn meniscus, and, in some instances, removal of loose bodies in the joint space. arthroscopic, adj. Arthroscopy arthroscopy Orthopedics The direct examination of a joint–eg, shoulder, wrist, knee, ankle, with an arthroscope Indications Diagnose and/or biopsy lesions of the meniscus, synovium, and extrasynovial tissues, and manage intraarticular lesions–eg, torn ligaments and cartilage Abnormal findings Baker's cyst, chondromalacia, chondromatosis, fractures, osteochondral disruption, fractures, osteochondritis dissecans, rheumatic disease, synovial defects, capsular or ligament tears Complications Nerve damage related to portal placement, postoperative joint infection, soft tissue or bone infections. See Arthroscope , Arthroplasty .

ar·thros·co·py (ar-thros′kŏ-pē) [ arthro- + -scopy] ARTHROSCOPY OF KNEE Direct joint visualization by an arthroscope, usually to remove, repair, or replace tissue, such as cartilage fragments or torn ligaments, or to anneal injured tissues. arthroscopic (ar″thrŏ-skop′ik), adjective See: illustration Patient care Preoperative: The patient is prepared physically and emotionally for the procedure. Baseline data (e.g., range of motion, girth measurements) are gathered. The operative site is prepared according to protocol and type of anesthesia. Postoperative: Vital signs are monitored until stable, and intravenous or oral fluids are provided, depending on the type of anesthesia used. Neurovascular status is assessed. The surgical dressing is inspected for drainage, and the presence of any drainage devices and their contents are documented. Postoperative teaching stresses expected sensations, such as joint soreness and grinding; the application of ice to relieve pain and swelling; use of analgesics; restrictions on activity or walking; weight-bearing exercises; and use of crutches or other such devices.

The patient is instructed to report any unusual drainage, redness, joint swelling, unusual softness in the joint, severe or persistent pain, or fever, because these may indicate infection, effusion, hemarthrosis, or a synovial cyst. The patient is referred for outpatient follow-up care as necessary. arthroscopy Examination of the inside of a joint by an optical device, usually a fine bore fibreoptic endoscope. arthroscopy procedure for visualizing the interior of a joint, using an intra-articular camera to assess, repair or reconstruct various tissues within and around it. arthroscopy an endoscopic technique for the examination or treatment of the interior of a joint ar·thros·co·py Arthroscopy Surgery - Recovery Time & Benefits What is Arthroscopy? Arthroscopy is a surgical procedure orthopaedic surgeons use to visualize, diagnose, and treat problems inside a joint. The word arthroscopy comes from two Greek words, “arthro” (joint) and “skopein” (to look).

The term literally means “to look within the joint.” In an arthroscopic examination, an orthopaedic surgeon makes a small incision in the patient’s skin and then inserts pencil-sized instruments that contain a small lens and lighting system to magnify and illuminate the structures inside the joint. Light is transmitted through fiber optics to the end of the arthroscope that is inserted into the joint. Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgical procedure in which an examination and sometimes treatment of damage of the interior of a joint is performed using an arthroscope, a type of endoscope that is inserted into the joint through a small incision. Arthroscopic procedures can be performed either to evaluate or to treat many orthopedic conditions including torn floating cartilage, torn surface cartilage, ACL reconstruction, and trimming damaged cartilage. Benefit of Arthroscopy The advantage of arthroscopy over traditional open surgery is that the joint does not have to be opened up fully. Instead, for knee arthroscopy for example, only two small incisions are made — one for the arthroscope and one for the surgical instruments to be used in the knee cavity to fully remove the knee cap.

This reduces recovery time and may increase the rate of surgical success due to less trauma to the connective tissue. It is especially useful for professional athletes, who frequently injure knee joints and require fast healing time. There is also less scarring, because of the smaller incisions. Irrigation fluid is used to distend the joint and make a surgical space. Sometimes this fluid leaks into the surrounding soft tissue causing extravasation and edema. The surgical instruments used are smaller than traditional instruments. Surgeons view the joint area on a video monitor, and can diagnose and repair torn joint tissue, such as ligaments and menisci or cartilage. It is technically possible to do an arthroscopic examination of almost every joint in the human body. The joints that are most commonly examined and treated by arthroscopy are the knee, shoulder, elbow, wrist, ankle, foot, and hip. How is Arthroscopy Performed? Arthroscopic surgery, although much easier in terms of recovery than “open” surgery, still requires the use of anesthetics and the special equipment in a hospital operating room or outpatient surgical suite. You will be given a general, spinal, or a local anesthetic, depending on the joint or suspected problem.

A small incision (about the size of a buttonhole) will be made to insert the arthroscope. Several other incisions may be made to see other parts of the joint or insert other instruments. When indicated, corrective surgery is performed with specially designed instruments that are inserted into the joint through accessory incisions. Initially, arthroscopy was simply a diagnostic tool for planning standard open surgery. With development of better instrumentation and surgical techniques, many conditions can be treated arthroscopically. Recovery Time after Arthroscopy The small puncture wounds take several days to recover. The operative dressing can usually be removed the morning after surgery and adhesive strips can be applied to cover the small healing incisions. Although the puncture wounds are small and pain in the joint that underwent arthroscopy is minimal, it takes several weeks for the joint to maximally recover. A specific activity and rehabilitation program may be suggested to speed your recovery time and protect future joint function. It is not unusual for patients to go back to work or school or resume daily activities within a few days. Athletes and others who are in good physical condition may in some cases return to athletic activities within a few weeks.

Remember, though, that people who have arthroscopy can have many different diagnoses and preexisting conditions, so each patient’s arthroscopic surgery is unique to that person. Recovery time will reflect that individuality. Hip Arthroscopy - HSS Hip arthroscopy is one of various forms of surgical treatments for hip conditions . To better understand the following discussion of these treatments, it is useful to first get an overview of the anatomy of the hip. Anatomy of the Hip Joint The hip joint is the ball-and-socket joint. The head of the femur (thighbone) forms the ball, and the acetabulum (a part of the pelvis) forms the socket. Articular cartilage covers both. While the cartilage covers the entire head of the femur, the acetabulum cartilage is in the shape of a horseshoe with a depression (fossa) in the center of the socket. This fossa contains soft tissue and a ligament connecting the femoral head to the socket. The socket has a rim of rubbery fibrocartilage called the labrum. The labrum acts as a gasket, sealing in fluid and helping to deepen the socket.

This labrum is analogous to the knee meniscus and shoulder labrum. The entire joint is covered with a tough capsule to contain the joint fluid and maintain cartilage lubrication and nutrition. In addition, numerous tendons surround the hip, as well as bursae, which are lubrication "cushions" where soft tissues glide over bony prominences. Illustration of hip joint Pathologic Conditions Congenital Abnormalities For the hip to last a lifetime, the anatomy must be normal along with the absence of catastrophic problems such as trauma or infection. Hip dysplasia refers to a hip that does not develop properly because of congenital dislocation or if the femoral head is not fully seated in the acetabulum. Degenerative changes can occur very early in life; the greater the abnormalities, the sooner symptoms may occur. Dysplasia can cause arthritis (loss of cartilage) because the shallow socket creates inadequate contact between the ball and socket. The overloaded cartilage can wear away if this situation is not corrected. In addition, the labrum (rim) is often torn, because of the high loads to which it is subjected in trying to maintain coverage of the head.

Dysplastic hip with poor head coverage Developmental Abnormalities Certain conditions may occur during childhood and adolescence. These include: Perthes disease (arrest of blood flow to the femoral head) and slipped capital femoral epiphysis (slippage of the cartilage growth plate in the femoral head). These conditions lead to abnormalities of the femoral head anatomy. If the femoral head is left squared, enlarged, or tilted, early arthritis and labral tears may occur. If the head is left displaced on the femoral neck, an impingement may occur. Impingement means that the femoral neck hits the rim of the socket prematurely during flexion which leads to decreased range of motion, labral tears and ultimately arthritis . Trauma The anatomy may be completely normal, but abnormal loads or positions may cause trauma to the joint. Depending upon the severity, the bone may fracture, the articular cartilage may be cracked or shear off either on the head or socket, or the labrum may be torn. Degenerative Conditions In the absence of trauma or congenital defects, the hip may simply wear out as we age. These conditions include arthritis (loss of cartilage) or labral tears.

Treatment Conservative Measures Nonoperative measures should always be considered first. Rest, behavior modification, physical therapy , and non-steroidal anti-inflammatory drugs may alleviate reversible disorders. For persistent pain, the correct diagnosis must be made. A skilled physician should be able to determine whether the pain is from the hip and not radiating from the lower back or abdomen. It can be very difficult to differentiate between "intra-articular" (inside the joint) problems such as labral tears, cartilage damage, and arthritis versus "extra-articular" (outside the joint) problems such as tendinitis or bursitis. Steroid injections can be placed into the joint or around bursae and tendons to: Confirm the diagnosis: The steroid is mixed with Marcaine, a local anesthetic. Provide longer lasting relief by reducing inflammation. High-resolution MRI scans are indispensable for visualizing bone and soft tissues to help confirm the correct diagnosis. Surgical Treatments The type of surgery depends upon the degree of damage, age of the patient, and natural history of the disorder.

For hip disorders the options include: Hip Arthroscopy Arthrotomy Total Hip Replacement Hip arthroscopy – Hip arthroscopy has been slower to evolve than arthroscopy of other joints such as the knee or shoulder. The difficulty is that the hip joint is much deeper in the body and therefore harder to access. To perform the arthroscopy adequately, it is necessary to use traction to distract the joint under anesthesia. This distraction temporarily opens the space between the ball and socket by approximately one-half inch. This space is necessary to insert the scope and small instruments without damaging the labrum and cartilage. While this is possible under general anesthesia, we prefer epidural anesthesia, which provides muscle relaxation and complete pain relief but does not require a tube to be inserted in the airway, resulting in a much safer outcome. Fluoroscopy ( X-ray ) is used during the case to ensure that the instruments and scopes are inserted properly. The instruments are inserted through two tiny skin incisions. Occasionally, a third or fourth incision may be required depending upon the procedure. Excellent visualization of the entire joint is possible. Through the second opening (portal) instruments are inserted to shave tissue, cauterize structures, or remove pieces.

On occasion, holes may be drilled into patches of bare bone where the cartilage has been lost. This technique, called "microfracture" or "picking" incites localized bleeding and encourages the formation of fibrocartilage (repair cartilage). Saline is pumped through the joint during the procedure to improve visualization and flush out debrided tissue. Traction creates space for instrument insertion Cleaning away torn cartilage Torn labrum at rim of socket Removal of loose body from inside the hip Once the case is finished, the hip may be injected with local anesthetic to decrease postoperative pain and facilitate discharge from the hospital. The procedure is usually done on an outpatient basis. Patients are usually discharged on crutches but can often return to full weight bearing after a few days. Physical therapy may be used during the postoperative period to increase range of motion and strength. It may be necessary to protect weight bearing for as long as six weeks following the procedure if the microfracture technique is used. It should be noted that while the procedure has vastly improved the ability to treat certain hip disorders with minimal surgical trauma, it is not always an appropriate replacement for other larger operations.

If the hip has severe degeneration, total hip replacement may be the only procedure that will provide long-term pain relief. Conversely, in younger patients with skeletal deformities ( i.e. dysplasia , impingement ) hip arthroscopy will usually provide relief. But the relief may be short-lived because the underlying pathologic condition has not been corrected. Osteotomy – Osteotomy (cutting the bone) is a technique were the anatomy of the femur or socket is altered to relieve pain and prolong survival of the joint by reducing the abnormal loads on the cartilage. Fusion – Fusion (arthrodesis) makes the hip permanently stiff by obliterated the joint via bone bridging across the joint. This procedure was performed much more frequently in the past and is still appropriate in certain conditions, such as severe arthritis of one hip in a young person. Arthrotomy – Arthrotomy (opening the joint) is a procedure where the joint is opened to clean out bone spurs, loose bodies, tumors, or to repair fractures. Total Hip Replacement – Total hip replacement is extremely effective at relieving pain and restoring function as well as range of motion.

But, it is an artificial joint and should be performed only if other "joint saving" procedures are not appropriate. Learn more about the HSS Arthritis Service . Reviewed: 7/6/2016 Published: 9/25/2003 • Diagnostic imaging examinations provided by HSS Radiologists Shoulder arthroscopy: MedlinePlus Medical Encyclopedia Damaged or inflamed tissue is cleaned out in the area above the shoulder joint. A ligament called the coracoacromial ligament may be cut. The underside of a bone called the acromion may be shaved. A bony growth (spur) on the underside of the acromion often causes impingement syndrome. The spur can cause inflammation and pain in your shoulder. Surgery for shoulder instability: If you have a torn labrum, the surgeon will repair it. The labrum is the cartilage that lines the rim of the shoulder joint. Ligaments that attach to this area will also be repaired. The Bankart lesion is a tear on the labrum in the lower part of the shoulder joint. A SLAP lesion involves the labrum and the ligament on the top part of the shoulder joint.

At the end of the surgery, the incisions will be closed with stitches and covered with a dressing (bandage). Most surgeons take pictures from the video monitor during the procedure to show you what they found and the repairs that were made. Your surgeon may need to do open surgery if there is a lot of damage. Open surgery means you will have a large incision so that the surgeon can get directly to your bones and tissues.

Why the Procedure is Performed Arthroscopy may be recommended for these shoulder problems: A torn or damaged cartilage ring (labrum) or ligaments Shoulder instability, in which the shoulder joint is loose and slides around too much or becomes dislocated (slips out of the ball and socket joint) A torn or damaged biceps tendon A torn rotator cuff A bone spur or inflammation around the rotator cuff Inflammation or damaged lining of the joint, often caused by an illness, such as rheumatoid arthritis Arthritis of the end of the clavicle (collarbone) Loose tissue that needs to be removed Shoulder impingement syndrome, to make more room for the shoulder to move around Risks Risks of anesthesia and surgery in general are: Allergic reactions to medicines Injury to a blood vessel or nerve Before the Procedure Tell your health care provider what medicines you are taking. This includes medicines, supplements, or herbs you bought without a prescription. During the 2 weeks before your surgery: You may be asked to stop taking medicines that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other medicines.

Ask your provider which medicines you should still take on the day of your surgery. If you have diabetes, heart disease, or other medical conditions, your surgeon may ask you to see your doctor who treats you for these conditions. Tell your provider if you have been drinking a lot of alcohol, more than 1 or 2 drinks a day. If you smoke, try to stop. Ask your provider for help. Smoking can slow wound and bone healing. Tell your doctor about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery. On the day of surgery: Follow instructions about when to stop eating and drinking. Take any drugs you're asked to take with a small sip of water. Follow instructions on when to arrive at the hospital. Be sure to arrive on time After the Procedure Follow any discharge and self-care instructions you are given. Recovery can take 1 to 6 months. You will probably have to wear a sling for the first week. If you had a lot of repair done, you may have to wear the sling longer. You may take medicine to control your pain. When you can return to work or play sports will depend on what your surgery involved. It can range from 1 week to several months.

Physical therapy may help you regain motion and strength in your shoulder. The length of therapy will depend on what was done during your surgery. Outlook (Prognosis) Arthroscopy often results in less pain and stiffness, fewer complications, a shorter (if any) hospital stay, and faster recovery than open surgery. If you had a repair, your body needs time to heal, even after arthroscopic surgery, just as you would need time to recover from open surgery. Because of this, your recovery time may still be long. Surgery to fix a cartilage tear is usually done to make the shoulder more stable. Many people recover fully, and their shoulder stays stable. But some people may still have shoulder instability after arthroscopic repair. Using arthroscopy for rotator cuff repairs or tendinitis usually relieves the pain, but you may not regain all of your strength. Alternative Names SLAP repair; SLAP lesion; Acromioplasty; Bankart repair; Bankart lesion; Shoulder repair; Shoulder surgery; Rotator cuff repair Images Shoulder arthroscopy References DeBerardino TM, Scordino L. Shoulder arthroscopy. In: Miller MD, Thompson SR, eds.

DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 45. Phillips BB. Arthroscopy of the upper extremity. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 52.

Read More Orthopaedic Treatment - Smit Orthopaedic Hospital & Dental Clinic | Joint Replacement Surgery Doctor in Anand | Fracture Treatment Center in Anand | Spine Surgeon Specialist in Anand | Arthroscopy Surgery in Anand | Hand Surgeon Specialist in Anand | Paediatric Orthopaedics Hospital in Anand | Best Dental Treatment in Anand | Teeth Cleaning Treatment in Anand | Dentistry Specialist Doctor in Anand | Implant Dentistry Treatment in Anand | Cosmetic Dentistry Treatment in Anand | Teeth Whitening Treatment in Anand | Best Orthopaedic Surgeon in Anand | Best Dental Surgeon in Anand | Best Orthopaedic Hospital in Anand Consultant orthopaedic Surgeon Trauma, Spine & Joint Replacement Specialist. Joint Replacement Orthotech by Dr. Niraj Shah has created a renowned name for itself in the medical industry by performing safe joint replacement surgeries. A joint refers to the coming together of two or more bones like the knee, the hip and the shoulder. A joint replacement surgery includes removal of a damaged joint and putting a new one in place of it. Sometimes, removal of an entire joint is not required while wherein only the damaged part is replaced or fixed.

This kind of a surgery is performed by a doctor called an orthopaedic surgeon. A joint replacement surgery is suggested with the view to improve your movements, relieve pain and subsequently help you live better. Usually hips and knees are replaced most often. Other joints that are replaced include the shoulders, fingers, ankles and the elbows Fracture Treatments Fracture Treatments The condition where a bone is broken is termed as a fracture. A bone can be fractured either completely or partially in any number of ways like crosswise, lengthwise or in multiple pieces. We have acquired a reputed name for offering the best treatment for fractures. The tests conducted by us are performed while observing utmost safety and precaution. The staff hired by us is experienced in their respective domain. These experts perform the diagnostic tests without leaving any scope for errors. Types of fractures Bones are usually strong and rigid, but they do bend or give way when an external force puts pressure on it. If the pressure is too great, the bones tend to break. This condition causes a fracture. The severity of a fracture is determined by the amount of force that caused the break.

In case the bone's breaking point has exceeded very slightly, then the bone may crack rather than break, however, if the force is extreme, for example in an auto-mobile crash or a gunshot, then the bone may shatter. Common types of fractures includeï¿½ Stable Fracture Spine Treatments Spine Treatments According to the Mayo Clinic, USA, approximately 80% of all Americans will certainly suffer from low back pain at least once in their life. Looking at this data, we can clearly see that back pain is one of a very common problems that ails people. Such is the effect of this ailment that it is considered as one of the common reasons for absence from work or visiting the doctor. As per the records of the NHS (National Health Service), UK; backache is the primary cause of work-related absence in the United Kingdom. Although back pain may be painful and may cause some discomfort, it is usually not serious. Back pain ails every individual belonging to any age-group, however, it significantly affects those falling in the age bracket of 35 years onwards. Pain in the upper back is caused due to disorders of the aorta, tumours in the chest and inflammation of the spine.

Back pain, on the other hand, is associated with the combined working of our bones, muscles and ligaments. Pain in the lower back may be linked to numerous reasons. These may include the discs between the vertebrae, lower back muscles, ligaments around the spine and discs, bony lumbar spine, spinal cord and nerves, abdomen & pelvic internal organs and the skin around the lumbar area. What are the factors causing back pain? Listed below are the factors that may act as a catalyst in causing back pain: A mentally stressful job Use a mattress that keeps you spine straight Arthroscopy Treatments Arthroscopy Treatments An arthroscopy refers to the type of keyhole surgery that is used for the dual purpose of diagnosing problems with the joints and repairing damage done to the same. The procedure is usually [performed on knees, wrists, elbows, ankles and shoulders. This surgery is recommended for those suffering from problems with joints, such as swelling or stiffness and whose initial imaging tests have not been able to determine its cause. An arthroscopy is then used to look at the inside of the joint. Orthotech is a clinic that is renowned for performing this surgery under the experienced guidance of Dr. Neeraj Bijlani.

We make use of standard instruments and sophisticated technology to ensure absolute safety and the success of the surgery performed by us. Why is arthroscopy necessary? Usually a joint injury or disease is diagnosed with the help of tests like x-rays, magnetic resonance imaging (MRI), computed tomography (CT along-with patient's medical history and physical examination. A final diagnosis is performed via the arthroscope. Performing this test ensures accuracy as compared with open surgery or from X-ray studies. Some of the most frequent and serious conditions found by arthroscopic examinations of joints include: Inflammation: Synovitis is an inflammation of the lining in the knee, shoulder, elbow, wrist, or ankle Acute or Chronic Injury : Removal of loose bone or cartilage in knee, shoulder, elbow, ankle, wrist How is arthroscopy performed? Arthroscopic surgery requires the use of anaesthetics where a patient is given either a general, spinal or a local aesthetic, depending on the joint or suspected problem. This process is followed by making a small incision (about the size of a buttonhole) so as to insert the arthroscope.

The corrective surgery is performed with the aid of technologically advanced and precision designed instruments that are inserted into the joint through accessory incisions. Earlier, arthroscopy was considered as a simple diagnostic tool for planning standard open surgery, however, with introduction of advanced and better instrumentation as well as surgical techniques, various conditions can be treated arthroscopically. The best part of an arthroscopic surgery is that the small incisions made for the surgery is covered with a dressing. Many patients require little or no pain medications. What are the possible complications? Complications, however rare, may occur occasionally during or following arthroscopy. Phlebitis (blood clots of a vein), infection, excessive swelling or bleeding, damage to blood vessels or nerves and instrument breakage are the some of the most common complications that occur in far less than 1 percent of all arthroscopic procedures. What are the advantages of arthroscopy? Arthroscopic surgery has gained immense preference as it has cured numerous well-known athletes. This surgery also serves as an excellent tool for all orthopaedic patients and is easier on the patient as compared with open surgery. Most patients get an arthroscopic surgery as outpatients and reach home several hours after the surgery.

What is recovery like after arthroscopy? The small puncture wounds take several days to heal. The operative dressing can be removed the morning after surgery and adhesive strips may be applied to cover the small healing incisions. Although the puncture wounds are small in size so the pain in the affected joint that underwent arthroscopy is minimal. However, it takes several weeks for the joints to fully recover. A specific activity chart as well as rehabilitation programs may be suggested to speed up your recovery and protect the joints. Hand surgery Hand surgery Hand is a priceless part of human body that helps the body to move around and perform all kinds of functions. Hand surgery can be affected by various injuries and trauma conditions like: Hand pain Fractures of the fingers, hand and wrist Tendon and ligament injuries Burn reconstruction What is a fracture? The hand is made up of many bones that are arranged in a framework. This framework acts as a point of attachment for the muscles that constitute the wrist and helps the fingers to move. A fracture happens when immense force is applied to a bone, heavy enough to break it. This results in pain, swelling along-with decreased use of the injured part. How does a fracture affect the hand?

Fractures taking place in the hand may cause severe pain, stiffness and loss of movement. Some fractures like in finger, will cause a deformity, however, many fractures do not. Owing to the proximity and close relationship of bones with ligaments & tendons, the hand may be stiff and weak after the fracture heals. Fractures that injure joints may lead to early arthritis in those joints. How are hand fractures treated? Medical evaluation and x-rays determine the seriousness of the fracture and the subsequent treatment. A splint or cast is used to treat a fracture that is not displaced or else to protect a fracture that has been set. Some displaced fractures need to be set and then held in place with wires or pins. This procedure is done without making an incision and is called closed reduction and internal fixation. Other kind of fractures may require surgery to set the bone and is termed as open reduction. Once the bone fragments are set, these are then held together in place with the help of pins, plates or screws. What types of results can I expect from surgery for hand fractures? Perfect alignment of the bone is not always shown in x-ray.

A bony lump may appear at the fracture site as the bone heals and is known as a ï¿½fracture callusï¿½. This is a normal healing process and the lump usually gets smaller over time. Problems with a healing fracture may include shift in position, stiffness, infection, slow rate of healing or complete failure to heal. Smoking also acts as a deterrent in the process of healing. A hand therapy program with splints and exercises may be advised to speed up and improve the recovery process. Paediatric Orthopaedics Knee arthroscopy: MedlinePlus Medical Encyclopedia Additional risks for this surgery include: Bleeding into the knee joint Damage to the cartilage, meniscus, or ligaments in the knee Blood clot in the leg Injury to a blood vessel or nerve Infection in the knee joint Knee stiffness Before the Procedure Always tell your health care provider what medicines you are taking, even drugs, supplements, or herbs you bought without a prescription. During the 2 weeks before your surgery: You may be told to stop taking medicines that make it harder for your blood to clot.

These include aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), and other blood thinners. Ask which medicines you should still take on the day of your surgery. Tell your provider if you have been drinking a lot of alcohol (more than 1 or 2 drinks a day). If you smoke, try to stop. Ask your provider for help. Smoking can slow down wound and bone healing. Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you have before your surgery. On the day of your surgery: You will most often be asked not to drink or eat anything for 6 to 12 hours before the procedure. Take the medicines you been told you to take with a small sip of water. You will be told when to arrive at the hospital. After the Procedure You will have an ace bandage on your knee over the dressing. Most people go home the same day they have surgery. Your provider will give you exercises to do. Outlook (Prognosis) Full recovery after knee arthroscopy will depend on what type of problem was treated.

Problems such as a torn meniscus, broken cartilage, Baker's cyst, and problems with the synovium are often easily fixed. Many people stay active after these surgeries. Recovery from simple procedures is fast in most cases. You may need to use crutches for a while after some types of surgery. Your provider may also prescribe pain medicine. Recovery will take longer if you have had a more complex procedure. If parts of your knee have been repaired or rebuilt, you may not be able to walk without crutches or a knee brace for several weeks. Full recovery may take several months to a year. If you also have arthritis in your knee, you will still have arthritis symptoms after surgery to repair other damage to your knee. Alternative Names Knee scope - arthroscopic lateral retinacular release; Synovectomy - knee; Patellar (knee) debridement; Meniscus repair; Lateral release; Knee surgery; Meniscus-arthroscopy; Collateral ligament-arthroscopy; Images Knee arthroscopy - series References Griffin JW, Hart JA, Thompson SR, Miller MD. Basics of knee arthroscopy. In: Miller MD, Thompson SR, eds.

DeLee and Drez's Orthopaedic Sports Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 94. Phillips BB, Mihalko MJ. Arthroscopy of the lower extremity. In: Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics. 12th ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 51. Read More Arthroscopic Gems: Hints for Accurate Coding - AAPC Knowledge Center Arthroscopic Gems: Hints for Accurate Coding 2 Comments By Denis Rodriguez, CPC, CCS, CIRCC, CASCC Arthroscopy refers to less invasive procedures in which an endoscope is placed within the joint for the performance of diagnostic and therapeutic procedures. As technology advances, procedures previously performed through large incisions are now performed arthroscopically. To accommodate this emerging technology, new arthroscopy, CPT® Category III codes, and HCPCS Level II codes, have been added over the past few years. There are three general principles of arthroscopic coding: 1.

If a procedure is started arthroscopically and finished open, it is coded using the open procedure code only. In such a case, assign diagnosis code V64.43 Arthroscopic surgical procedure converted to open procedure to report the arthroscopic component. For example, a patient presents with intra-articular fracture of the distal radius. The surgeon attempts arthroscopic reduction of the fracture fragments after synovial debridement for visualization. The surgeon finds the fragments are not sufficiently mobile for arthroscopic reduction, and converts to an open reduction and internal fixation of the three distal radial fragments. CPT® coding is 25609 Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments. The arthroscopic attempt at reduction and synovectomy for visualization is included in the open completion of that procedure, as indicated by V64.43, which also is reported. 2. Seven CPT® codes describe “arthroscopically aided” procedures. This means that even though part of the procedure is performed open, the arthroscopic procedure codes should be assigned.

The codes are: 29850 Arthroscopically aided treatment of intercodylar spine(s) and/or tuberosity fracture(s) of the knee, with or without manipulation; without internal or external fixation (includes arthroscopy) 29851 with internal or external fixation (includes arthroscopy) 29855 Arthroscopically aided treatment of tibial fracture, proximal (plateau); unicondylar, includes internal fixation, when performed (includes arthroscopy) 29856 bicondylar, includes internal fixation, when performed (includes arthroscopy) 29888 Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction 29889 Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction 29892 Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy) 3. Diagnostic procedures for each arthroscopic code family are included in any surgical procedures performed from that same family.

The families are: temporomandibular (29800-29804) hip (29860-29863) metacarpophalangeal joints (29900-29902) Within these families, the initial code describes the diagnostic procedure and subsequent codes describe surgical procedures. The code families for the ankle (29891-29899) and the subtalar joints (29904-29907) do not contain diagnostic codes. Note: Two codes in this section (29848 Endoscopy, wrist, surgical, with release of transverse carpal ligament and 29893 Endoscopic plantar fasciotomy) are not technically arthroscopies (that is, they are not endoscopies within a joint), but rather are musculoskeletal endoscopies.

Although these general rules always apply, due to the unique nature of the different joints, many arthroscopy rules are specific to each joint, as shown here: Shoulder Shoulder arthroscopy codes encompass two joints in the shoulder area: the glenohumeral joint (typically called the shoulder joint) and the acromioclavicular joint. The acromioclavicular joint is the smaller of the two and there are arthroscopy codes specific to it; excision of the distal clavicle, 29824 Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure) and decompression of the subacromial space, 29826 Arthroscopy, shoulder, surgical; decompression of subacromial space with partial acromioplasty, with or without coracoacromial release, which includes partial excision of the acromion or acromioplasty.

Arthroscopic debridement of the labrum and of the undersurface of the rotator cuff (29822 Arthroscopy, shoulder, surgical; debridement, limited) may be reported separately when performed with subacromial decompression (29826), according to the May 2001 CPT® Assistant. Per the same edition, Subacromial decompression includes acromioplasty, arch decompression, excision of bursa, and coracoacromial ligament release. Open procedures 23410, 23412, and 23420 differentiate between whether the tear is acute or chronic or how many tendons are repaired. The arthroscopic code for rotator cuff repair (29827 Arthroscopy, shoulder, surgical; with rotator cuff repair) makes no such distinctions, and can be reported whether the tear is acute or chronic; whether one, two or three tendons are repaired, or; whether one or more portals is required to repair the cuff (February 2008 CPT® Assistant).

Often the surgeon will perform a biceps tenotomy (i.e., tendon release) via arthroscopy, and then perform a tenodesis via an open procedure. In such cases, the code for open biceps tenodesis (23430 Tenodesis of long tendon of biceps) is most appropriate. Only assign the code for arthroscopic biceps when the tenodesis portion of the procedure is performed via arthroscope. Arthroscopic capsular shrinkage (i.e., thermal capsulorrhaphy) is at times used to treat joint instability. For payers recognizing HCPCS Level II S codes, S2300 Arthroscopy, shoulder, surgical; with thermally-induced capsulorrhaphy is appropriate for these procedures. For payers who do not recognize S codes, CPT®29999 Unlisted procedure, arthroscopy is appropriate. This procedure generally is considered investigational and not payable by many payers. Knee The knee is a hinged joint and, per the American Medical Association (AMA), is composed of three compartments: medial, lateral, and patellofemoral. The compartment coding concept is important for coding arthroscopic procedures in the knee accurately.

The code for arthroscopic abrasion arthroplasty, multiple drilling and/or microfracture (29879 Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture) may be coded per compartment so you should code microfracture of both medial and lateral femoral condyles as 29879, 29879-59 Distinct procedural service. As the descriptor states, chondroplasty (29877 Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)) is included in 29879 when chondroplasty is performed in the same compartment. However, a chondroplasty performed in a separate compartment may be reported separately to 29877-59 (August 2001 CPT® Assistant).

For Medicare, G0289 Arthroscopy, knee, surgical, for removal of loose body, foreign body, debridement/shaving of articular cartilage (chondroplasty) at the time of other surgical knee arthroscopy in a different compartment of the same knee may be reported once for a chondroplasty and/or loose body removal performed in each compartment where it is the only procedure performed. In contrast to 29879, report code 29877 only once per knee, regardless of the number of compartments in which it is performed (December 2005 CPT® Assistant). An often overlooked code is 29884 Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure), which may be assigned for excision of fibrosis/adhesions/scar due to previous procedures or injuries. Debridement of cyclops lesions after total knee replacement(s) is a common condition for which arthroscopic lysis of adhesions is performed.

Code 29884 is considered to be included in any other major arthroscopic procedure performed in the knee, regardless of whether it is performed in a separate compartment. When synthetic plugs are used for osteochondral grafting of the knee (i.e., mosaicplasty), 29867 Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty) may be assigned, even though the descriptor refers to allograft, per the December 2008 CPT® Assistant. The same, however, does not apply for the ankle. Rather than assign code 29892 Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy) for placement of synthetic material, report unlisted code 28899 Unlisted procedure, foot or toes. Wrist In contrast with knee arthroscopies, compartments do not matter for wrist arthroscopies.

For example, 29846 Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement includes a synovectomy (29845 Arthroscopy, wrist, surgical; synovectomy, complete), regardless of whether the synovectomy was performed in a separate compartment (CPT® Assistant, December 2003). Ankle Note that CPT® does not have an arthroscopic complete synovectomy code for the ankle. A total synovectomy is not anatomically possible because it would cause dislocation of the joint. When synovium is debrided from the medial and lateral aspects of the ankle, report a partial arthroscopic synovectomy (29895 Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial), according to CPT® Assistant, December 2008. Coding arthroscopies can be challenging; however, with a good understanding of anatomy and with applying AMA’s guidance for each joint, you can code with accuracy.

**************** Denis Rodriguez, CPC, CCS, CIRCC, CASCC, is senior ambulatory surgery center (ASC) coder and compliance auditor for The Coding Network, LLC. He has 20 years experience in the medical field, the last eight of which have been spent exclusively in ASC coding, auditing, and education. February 27, 2012 at 9:14 am Hi. I enjoy your articles and do get some great info from them. I was reading your article in March 2012 Coding Edge regarding the new Dupuytren’ s injection. In describing the manip on the following day, you state that “Code descriptors language implies that codes are reported once per palmar fascial cord treated. (A parenthetical note instruct you NOT to report separately fabrication/application of any custom orthosis.)” But in the CPT book it states “Code also custom orthotic fabrication and/or fitting.” I thought I would let you know that there needs to be a correction on your article. Thanks!

Leave a Reply Welcome to Smit Orthopaedic Hospital & Dental Clinic | Hand Surgeon Specialist in Anand | Paediatric Orthopaedics Hospital in Anand | Best Dental Treatment in Anand | Teeth Cleaning Treatment in Anand | Dentistry Specialist Doctor in Anand | Implant Dentistry Treatment in Anand | Cosmetic Dentistry Treatment in Anand | Teeth Whitening Treatment in Anand | Best Orthopaedic Surgeon in Anand | Best Dental Surgeon in Anand | Best Orthopaedic Hospital in Anand | Joint Replacement Surgery Doctor in Anand | Fracture Treatment Center in Anand | Spine Surgeon Specialist in Anand | Arthroscopy Surgery in Anand Life is movement, movement is life Best Ortho Hospital in Anand Life is movement, movement is life Best Ortho Hospital in Anand Life is movement, movement is life Best Dentist Hospital in Anand Welcome to Smit Orthopaedic Hospital & Dental Clinic Smit Orthopaedic Hospital & Dental Clinic, a clinic that specialises in treating various kinds of musculoskelatal problems. Under the proficient guidance of Dr. Niraj Shah, Smit Orthopaedic Hospital & Dental Clinic has been helping clients get relief from various kinds of orthopaedic problems.

We make all possible efforts to promote a healthy and pain free life. Our endeavours to ensure 100% success in all surgeries has led us to not only hire expert professionals but also ensure a highly advanced infrastructure facility which comprises advanced tools and sophisticated technology. A contemporary infrastructure ensures that the patients feel absolutely comfortable before and after surgery. Our mission to spread our knowledge and to provide a smile to the face of all those who suffer from orthopaedic problems, drives us to frequently strive for the best. This mission leads us in keeping abreast with the developments in the industry and to bring the same to our clinic for the benefit of our patients. By resorting to such unfailing efforts, we have been successful in garnering immense acclaim in the industry. Hand Surgery Smit Orthopaedic Hospital & Dental Clinic by Dr. Niraj Shah has created a renowned name for itself in the medical industry by performing safe joint replacement surgeries. A joint refers to the coming together of two or more bones like the knee, the hip and the shoulder. A joint replacement surgery is suggested with the view to improve your movements, relieve pain and subsequently help you live better. Usually hips and knees are replaced most often.

Other joints that are replaced include the shoulders, fingers, ankles and the elbows Read more about Treatment The condition where a bone is broken is termed as a fracture. A bone can be fractured either completely or partially in any number of ways like crosswise, lengthwise or in multiple pieces. We have acquired a reputed name for offering the best treatment for fractures. The tests conducted by us are performed while observing utmost safety and precaution. The staff hired by us is experienced in their respective domain. These experts perform the diagnostic tests without leaving any scope for errors. Read more about Treatment According to the Mayo Clinic, USA, approximately 80% of all Americans will certainly suffer from low back pain at least once in their life. Looking at this data, we can clearly see that back pain is one of a very common problems that ails people. Such is the effect of this ailment that it is considered as one of the common reasons for absence from work or visiting the doctor. Read more about Treatment An arthroscopy refers to the type of keyhole surgery that is used for the dual purpose of diagnosing problems with the joints and repairing damage done to the same. The procedure is usually [performed on knees, wrists, elbows, ankles and shoulders.

This surgery is recommended for those suffering from problems with joints, such as swelling or stiffness and whose initial imaging tests have not been able to determine its cause. An arthroscopy is then used to look at the inside of the joint. Smit Orthopaedic Hospital & Dental Clinic is a clinic that is renowned for performing this surgery under the experienced guidance of Dr. Niraj Shah. We make use of standard instruments and sophisticated technology to ensure absolute safety and the success of the surgery performed by us. Read more about Treatment What is paediatric (children's) orthopaedics? Orthopaedics refers to the diagnosis as well as corrective treatment of disorders of bones, joints and muscles. The medical treatment meted out is often shared by orthopaedic surgeons, haematologists, sports doctors and GPs. Some babies are born in a way which makes them vulnerable to the risk of having abnormal hips. These babies should at once be examined by the GP who will refer the babies for an x-ray while some may require to be checked by an orthopaedic surgeon. Orthopaedic surgeons also treat fractures, except for the most minor ones. These surgeons possess immense expertise to assess the damage around the fracture and offer the best treatment to mend the fracture.

Hand is a priceless part of human body that helps the body to move around and perform all kinds of functions. Hand surgery can be affected by various injuries and trauma conditions like: Hand pain Fractures of the fingers, hand and wrist Tendon and ligament injuries

Question: Arthroscopy refers to surgery performed on what parts of the human body?
Answer: Joints