Arthroscopy‏

Many people have taken surgery and its recovery for granted. Some think a knee arthroscopy is like getting their teeth cleaned with little recovery time and little inconvenience to people’s schedules and their day to day activity. It was not that long ago where surgery on the knee and its recovery were major surgeries with incisions extending for several inches and cutting into the capsule to get a good look at the joint.

For a cartilage tear of the knee, just ask someone who had the old procedure, the job was not done unless the whole meniscus was removed in its entirety.  Surgeons in the 60’s and 70’s thought the meniscus was like the appendix, expendable and only a source of pain. Then recovery would last months and months after being put in a cast to immobilize the joint.  What resulted were stiff joints that took months to recover and ended up with people developing arthritis because their cushion was removed.

The arthroscope allows surgeons to remove only the torn tissue because it is easier to see inside the knee when the camera is placed inside the joint. Repair of tissue is also easier arthroscopically. The arthroscope is a device that revolutionized the way surgery is performed on people and their joints.  Shoulder surgery used to involve that Bruce Willis like incision in the front of the joint. Now most shoulder surgeries can be accomplished with 2 or 3 poke holes passing instruments and sutures through cannulas about 6 mm wide or about the size of a pencil.


Just like an affiliate team, arthroscopes come in different sizes. Some are short and thin and others are long and relatively wide.


The word comes from the Greek root arthro meaning joint and scope to check out (just kidding). It was first described in the 1910’s for visualizing the inside of a joint. Surgeons would look in with the camera and then perform the typical open procedure. Then in the 60’s people were able to treat conditions arthroscopically with surgical instruments, small and thin, repairing or excising the tissue.

In order to see inside the joints, doctors found it was easier to see, if the joint was filled with fluid.  Pressure devices also came along that helped push the fluid into the joint to decrease bleeding and improve visualization. The joint literally gets distended like a balloon and the camera roams around the joint navigating through different areas of the joint like an underwater sub exploring the Titanic.  The surgeon can see any structure that is inside the joint. Cartilage joint surfaces, meniscus cartilage, labrum, tendons, ligaments, bone spurs, tears, and  loose bodies are all easily visible with the arthroscope.

Rehab from minimally invasive surgery is quicker with decreased risk of clots, infections, and wound problems.  Stiffness is less of a problem also if you don’t have to cut muscle or tendon.



As you can see, the camera can travel into places that would be difficult to see even in an open procedure. The bloodless field also helps visualization. So I hope you can appreciate the technology behind the arthroscope and how it lets us look into another world allowing us to improve our scope of work.

4 Comments

  1. Hey I hope everything went well. Every person is different and every shoulder is different but typically getting back to overhead 2 to 3 months. Hopefully it was just a decompression. Sean

  2. Hello!

    I am scheduled for an acromion decompression this week on both shoulders. I have one shoulder that carries must of the pain but compensating with the other shoulder has caused inflammation in that one too. I have had an MRI and, luckily, there were no tears! I seem to go thru cycles of pain then rest and injections, pain and then rest and injections, etc. My orthopedic doctor seems to think this will be very minor for me and the recovery will be quick; not a ton of mobility will have to be regained, etc. I have been working with him to manage this issue, trying to avoid surgery, for over a year now.

    Currently, I plan (if all goes well) to take a week off from everything, and then modify WODs for several weeks while rehabbing my shoulders. He says I can go light overhead in about 4 weeks.

    I am starting to get a bit anxious (I have 4 days) about what to expect— I am an avid Crossfitter and will look to get back to moving around quickly.

    What advice or insights do you have for me?

    Thanks,

    Jessica

  3. I would say she should be seen by a doctor.

  4. My mom is 55 years old, she has arthritis in her neck. if she works her neck little inclined to front for few minutes in a day she get pain and she need neck belt to support, what kind of rehab do you suggest her.

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About Me

Dr. Sean Rockett is an Orthopedic Surgeon specializing in Sports Medicine. His group is Orthopedics New England with offices in Dedham, Natick and Newton, Massachusetts. Dr. Rockett is a CrossFit Level 1 Trainer and has been a CrossFitter at CrossFit New England since 2007. Dr. Rockett is on the Medical Team for the CrossFit Games and the Northeast Regionals.

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