Board Certified Orthopedic Surgeon Board Certified Orthopedic Sports Medicine
Arthroscopic Surgery
Darren J. Friedman MD is an arthroscopic surgeon in New York City. Dr. Friedman is a board-certified Orthopedic Surgeon with a sub-specialty in Sports Medicine and specializes in minimally invasive arthroscopic surgery of the shoulder, elbow, and knee. He is a Fellow of the Arthroscopy Association of North America, a prestigious group of arthroscopic surgery specialists from around the globe.
What is Arthroscopic Surgery?
Arthroscopic Surgery is a surgical procedure that orthopedic surgeons use to visualize, diagnose, and treat problems inside of a joint. The word arthroscopy comes from the Greek words, “arthro” (joint) and “skopein” (to look). The term literally means “to look within the joints.” In an arthroscopic examination, the doctor makes a small incision in the patient’s skin and 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 fiberoptics to the end the arthroscope that is inserted into the joint. By attaching the arthroscope to a miniature camera, the doctor is able to see the interior of the joint through this very small incision rather than a large incision needed for conventional “open surgery.” The television screen attached to the arthroscope displays the image of the joint, allowing the doctor to look, for example, throughout the knee – at cartilage and ligaments, under the kneecap, at the joint lining. The doctor can determine the amount and type of injury, and then repair or correct the problem, if necessary.
How is Arthroscopic Surgery performed?
Arthroscopic surgery, although much easier in terms of recovery than “open” surgery, still requires use of anesthetics and special equipment in a hospital operating room or outpatient surgical suite. You will be given a regional anesthetic, depending upon the joint and suspected problem. A small incision (about the size of a buttonhole) will be made to insert the arthroscope. Other small incisions may be made to see other parts of the joint or insert instruments. When indicated, corrective surgery is performed with specially designed instruments that are inserted into the joint through the accessory incisions. Initially, arthroscopy was a simple diagnostic tool for planning standard open surgery. With the development of better instruments and surgical techniques, many conditions can now be treated completely arthroscopically. For instance, most meniscal tears and ACL reconstruction in the knee and rotator cuff tears and labral tears in the shoulder can be treated successfully with arthroscopic surgery. Some problems associated with arthritis can also be treated.
What are the possible complications?
Although uncommon, complications do occur occasionally during or following arthroscopy. Infection, phlebitis (blood clots of a vein), excessive swelling or bleeding, joint stiffness, damage to blood vessels or nerves, and instrument breakage are the most common complications but occur in far less than 1% of all arthroscopic procedures.
Recovery after arthroscopy?
The small puncture wounds take several days to heal. The operative dressing can usually be removed three days after surgery. There will be adhesive strips that are applied over the skin covering the incisions. Although the puncture wounds are small and the pain in the joint that underwent arthroscopy is minimal, it takes several weeks (6 to 8 weeks, sometimes longer) for the joint to maximally recover. A specific rehabilitation program may be suggested to speed your recover. 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 case return to athletic activities within a few weeks.
Dr. Friedman proudly serves the tri-state area while providing comprehensive patient care. You can contact Darren J. Friedman, MD at his Manhattan office to determine if arthroscopic surgery is the best solution for you, and he'll make sure you're knowledgeable of your condition and treatment options.
Why is Arthroscopic Surgery necessary?
Diagnosing joint injuries and disease begins with a thorough medical history, physical examination, and x-rays. Additional tests such as MRI or CT scan also may be needed. Through the arthroscope, a final diagnosis is made, which may be more accurate than through “open” surgery, x-ray studies, or MRI alone. Disease and injuries can damage bones, cartilage, ligaments, muscles, and tendons. Some of the most frequent conditions found during arthroscopic examination of joints are:
- Inflammation
- Synovitis –inflamed lining (synovium) in knee, shoulder, elbow, or ankle.
- Injury (acute and chronic)
- Shoulder- rotator cuff tendon tears, impingement syndrome, instability, labral tears.
- Knee – meniscus (cartilage) tears, chondromalacia (wearing or injury of cartilage lining of the bone), anterior cruciate ligament tears.
- Loose bodies of bone and/or cartilage.
- Knee, shoulder, ankle, elbow.
Although the inside of nearly all joints can be viewed with an arthroscope, six joints are the most frequently examined with this instrument. These include the knee, shoulder, elbow, ankle and wrist. As engineers make advances in electronic technology and orthopedic surgeons develop new techniques, other joints may be treated more frequently in the future.
What happens after arthroscopy?
After arthroscopic surgery, the incisions will be covered with a soft dressing. Some patients need little or no pain medication, although it is not uncommon to have pain if an injury was treated. Before being discharged, you will be given instructions about care for your incisions, what activities you should avoid, and which exercises you should do to aid your recovery. During the follow-up visit, the doctor will inspect your incisions, remove sutures, and discuss your rehabilitation program. At your first postoperative visit you will likely receive a prescription for guided physical therapy. The amount of surgery required and recovery time will depend upon the complexity of your problem.
What are the advantages?
Although arthroscopic surgery has received a lot of public attention because it is used to treat well-known athletes, it is an extremely valuable tool for all orthopedic surgeons and patients and is generally easier on the patient than “open” surgery. Most patients have their arthroscopic surgery as an outpatient and are home several hours after the surgery.
Lastly
Remember, although people who have arthroscopy can have many different diagnoses and preexisting conditions, each patient’s arthroscopic surgery is unique to that individual. Recovery time will reflect that individuality.
Why Choose Dr. Friedman?
- Board Certified Orthopedic Sports Medicine Specialist
- Board Certified Orthopedic Surgeon
- Director - New York Downtown Center for Sports Medicine @ New York Presbyterian Lower Manhattan Hospital
- Clinical Assistant Professor Dept. of Orthopedic Surgery – Weill Cornell Medical College
- Fellow – American Academy of Orthopedic Surgeons
- Fellow – Arthroscopy Association of North America
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