Treatments and Procedures

Arthroscopic Surgery

Arthroscopic surgery is a remedial measure for many joint problems. Some of the common joint damages remedied by arthroscopic surgery are:

1) Anterior cruciate ligament (ACL) tears in the knee

What is an ACL tear?

An ACL tear is an injury that occurs in your knee joints. Usually, this is a sports injury. Other causes include accidents while driving motor vehicles, falls etc. . ACL is one of the major ligaments supporting the knee. A tear in this ligament is a cause for concern.

Symptoms:-

Usually, an ACL injury is accompanied by a loud pop sound. The injured person may also feel a shift in their joints. Other common symptoms to look out for are:

  • Swelling and knee pain lasting for more than 2 days
  • Difficulty in standing or walking
  • Affected knee unable to support body weight
  • Change in shape on the side of your knee

Diagnosis:-

X-rays and MRI scans help in detecting ACL tears. To check for ACL tears doctors may conduct a physical examination along with a few physical tests (Lachman Test, Drawer Test, Pivot Shift Maneuver).

Treatment:-

Surgery becomes necessary only in cases of Grade 3 ACL tear. This procedure is called an ACL reconstruction. The ACL ligament is reconstructed using another ligament or tendon. This tendon can be from another part of your body or from a donor. This is a major surgical procedure. Yet, being a minimally invasive procedure reduces the pain & increases recovery speed.

2) Carpal tunnel syndrome in the wrist

What is Carpal tunnel syndrome?

Carpal tunnel syndrome is also known as median nerve compression. It is a tingling or numbing sensation in your hands. The median nerve is a nerve that runs through our arm. It passes through a passage in our wrist called the carpal tunnel. When there is extra pressure on the median nerve, it gets compressed. This compression causes tingling or numbness.

Symptoms:-

  • Burning, Itching or tingling sensation in hands
  • Hands feel weak and have trouble holding things
  • Sudden shock-like sensation in hands
  • Tingling sensation along the arm

Diagnosis:-

Apart from your symptoms, a few tests and scans may be required to confirm carpal tunnel syndrome.

  • Physical Examination: To test the sensitivity and strength of your hands
  • X-Rays: To rule out other causes of wrist pain.
  • Electromyography: A test to measure electrical discharges in muscles. This test uses thin needle electrodes. These electrodes are inserted into various muscles to measure electrical activity. It will help identify if the damage is in the muscles controlled by the median nerve.
  • Nerve Conduction Study: To conduct this test two electrodes are taped to the skin. A small shock is passed through the median nerve. The speed of the electrical impulse is measured to check for any slow down in the carpal tunnel.

Treatment:-

Surgical treatment is advised only in cases the symptoms are very severe. Both open surgery and arthroscopic surgery are possible treatments. Arthroscopic treatment is less painful is hence preferred. Tiny incisions are made in the hands and wrists. Through these incisions, the ligaments causing pressure on the median nerve is cut.

Chondromalacia (cartilage damage) in the kneecap

What is Chondromalacia?

Chondromalacia refers to the softening or damage of cartilage underneath the kneecap. Usually found among young athletes or elderly people with knee arthritis. This condition can be congenital, due to old age or due to repeated stress to the knee joint.

Symptoms:-

Patients suffering from chondromalacia often have a dull throbbing pain around their kneecap. They will have difficulties walking up or down a staircase. They may experience a grinding sensation while moving their knees. Other symptoms include difficulty in getting out of a chair, pain from standing too long etc. Swelling and inflammation of the kneecap is also a sign of Chondromalacia.

Diagnosis:-

Imaging scans like X-rays and MRIs are usually enough to determine Cartilage damage. Doctors may also conduct some physical exam to confirm the diagnosis.

Treatment:-

For mild cases treatments like physical therapy, bracing, and injection will be enough. Sometimes proper rest and activity modifications would be enough. In serious cases, arthroscopic surgery is necessary. Instruments are inserted through small incisions on the knee. Any unstable cartilage flaps are shaved down. Even after the surgery it is better to avoid activities that can cause wear & tear on cartilage.

4) Ankle Impingement syndrome

What is Ankle Impingement syndrome?

A condition which causes bone spurs to form in front of the ankle joint. The spurs cause pain when the foot is pushed upwards. Bone spurs are bony projections formed along the joints. This condition is caused due to repetitive trauma to the ankle. People in lines of work that exert the ankle are susceptible to this disorder. Eg. footballers, ballet dancers etc.

Symptoms:-

Those who suffer ankle impingement, experience pain whenever the foot pushes upwards. Recurrent ankle sprains are also an indicator of ankle impingement. Occasionally, there may be swelling in the ankles.

Diagnosis:-

X-ray alone is enough to determine a case of ankle impingement. Sometimes CT Scans or MRI is done to confirm the diagnosis.

Treatment:-

If other methods of treatment prove unsuccessful then surgery is an option. Through arthroscopy, the troublesome bone spurs are removed.

5) Labral tears in the shoulder

What are Labral tears?

Labrum is a cuff of cartilage that holds the shoulder bones in place. Some shoulder injuries can cause a tear in the Labrum. Labral tears can also occur due to old age.

Symptoms:-

Common symptoms of a labral tear are

  • Pain in the shoulder joints
  • Shoulder movements becoming difficult
  • Pain while doing tasks involving the shoulder

Diagnosis:-

A study of the injury and areas of pain can be an indicator. Physical examination also helps identify the issue. MRIs are usually the best way to determine labral damage.

Treatment:-

Surgery is usually the last resort in cases of labral tears. A surgeon removes the damaged part of the labrum through arthroscopic surgery.

6.) Meniscal tears of the knee

What are Meniscal Tears?

The meniscus is c-shaped cartilage. It functions as a shock absorber between the shinbone and the thighbone. A tear in the meniscus is a common knee injury. Usually caused due to forceful twisting or rotation of the knee.

Symptoms:-

  • Knee Pain
  • Swelling in the knees
  • Stiffness in the knees
  • Trouble extending the knees

Diagnosis:-

X-rays or MRIs are usually enough to determine a meniscal tear. To test for meniscal tears, doctors generally conduct a test called McMurray test. The doctor bends your knee, straightens it and rotates your knee. If a meniscus tear is present this motion will produce a clicking sound.

Treatment:-

The torn meniscus can be surgically removed from the knee. This arthroscopic surgery is known as meniscectomy.

There are two types of meniscectomy:

  • Partial Meniscectomy: Removing only a part of the torn meniscus
  • Total Meniscectomy: Removing the whole meniscus.

Partial Meniscectomy is the preferred option. Removing the meniscus completely can cause other problems in the future.

7) Recurrent shoulder dislocation

What is a shoulder dislocation?

The shoulder joint is made up of a ball and socket. The ball can sometimes come out of the socket. This injury is a shoulder dislocation. It is usually caused by some traumatic damage to the shoulder. It is very common and is easily treatable in most cases. But frequent dislocation of the shoulder is a serious condition that would require surgery.

Symptoms of shoulder dislocation:-

  • The shoulder is out of place
  • Swelling in your shoulder
  • Extreme pain in your shoulder
  • Difficulty in moving the shoulder

Treatment:-

Surgical treatment is only referred to patients who experience repeated shoulder dislocation. Surgery helps repair the structure that holds the shoulder in place.

8) Rotator cuff tendon tears in the shoulders

What are rotator cuff tendon tears?

There are a group of muscles and tendons called the rotator cuff. They link the upper arm bone with the shoulders. The rotator cuff enables lifting and rotation of our arms. Repetitive shoulder motions may sometimes cause a tear in the tendons. Such tears are called rotator cuff tears.

Symptoms:-

  • Shoulder Pain
  • Pain while lying on the affected shoulder
  • Difficulty in lifting
  • Pain while performing certain arm movements
  • Crackling sensation on shoulders

Diagnosis:-

Doctors may conduct physical examinations to detect the presence of tears. For example, pressing different parts of the shoulder or moving arms to different positions. They may also test the strength of muscles around the shoulder and arm.

They may also suggest some imaging test like:

X-Ray:-

Rotator cuff won't show up in X-rays. But X-rays help rule out other causes of pain. Ultrasound or MRIs help detect rotator cuff injuries better.

Treatment:-

There are many treatments for this condition. The treatment via arthroscopic surgery is called Arthroscopic rotator cuff repairs. A surgical tool is inserted via a small incision. This tool is fitted with a camera. With this tool, necessary repairs are done to the rotator cuff.

9) Shoulder Bursitis

What is Shoulder Bursitis?

Bursa is a small fluid filled sac present in the shoulders. Their function is to reduce the friction between the bones in joints. Bursitis is the inflammation of the bursa. This could be caused by an injury, overuse or an existing medical condition.

Symptoms:-

  • Difficulty in lifting arm above head height
  • Pain while sleeping
  • Pain outside of shoulder in upper arm

Diagnosis:-

Physical exams alone can generally reveal bursitis. X-rays also provide an useful indicator. In rare cases, MRIs are done to confirm the diagnosis.

Treatment:-

Very rarely is surgery necessary to treat bursitis. In surgical treatment, the inflamed bursa is surgically removed through a small incision.

Advantages of Arthroscopy

Compared to open surgery arthroscopic surgery has many benefits. Arthroscopic surgery requires only small incisions. This ensures the scarring is minimal. Arthroscopy reduces the loss of blood and reduces the pain. It also improves the speed of recovery. A major advantage of arthroscopy is that the chances of infection are very low.

After Surgery

After the surgery, you only need to wait till the effects of anaesthesia wear off. Most cases you can leave the hospital once you are steady enough to stand.

There could be some pain and inflammation during the recovery period. This can be treated with R.I.C.E (Rest, Ice application, Compression and Elevation of joint). After some surgeries, you may need to take pain killers for a few days.

Apart from pain management, an important step is avoiding infection. Change the dressing regularly to avoid infections. Also, you must ensure the incision doesn't open up.

Some physical therapy may be required after arthroscopic surgeries. The duration and methods of this depend on the type of injury.

At Dr. Rela Institute & Medical Centre, we have the best team of experienced doctors on board. Our expert specialists will diagnose your condition and design a treatment plan that’ll help you recover from your condition quickly. Book an appointment at Dr. Rela’s Institute and Medical Centre, today!

Rest assured, at Dr.Rela’s Institute and Medical Centre, you will get only the most reliable treatment.

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