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The physicians and surgeons at Orthopaedic Asssociates of Central Texas (OACT) are leaders in
caring for the joints of the body. We service patients in Williamson and surrounding Counties,
Central Texas, and the Greater Austin area. Our physicians and surgeons have advanced training performing arthroscopic surgery and use the latest advancements in technology to diagnosis and perform the correct treatment plan to maximize your recovery.
What is Arthroscopic Surgery?
OACT performs many procedures through the use of arthroscopic surgery. Arthroscopic surgery is a common procedure performed by an orthopaedic surgeon to diagnose and treat problems within a joint. The word "arthroscopy" comes from two Greek words: 'arthro,' meaning "joint," and 'scope,' meaning "look." Arthroscopic surgery is a means to look inside a joint; literally a camera attached to the arthroscope displays the image of the joint and its structures on a screen without exposing the entire joint. The end result of arthroscopic surgery is repair and/or removal of the damaged structure, if it exists, and leaves less damage to surrounding structures, aiding in the recovery time.
Areas of the Body That Can Undergo Arthroscopic Surgery
Arthroscopic surgery is most commonly performed on the knee and shoulder joints. Less commonly arthroscoped joints include the hip, wrist, elbow, and ankle. The reason the knee and shoulder are the most commonly arthroscoped joints is that they are large enough to manipulate the instruments around, and they are amenable to arthroscopic surgery treatments.
Performing Arthroscopic Surgery
During joint arthroscopy a camera is inserted into the joint through a small incision (about one centimeter). The arthroscopic surgery camera is attached to a fiberoptic light source and shows a picture of the inside of the joint on a monitor. The surgeon uses water under pressure to "inflate" the joint allowing more maneuverability and to remove any debris. One or more additional incisions are made to insert instruments that can treat the underlying problem.
Common Arthroscopic Surgery
Many common knee and shoulder problems are amenable to arthroscopic surgery. As mentioned above, some common arthroscopic procedures include:
- Trimming a torn meniscus
- Repairing a torn meniscus
- Treatment of shoulder bursitis
- Repair of the rotator cuff
- Treatment of cartilage damage in the knee
- Treatment of labral tears in the shoulder
Safety of Arthroscopic Surgery
Understand that arthroscopic surgery is a surgical procedure and involves risks, which may include infection, blood clots, problems with anesthesia, etc. These are serious risks and the decision to undergo arthroscopic surgery should be taken seriously. That said, arthroscopic surgery is a "less invasive" procedure, and when performed for the right indications (meaning the right problems) it is often very successful. Ask your doctor for more information about arthroscopic surgery, and talk about the possible risks of undergoing the procedure.
Q) What area of the body is arthroscopic surgery performed on?
A) Most commonly arthroscopic surgery is performed on the knees and shoulder, however other joints such as the hip, back, and wrist as also indicated for this type of procedure.
Q) How is arthroscopic surgery preformed?
A) During joint arthroscopy a camera is inserted into the joint through a small incision (about one centimeter). The arthroscopic surgery camera is attached to a fiber optic light source and shows a picture of the inside of the joint on a monitor. The surgeon uses water under pressure to "inflate" the joint allowing more maneuverability and to remove any debris. One or more other incisions are made to insert instruments that can treat the underlying problem.
Q) What are the benefits of arthroscopic surgery vs. an open procedure? Is there less pain with type of procedure?
A) Arthroscopic surgery is a valuable tool for all orthopaedic patients and is generally easier on the patient than "open" surgery. Most patients have their arthroscopic surgery as an outpatient procedure, meaning they go home the same day after the surgery. Another benefit of arthroscopic surgery, and when performed for the right indications, is less pain because there is less compromise to the surrounding tissues. However, for the first one to two days after surgery, pain is very well controlled with oral medications, such as Percocet or Vicodin, are usually adequate. Typically within one to two weeks after surgery, most patients find that their pain is greatly diminished and nothing stronger than aspirin or other Over the Counter Mediation is needed.
Q) Once I decide to have the surgery, how soon can it actually take place?
A) Once your insurance is approved and medical clearance is granted, the surgery can then be scheduled.
Q) What type of anesthesia is used for these Arthroscopic procedures?
A) The patient is sedated and comfortable throughout all procedures. A local anesthetic is administered at the surgical site and intravenous medications are used to make the patient comfortable.
Q) What are the possible complications?
A) Although uncommon, complications do occur occasionally during or following arthroscopic surgery. Infections are the most common complication and these can be prevented with pre-operative and post-operative antibiotics and gentle exercises. Other complications can include: phlebitis (blood clots of a vein), excessive swelling or bleeding, damage to blood vessels or nerves, and instrument breakage are the most common complications, but occur in far less than 1 percent of all arthroscopic procedures.
Q) Is bleeding around the incisions after surgery normal?
A) It is not unusual to have some mild bleeding through the small incision areas, and the area should be kept dry and covered. Should this happen and you are at home, you should reinforce the dressing with more sterile gauze. However, if bleeding persists, contact the office.
Q) Can I go home immediately after surgery?
A) Generally speaking, many patients can go home the same day as their procedure. It is important to have a healthy spouse or close family member for driving and at home to help them during the initial days after surgery. For those unable to depend on family or close friends, staying at the hospital for one to two days is occasionally an alternative.
Q) When can I return to regular exercise or my sport?
A) Most patients who undergo arthroscopic surgery will return to regular exercise and sports. However, the timing to return to activity varies greatly on the injury and specific procedure used to correct the problem (which may not be known until after the procedure). Additional factors include prior level of fitness, the rehabilitation process, and the type and level of activity which play an important role in determining return to play criteria. Talk with your physician about your specific injury and procedure to get the most accurate gauge. Keep in mind, that the physicians at Orthopaedic Associates of Central Texas are trained to maximize your return to play status while keeping you long term safety in focus.
Admission: You will be admitted to the hospital or outpatient surgery center the morning of your surgery.
Medications: Stop anti-inflammatory medications and/or aspirin; if you take anticoagulants such as Coumadin, your surgeon will tell you how long you should cease taking them prior to surgery.
Food and drink: Do not eat or drink anything for eight hours prior to surgery, except for prescribed medications. On the day of surgery, if you do have a prescribed medication to take, swallow it with a small sip of water.
Length of Surgery: The length of surgery is typically one to two hours followed by another one to two hours in the recovery room. Typically, you will be released into your family’s care and return home the same day with specific instructions from the physician and/or surgery center / hospital staff on follow up care and appointments.
Length of Hospitalization: Average stay for arthroscopic surgery is six to eight hours. Arthroscopic surgery is general performed in the outpatient setting, meaning that you will arrive in the morning and generally go home the same day. This may vary on your specific procedure, family/home support, and other factors as outlined by your physician.
Anesthesia: Patients will undergo general anesthesia, and may benefit from regional nerve blocks for post-operative pain control.
Physical Therapy: It is important after surgery to regain full range of motion but to do it with the instruction of trained physical therapists. You will work with a physical therapist each day after surgery to help you retain a full and active range of motion. After you go home from the hospital, you will need physical therapy from three to six times a week for three to six weeks. Before surgery, please consult with our staff to arrange home health services and outpatient physical therapy with Orthopaedic Associates of Central Texas.
IMPORTANT: Prior to surgery, VERIFY INSURANCE BENEFITS FOR YOUR CONTINUOUS PASSIVE MOTION (CPM) AND PHYSICAL THERAPY. THESE ITEMS ARE NOT ALWAYS COVERED BY ALL COMPANIES. IT IS VERY IMPORTANT THAT YOU CONFIRM THE NUMBER OF PHYSICAL THERAPY VISITS APPROVED BY YOUR INSURANCE COMPANY FOLLOWING SURGERY. INFORM YOUR PHYSICAL THERAPY PROVIDER ABOUT WHAT HAS BEEN APPROVED BEFORE YOU BEGIN THERAPY.
Pain management: It is important to maintain a schedule for the pain medications provided and prescribed. It is best to address the pain before it intensifies. Pain is manageable with medications and will lessen as your surgery heals. Pain medicine can cause itching, nausea, and/or constipation. These are all common side-effects of narcotic-based medications and do not necessarily indicate a drug allergy.
Wound Care: The surgical dressing is usually removed after two or three days. You may keep the incision open to air as long as there is no bleeding or drainage. We will remove your sutures in the office approximately two weeks after your surgery.
Driving: Most patients are able to safely drive a car approximately three days to two weeks after surgery. We recommend that patients do not drive cars with a manual transmission while they are healing because of the sudden and jerky movements that can accompany shifting gears and using the clutch.
Home Care: You will need help with meal preparation for several days following discharge from the hospital / surgery center. We recommend that you have someone stay with you after you leave for at up to a week (and longer if possible). If this is not possible, please let the nurse know you will need assistance after surgery.
Things to Report: Call the office at (512) 244-0766 if you develop any of the following:
- Redness around the incision
- Drainage or bleeding from the incision
- Fever over 101 degrees
- Increased swelling
Return to Work: Following arthroscopic surgery, depending on the joint, specific procedure, and outcomes, you will be able to return to sedentary work within one to four weeks after surgery. We recommend restricting certain work activities depending on the type and extent of your individual procedure. Please consult your physician with your individual case.