What is arthroscopy?Schematic representation of arthroscopy of the shoulder joint. Click to enlarge.
Arthroscopy is a so-called minimally invasive operation. This refers to a medical procedure in which the living body is invaded, but not to the extent that is the case with a normal operation.
Rather, a special instrument is introduced into the body through a few millimeters large incision opening. The aim of arthroscopy, as her Greek-derived name suggests, is to look at the exact condition of a joint from within.
"Arthros" translated from Greek means "joint"; "skopien" can be translated as "looking" or "reviewing". Viewing or just assessing the joint takes place during arthroscopy by means of an endoscope.
This is a medical instrument that resembles a tube in a purely optical way. The special feature of this "tube" is that at the top of a high-resolution camera is installed, which sends the optical data to a monitor, to the attending physician can follow the course of arthroscopy and assess the condition of the joint.
Furthermore, other instruments are appropriate, such as hooks and cutting tool to treat the joint during the arthroscopy therapeutically, if necessary. The history of arthroscopy goes back to the Swiss surgeon Eugen Bircher, who practiced this approach at the beginning of the 20th century as the first and has established to the present day.
Function, effect & goals
Before the arthroscopy can begin, the joint to be examined must be filled with a liquid, more rarely with a gas. While Bircher still uses nitrogen at that time, today the golden standard is the sodium chloride solution or the Ringer solution.
Rarer, for example, in the case of allergic reactions of the patient to be feared, is avoided on carbon dioxide. The chosen solution is then injected through a syringe into the joint. Subsequently, the blood supply of the body area in which the joint is located, interrupted by means of cuffs. As far as the patient so wishes, the arthroscopy can be done under general anesthesia; otherwise, which is more standard, only the affected area is stunned.
As far as the anesthesia begins to work, the actual operation is done by cutting an approximately five millimeters small Einschnittstelle. The endoscope is introduced via this incision interface. With regard to the purpose for which arthroscopy is intended to serve at all, diagnostic and therapeutic arthroscopy are distinguished. In diagnostic arthroscopy, the physician confines himself to assessing the condition of the joint and checking its functioning.
For this purpose, he uses, for example, attached to the endoscope hook to check the tear stability of the cruciate ligaments. Therapeutic arthroscopy continues and performs surgical procedures. In order to use the example of the knee, it is possible to remove cornifications by means of the instruments attached to the endoscope, or to replace the ligaments by new ones in cases of cruciate ligament rupture.
After successful arthroscopy it is indispensable for the patient to participate in a physiotherapy. This is - especially in therapeutic arthroscopy - the functioning of the joints and possibly newly inserted ligaments after arthroscopy to be checked and practiced by a physician.
Risks & Dangers
At the arthroscopy but also criticism is exercised. For example, especially the diagnostic arthroscopy is accused of being obsolete.
At least since the introduction of computed tomography, it has become superfluous. Furthermore, as with all other operations, observations have been made that arthroscopy increases the risk of thrombosis. Also, wound healing disorders were registered as a result of arthroscopy.
Despite the criticism, especially in therapeutic arthroscopy is a particularly gentle measure to treat existing diseases. For the same points of criticism accused of arthroscopy also apply to classical operations - and to an even greater extent.