Charleston Orthopaedic Charleston Orthopaedic Charleston Orthopaedic
Charleston Orthopaedic
Charleston Orthopaedic
Charleston Orthopaedic
Charleston Orthopaedic Charleston Orthopaedic Charleston Orthopaedic
Charleston Orthopaedic Charleston Orthopaedic Charleston Orthopaedic
Charleston Orthopaedic
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Procedures >> Shoulder & Knee Arthroscopy

Arthroscopy

Arthroscopy is a very common procedure that allows Dr. Friedman to examine and repair the shoulder and knee joints for many orthopaedic problems.  This is a minimally invasive procedure involving incisions of approximately 1/4 inch.  These incisions are called portals.  The arthroscope is a small, pencil sized instrument with a miniature video camera.  The arthroscope is introduced into the joint spaces through the portals.  A video monitor will show the inside of the joint and Dr. Friedman’s progress as he examines and repairs the joint.  Repairs are made using very small surgical tools such as miniature scissors, shavers, knives, and other motorized and non-motorized instruments.  Usually between 2 and 4 portals are used to perform arthroscopic surgery.

Knee Arthroscopy

Knee ArthroscopyThe most common reason for knee arthroscopy is a torn meniscus (or knee cartilage). The meniscus consists of two
C-shaped pads of cartilage that cushion the bones of the knee joint.  Your meniscus can tear if the joint is twisted and the bones pinches the cartilage.

In some cases, there may be loose debris or loose bodies within the knee joint causing pain and irritation.  These are broken pieces of bone or cartilage loose within the joint.  They can result from direct trauma or from swelling of arthritis.

Surface defects are another problem that can usually be repaired arthroscopically.  These rough areas on articular cartilage are a sign of osteoarthritis.  With time, surface defects can break off and become loose bodies within the knee joint.  Arthroscopy can be used to smooth out the surface defects in the knee’s articular cartilage.

What should I expect before surgery?

Dr. Friedman will discuss the injury to your knee joint based on his examination and any test results, such as an MRI.  Some injuries may improve with physical therapy.  If your injury is one that may improve with physical therapy, that will be tried first.  If surgery is indicated, he will discuss the procedure, what you should expect after surgery, and your recovery.

How is knee arthroscopy performed?

At the outpatient surgical facility, you will be “prepped” for surgery – someone will clean your leg using an antiseptic solution.  IV lines will be placed so that your body can receive medications and fluids.  Anesthesia will be administered.  The anesthesiologist will discuss directly with you what type of anesthesia is best for you.

Next, your leg will be positioned and placed in a holder so that it remains still during your procedure.  Dr. Friedman will make the needed portals and insert the arthroscopic equipment through the portals.  He will monitor the repair progress on the video monitor.  Once the repairs are complete, the arthroscope is removed and the portals are stitched closed.

What should I expect after surgery?

After surgery, you will be taken to the recovery room.  Here nurses will monitor your vital signs and your progress of recovering from anesthesia.  You will be given specific directions concerning how to care for your knee after surgery.  Our office can give you some general instructions; however, as each patient is different, each persons post operative care can vary.  You will be able to call our office with any questions concerning your knee after surgery.

Rehabilitation after knee arthroscopy

Depending on the procedure, patients will likely be able to resume work and moderate exercise with in a relatively short amount of time.  In some cases, the recovery may take longer.  Recovery is aided by physical therapy.  Physical therapy exercises will target explicit muscle groups to help your knee recover and strengthen in a manner that will help to support the repairs.  Your physical therapist will aid you in learning these specific exercises and teach you to do them at home as well as in therapy. 

Shoulder Arthroscopy

Tendonitis, bursitis, and impingement are a few of the reasons shoulder arthroscopy may be needed.  Tendonitis is the inflammation of the tendons, the strong tissues that attach muscle to bone.  The shoulder has the bicep tendon (tendon of the upper arm) and the tendons of the rotator cuff (composed of the shoulder muscles).  If the tendons are pinched by the bones of the shoulder, it can lead to an impingement syndrome.  This causes the inflamed tendons to thicken and become trapped (or impinged) under part of the shoulder blade.  Should the bursa, sac of fluid between the rotator cuff and shoulder blade, become inflamed, the result is bursitis.  Before surgical intervention is considered, physical therapy may be tried to see if your symptoms cannot be alleviated non-surgically.  Should you not get better, or should your injuries be past a point of being helped with physical therapy, shoulder arthroscopy will be discussed.

Rotator cuff tears are another injury that can be fixed using arthroscopic surgery.  The rotator cuff is a group of muscles and tendons that attach the upper arm to the shoulder blade.  If you have a torn rotator cuff, you will likely experience pain, inflammation, soreness, swelling, popping, and catching at the top of the shoulder.  It is particular painful with the arm in the overhead position.

The shoulder joint is the move movable joint in the human body.  In exchange for this extended mobility, it is the least stable joint in the human body.  Shoulder instability includes dislocation and subluxation (misalignment), which occur when your shoulder moves beyond its normal range.  Depending on the degree of instability, physical therapy may be tried, or it may be best to proceed with surgical intervention.

Loose bodies, broken pieces of bone or cartilage within a joint, can occur in the shoulder joint.  They can be a result from an injury or a sign of arthritis.  They can be removed from the shoulder joint arthroscopically.

If you are suffering from severely restricted movement of the shoulder, you may have a frozen shoulder.  The condition, also know as adhesive capsulitis, occurs because of inflammation which contracts the tissues lining the shoulder.  The motion of the shoulder seems to freeze.  Arthroscopy will allow these tissues to be released, along with physical therapy, and your motion to return.

What should I expect before surgery?

Dr. Friedman will discuss the injury to your shoulder joint based on his examination and any test results, such as an MRI.  Some injuries may improve with physical therapy.  If your injury is one that may improve with physical therapy, that will be tried first.  If surgery is indicated, he will discuss the procedure, what you should expect after surgery, and your recovery.

How is shoulder arthroscopy performed?

At the outpatient surgical facility, you will be “prepped” for surgery – someone will clean your shoulder using an antiseptic solution.  IV lines will be placed so that your body can receive medications and fluids.  Anesthesia will be administered.  The anesthesiologist will discuss directly with you what type of anesthesia is best for you.

Next, your shoulder will be positioned and placed in a holder so that it remains still during your procedure.  Dr. Friedman will make the needed portals and insert the arthroscopic equipment through the portals.  He will monitor the repair progress on the video monitor.  Once the repairs are complete, the arthroscope is removed and the portals are stitched closed.

What should I expect after surgery?

After surgery, you will be taken to the recovery room.  Here nurses will monitor your vital signs and your progress of recovering from anesthesia.  You will be given specific directions concerning how to care for your shoulder after surgery.  Our office can give you some general instructions; however, as each patient is different, each persons post operative care can vary.  It is very important to follow these directions.  Re-injury can occur should the wrong types of movements be made before your shoulder has recovered sufficiently. You will be able to call our office with any questions concerning your shoulder after surgery.

Rehabilitation after shoulder arthroscopy

Depending on the procedure, patients will likely be able to resume work and moderate exercise with in a relatively short amount of time.  In some cases, the recovery may take longer.  Recovery is aided by physical therapy.  Physical therapy exercises will target explicit muscle groups to help your shoulder recover and strengthen in a manner that will help to support the repairs.  You may start with only small amounts of movement and may remain in a sling for a few weeks after surgery.  This, again, depends on the repairs done to your shoulder.  The restriction of movement will allow certain repairs to heal appropriately.  Your physical therapist will aid you in learning these specific exercises and teach you to do them at home as well as in therapy.

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