When conservative treatments fail to resolve knee and shoulder disorders, arthroscopic surgery may be a good option. Fernando A. Moya, M.D.,  Ph.D., a Board-certified orthopedic surgeon with Baptist Health Orthopedic Care in Plantation , discussed knee and shoulder arthroscopy at a recent Baptist Health virtual community health presentation.
Arthroscopic surgery is a minimally-invasive technique that enables an orthopedic surgeon to see inside the body to make a diagnosis and perform a surgical repair. The procedure uses a thin, flexible fiber optic tube called an arthroscope, which contains a light and tiny camera that feeds images to a video display. The arthroscope requires only one small incision. Another small incision is made to accommodate a set of long, slender surgical tools used by the surgeon to make precise movements.
Orthopedic surgeons perform arthroscopy to help diagnose and treat a variety of joint conditions, most commonly those affecting the knee, shoulder, elbow, wrist, hip and ankle. “Diagnosis and surgery can both be performed in one procedure,” Dr. Moya explained. “We often turn to arthroscopy if X-rays and other imaging studies have left some diagnostic questions unanswered.”
The benefits of arthroscopy are small incisions, less scarring, quicker healing, faster return to normal activities and reduced risk of infection and swelling.
Although the benefits of arthroscopy are clear, any type of surgical procedure is the last resort, explains Dr. Moya. “I first work with patients to develop a non-surgical treatment plan because most people do not need surgery,” he said. “The healing process usually starts with movement, so physical therapy is instrumental in avoiding surgery. Only after a patient fails to get better with therapy and other non-surgical protocols such as anti-inflammatory medications, bracing, activity modification, ice and injections do I perform arthroscopy.”
Patients still experiencing pain, instability, decreased strength and decreased range of motion after a conservative line of treatment may benefit from knee or shoulder arthroscopic surgery.
Common knee conditions treated with arthroscopy include:
- Torn posterior or anterior cruciate ligament
- Unstable or dislocated kneecap
- Knee fracture
- Deteriorated cartilage within the knee joint
- Synovitis (swelling of the synovial lining)
- Baker’s cyst (an accumulation of fluid at the back of the knee)
Common shoulder conditions treated with arthroscopy include:
- Torn shoulder ligaments or rotator cuff tissues
- Recurring dislocation
- Impingement syndrome (tendons of the rotator cuff are pinched as they pass between the bones)
- Bone spurs or loose cartilage
- Torn labrum (ring of cartilage that helps hold the ball of the shoulder in its socket)
The goal of arthroscopy, says Dr. Moya, is focused on helping a patient decrease pain and regain strength and range of motion in the affected joint.