Arthroscopic Surgery FAQ
What factors determine if my injury can be repaired arthroscopically, or requires open surgery?
People always ask this question. Arthroscopic surgery is not a panacea. And open surgery is not all bad.
The right treatment is whatever it takes to get you back, nearly as good as new, as fast as possible. It's
not about the latest procedure, but rather the best route to recovery for each patient. And that will depend
entirely on the patient and the scope of their injury.
What are the risks associated with arthroscopic procedures?
The same risks as with any procedure. These include infection (less than one percent), hemorrhage (less than one percent),
Thromboembolic disease (nearly nonexistent in the upper extremity - as well as in the lower extremity when patients take
Lovenox). Though, the greatest risk is having a surgery that is not necessary or fails to correct the problem.
Are Arthroscopic procedures as effective as traditional surgery?
Depends on the procedure. For subacromial decompression, excision of the distal clavicle, and rotator cuff repair in the
shoulder, the answer is yes. For repair of recurrent subluxation or dislocation, the answer is maybe. In the knee,
arthroscopic surgery is excellent for treating torn meniscal cartilages. It is no more effective for ACL reconstruction
than a miniarthrotomy. It is not helpful in treating patellofemoral disorders. And it is a waste of time in arthritis
cases. It is of questionable value in most disorders of the wrist and ankle, except to remove a loose bony body, or joint
mouse. In the elbow, it is useful to remove a joint mouse, and to improve stiffness manifested by loss of motion.
Is the recovery time following an arthroscopic procedure less than traditional surgery?
It depends on the procedure. Certainly, it is for the conditions we discussed in the previous question. For those conditions
not helped by arthroscopic surgery, it doesn't matter how fast the recovery is if it merely returns the patient to their
preoperative state. Remember, the name of the game is to recover well enough such that you don't have to spend the rest of
your life with our business card in you wallet indicating when your next appointment is!
I understand that when knee cartilage is torn, the torn edge is "shaved" - usually in an arthroscopic procedure - to relieve
the pain and feeling of friction within the knee. But, does the remaining cartilage regenerate itself? Or, is this reduction in
cartilage permanent?
The remaining cartilage does not regenerate. In the ideal situation, only a small amount of cartilage is removed and the knee can
function at nearly complete normal capacity.
