Operating Room ProcedureGuidelines : ARTHROSCOPY ( Shoulder, Elbow, Wrist, Hip, & Knee)

Descriptions:

ATHROSCOPY =is comes from the “Greek WORD’ “ARTHRO” means “JOINT” and “SKOPIEN” means “To Look ” Literally
means “TO LOOK WITHIN THE JOINT”, and it is simply means “HOLE” instead of ““OPEN. It is invasive technique used of
orthopedic surgeon to diagnose and treat a range of condition affecting the joint. And it is surgical procedure to view inside
the joint, used a Thin Tools called ARTHROSCOPE

ARTHROSCOPE = is a fiber optic telescope that can be inserted into a joint commonly used in Knee, Shoulder , and ankle, ant
can be used also in Hip, Elbow and wrist,

WRIST SHOULDER

ANKLE HIP ELBOW & KNEE

Shoulder Arthroscopy =surgical repair of rotator cuff tears is the most effective method to restore shoulder
strength and eliminate pain in person who continue to have symptoms despite an adequate trial of physical
therapy.
 ELBOW ARTHROSCOPY

Elbow arthroscopy= not all causes of elbow pain can be effectively treated with an arthroscopic procedure. Some of
the reason to perform an arthroscopic elbow surgery or elbow arthroscopy include: Removing loose debris –as a result of
arthritis or injury Removing bone spurs -osteophytes (don’t cause symptoms but cause swelling pain and tearing of the
surrounding tissue or tendon)

1. Loosening the joint capsule

2. Assessing cartilage damage
3. Tennis elbow

WRIST ARTHROSCOPY

Wrist arthroscopy = is minimal invasive surgery that may accelerate an injured athlete’s return to sports participation or
general recovery for non-athletes. The value of wrist arthroscopy as minimally invasive means of diagnosis and treatment is
clear for a wide range of wrist injuries and condition (ligament tears)

HIP ARTHROSCOPY
Hip Arthroscopy= an exploratory surgery that allows the. surgeon to diagnose the cause of hip pain or other
problems with the joint
 ANKLE ARTHROSCOPY

ANKLE ARTHROSCOPY= is performed for surgical evaluation and treatment of a variety of Ankle condition
like::Torn cartilage, Bone chip, Ligament damage (severely sprain ankle

KNEE ARTHROSCOPY
Knee Arthroscopy=a surgical technique that can diagnose and treat problems in knee joint

INDICATION

 Unexplained pain
 Swelling
 Stiffness
 Loss of motion in joint
 Arthritis
 Loss of foreign object in the joint
 Soft tissue infection
 Tendonitis
 Discoloration of skin
 Inflammation of affected part.
INSTRUMENTS
 PROBE

Power shaver with shaver blades

POSITIONING

SHOULDRER ARTHROSCOPY POSITION ELBOW ARTHROSCOPY POSITION

Wrist arthroscopy position

Hip arthroscopy position

 KNEE ARTHROSCOPY POSITION ANKLE ARTHROSCOPY POSITION

PROCEDURE

 Arthroscopy under anesthesia

(Diagnostic arthroscopy can be performed under local. Regional, or general anesthesia.)

(Combined spinal and epidural is best for Knee and ankle arthroscopy.)

 Range of motion and stability are ascertained

 Tourniquet is applied but not inflated.
 The knee joint is distended with.
 Marking
 A 3mm incision is made according to the surgeon preference over the Anterolateral aspect of
a joint.
 A trocar and sheet are inserted and obturator replaces the trocar in the sheath.
 And the obturator is advance into the joint.
 The obturator is removed and replaced by Arthroscope with attached camera with Scope.
 Inflow and Out flow irrigation tubing’s are attached.
 The knee joint is thoroughly examined
 Additional portal can be employed accordingly

RISK FACTORS:
 The use of intraarticular corticosteroids
 Prolonged tourniquet time
 Patient age of more than 50 years
 Failure to prepare the surgical site again before conversion to arthrotoy
 Procedure complexity
  And hx of previous procedures and noted that several reported outbreaks of infection after
arthroscopy were related to breaks in infection control or to contaminated instruments


REMINDER:

 Always blunt obturator

 Smooth transition from obturator to sheath
 Smooth transition from scope to sheath

REFERENCES:
 Bones &Joints of the ShoulderDoc by Prof Lenmard Funk

https/www.shoulderdoc.co.uk

 Washington University Orthopedics

https/www.ortho wustl.edu

 Wrist-wikipedia
htts/en, Wikipedia.org>wiki>wrist
 Knee joint- anatomy picture and information- inner body
Wwwminnerbody. Com.image>image>skel16


Lecture prepared by: RUBY S ANTONINO

OR Head Nurse