Medically reviewed by Dr. L. Bharath , Consultant Orthopaedic Surgeon, Bharath Orthopaedics
Joint pain, swelling, stiffness and difficulty moving an arm or leg can affect everyday activities. Simple movements such as climbing stairs, walking, lifting objects or playing sports may become uncomfortable when a joint is injured or affected by an underlying condition.
Some joint problems involve structures inside the joint, including cartilage, ligaments, tendons and the meniscus. These conditions may require a detailed orthopaedic assessment to understand the cause and decide on appropriate treatment.
Arthroscopy is a minimally invasive surgical technique used to examine and treat certain problems inside a joint. It involves a small camera called an arthroscope and specialised instruments that allow the surgeon to view and work within the joint through small incisions.
People searching for an Arthroscopic Surgeon in Chennai may be looking for information about knee injuries, shoulder pain, ligament damage, meniscus tears or other joint-related problems. Understanding the available treatment options can help patients have an informed discussion with their doctor.
What is Arthroscopy?
Arthroscopy is a surgical procedure used to examine and treat certain conditions affecting the inside of a joint. The word comes from two terms: arthro, meaning joint, and scopy, meaning to look.
During the procedure, an arthroscope containing a small camera is inserted into the joint through a small incision. The camera transmits images to a monitor, allowing the surgeon to examine the internal structures.
Additional small incisions may be made to introduce surgical instruments when treatment is required.
Arthroscopy is commonly performed on the knee and shoulder. It may also be used for certain conditions affecting the ankle, elbow, wrist and hip.
The decision to perform arthroscopy depends on the type of injury, the extent of joint damage, the patient’s symptoms and the findings from clinical examinations and imaging tests.
Arthroscopic Surgeon in Chennai – Dr. L. Bharath
Dr. L. Bharath (Dr. Bharath Loganathan) is an Orthopaedic Surgeon practising in Chennai. His clinical practice includes the assessment and management of knee and hip conditions, joint replacement procedures, revision joint replacement, sports injuries and arthroscopic procedures.
His academic qualifications include MBBS from Stanley Medical College, Chennai, MS in Orthopaedic Surgery from Grant Medical College and JJ Group of Hospitals, Mumbai, and MRCS from the Royal College of Surgeons of Edinburgh.
He has also undertaken additional training in adult joint reconstruction and hip and knee replacement surgery.
His clinical areas include:
- Knee and shoulder arthroscopy.
- Assessment of sports-related injuries.
- Meniscus and ligament-related conditions.
- Knee and hip replacement surgery.
- Revision joint replacement procedures.
- Other orthopaedic conditions.
The choice of treatment is based on the patient’s symptoms, clinical examination, relevant investigations and individual medical requirements.
Patients seeking information about arthroscopic treatment can discuss their symptoms and available management options during an orthopaedic consultation.
When is Arthroscopic Surgery Considered?
Not every joint problem requires surgery. Many conditions can initially be managed through medication, activity modification, physiotherapy or other non-surgical treatments.
Arthroscopic surgery may be considered when a patient has a specific joint condition that may benefit from treatment using this technique.
Some situations in which arthroscopy may be discussed include:
- Meniscus tears: Damage to the cartilage cushion inside the knee, which may cause pain, swelling or difficulty moving the joint.
- ACL injuries: Tears involving the anterior cruciate ligament, particularly when knee instability affects daily activities or sports.
- Loose bodies: Small fragments of bone or cartilage inside a joint that may cause catching or locking.
- Cartilage injuries: Damage to the smooth tissue covering the ends of bones within a joint.
- Shoulder conditions: Certain rotator cuff injuries, labral tears and other structural problems.
- Joint inflammation: Selected conditions where examination and investigation findings indicate that arthroscopic assessment or treatment may be appropriate.
The presence of these conditions does not automatically mean that surgery is necessary. The appropriate approach should be determined after an individual assessment.
Conditions That May Be Treated Through Knee Arthroscopy
The knee is one of the joints most frequently treated using arthroscopic techniques. It contains several structures that work together to provide stability and movement.
Injuries to these structures may develop during sports, physical activity, accidents or everyday movements.
1. Meniscus Tear
The meniscus consists of two C-shaped pieces of cartilage that help distribute weight and absorb shock within the knee joint.
A tear may occur when the knee twists suddenly, particularly when the foot remains planted on the ground. Meniscus injuries can also develop gradually with age-related changes in the joint.
Common symptoms include:
- Pain along the inner or outer side of the knee.
- Swelling after an injury.
- Difficulty bending or straightening the knee.
- A catching or locking sensation.
- Discomfort during twisting movements.
Treatment depends on the location, pattern and severity of the tear. Some injuries improve with physiotherapy and activity modification. In selected cases, arthroscopic surgery may be considered for meniscus repair or removal of an unstable damaged portion.
2. ACL Injury
The anterior cruciate ligament (ACL) is one of the main ligaments responsible for stabilising the knee.
An ACL injury may occur during sports involving sudden changes in direction, jumping, landing or stopping. It can also happen following a road accident or other traumatic injury.
Patients may experience:
- A sudden popping sensation at the time of injury.
- Swelling around the knee.
- Difficulty bearing weight.
- A feeling that the knee may give way.
- Reduced confidence during walking or physical activity.
An ACL injury does not always require surgery. Treatment depends on the degree of ligament damage, knee stability, activity requirements and associated injuries.
For selected patients, arthroscopic ACL reconstruction may be recommended. The procedure involves replacing the damaged ligament with a graft to help restore knee stability.
3. Cartilage Damage
Articular cartilage is the smooth tissue covering the ends of bones within a joint. It allows the joint surfaces to move against each other with minimal friction.
An injury to this cartilage may cause pain, swelling and movement difficulties.
Depending on the location and extent of damage, treatment may involve rehabilitation, activity modification or selected surgical procedures. Arthroscopic techniques may be used for certain cartilage injuries.
4. Loose Bodies in the Knee
Small fragments of bone or cartilage may sometimes become detached and move freely within the knee joint.
These fragments can cause sudden pain, catching or locking during movement.
If a loose body is responsible for persistent mechanical symptoms, arthroscopic removal may be considered after appropriate evaluation.
Shoulder Arthroscopy: Conditions That May Require Assessment
Shoulder pain can interfere with dressing, lifting objects, reaching overhead and sleeping comfortably.
The shoulder is a complex joint involving muscles, tendons, ligaments and cartilage. Damage to these structures can affect normal shoulder movement.
Arthroscopy may be considered for selected shoulder conditions.
1. Rotator Cuff Tears
The rotator cuff is a group of muscles and tendons that help stabilise the shoulder and control arm movements.
A tear may occur following an injury or develop gradually due to age-related changes and repeated strain.
Common symptoms include:
- Pain while lifting the arm.
- Shoulder weakness.
- Discomfort at night.
- Difficulty reaching behind the back.
- Restricted shoulder movement.
Depending on the size and nature of the tear, treatment may include physiotherapy, medication or arthroscopic rotator cuff repair.
2. Shoulder Labral Tears
The labrum is a ring of cartilage surrounding the shoulder socket. It helps deepen the socket and contributes to shoulder stability.
An injury may occur during sports, heavy lifting, a fall or shoulder dislocation.
Patients may experience pain, clicking, a feeling of instability or difficulty performing overhead activities.
Arthroscopic assessment and repair may be considered in selected cases based on the type of tear and clinical findings.
3. Shoulder Impingement
Shoulder impingement refers to irritation or compression of structures around the shoulder during certain movements.
It may cause pain when lifting the arm, particularly above shoulder level.
Initial treatment often includes physiotherapy, activity modification and medication when appropriate. Surgery is considered only in selected cases after assessing the underlying cause and response to non-surgical treatment.
How is Arthroscopic Surgery Performed?
The exact procedure depends on the joint being treated and the underlying condition.
In general, arthroscopic surgery involves the following steps:
Step 1: Preoperative Assessment
The surgeon reviews the patient’s symptoms, medical history, physical examination findings and imaging reports.
Tests such as X-rays or MRI scans may be recommended to understand the joint condition.
Step 2: Anaesthesia
Arthroscopic surgery is performed under an appropriate form of anaesthesia. The choice depends on the procedure, the joint involved and the patient’s medical condition.
Step 3: Small Incisions
Small incisions are made around the affected joint to introduce the arthroscope and other instruments.
Step 4: Examination of the Joint
The camera provides images of the internal joint structures on a monitor. The surgeon examines the affected tissues and identifies the problem.
Step 5: Treatment of the Identified Problem
Depending on the diagnosis, the surgeon may repair damaged tissue, remove loose fragments or perform another appropriate procedure.
Step 6: Postoperative Care
After surgery, the patient is monitored and given instructions regarding wound care, movement, medication and rehabilitation.
The duration of the procedure and hospital stay varies according to the type of surgery and the patient’s overall condition.
What are the Benefits and Limitations of Arthroscopy?
Arthroscopy is used for specific joint conditions where minimally invasive access is appropriate.
Some potential benefits include:
- Smaller incisions compared with many open surgical procedures.
- Direct visualisation of structures inside the joint.
- The ability to diagnose and treat certain joint problems during the same procedure.
- Less disruption to surrounding tissues in suitable procedures.
- Rehabilitation planning based on the treatment performed.
However, arthroscopy is not suitable for every joint condition.
It may not be appropriate for advanced joint degeneration or conditions that require a different surgical approach. The expected benefits also depend on the type of injury and the extent of damage.
Like other surgical procedures, arthroscopy has potential risks, including infection, bleeding, blood clots, stiffness, anaesthesia-related complications and injury to surrounding structures.
These risks should be discussed with the treating surgeon before making a decision.
What is the Recovery Process After Arthroscopic Surgery?
Recovery following arthroscopy differs from one patient to another. It depends on the joint involved, the type of procedure, the extent of tissue damage and the patient’s general health.
Some patients may begin gentle movement soon after surgery, while others may need temporary support or restrictions on weight-bearing and joint movement.
The recovery process may include the following stages:
Initial Recovery
During the early period, the focus is generally on managing discomfort and swelling, protecting the operated joint and following wound-care instructions.
Physiotherapy and Rehabilitation
Physiotherapy helps improve joint movement, muscle strength, flexibility and functional ability.
The exercises and their progression depend on the procedure performed. For example, rehabilitation following meniscus surgery may differ from rehabilitation after ACL reconstruction.
Gradual Return to Daily Activities
Walking, working, driving and other everyday activities can be resumed according to medical advice.
Returning to sports or strenuous physical activity requires adequate healing, strength and functional assessment. Patients should not resume these activities solely because pain has reduced.
Is Arthroscopy Better Than Open Surgery?
Arthroscopy and open surgery are different surgical approaches. Neither is automatically suitable for every patient.
Arthroscopy uses a camera and instruments introduced through small incisions. Open surgery involves a larger incision to access the affected structures directly.
Arthroscopy may be suitable for selected ligament injuries, meniscus problems and certain shoulder conditions.
Open surgery may be necessary for conditions that require broader access or a different type of reconstruction.
The choice depends on the diagnosis, the affected joint, the surgical objective and the surgeon’s clinical assessment.
When Should You Consult an Orthopaedic Surgeon?
Joint pain following an injury should not always be ignored, particularly when it affects normal movement or weight-bearing.
An orthopaedic evaluation may be appropriate if you experience:
- Persistent knee or shoulder pain.
- Swelling following an injury.
- Difficulty bending or straightening a joint.
- Repeated episodes of joint instability.
- Locking or catching sensations.
- Difficulty walking or performing everyday activities.
- Pain that continues despite initial treatment.
Sudden severe pain, an obvious joint deformity, inability to bear weight after an injury or a hot, swollen joint accompanied by fever requires prompt medical attention.
Early assessment can help identify the cause and determine whether medication, rehabilitation, further investigations or surgical treatment should be considered.
Read also: Knee Replacement Surgeon in India