Looking inside a joint through a keyhole and a telescope is called arthroscopy (arthro = joint and scopy = look at). An MRI investigation often precedes this procedure.
The most common joint that is usually arthroscoped is the knee. The procedure is usually done under general anaesthesia as a day case. Following arthroscopy the patient leaves the hospital on a pair of crutches and can mobilize and recuperate at home. The patient will then be reviewed in 7 to 10 days time when the wound will be checked, following which a formal course of physiotherapy may be required. The procedure not only looks inside the joint cavity but can also be used to treat some conditions at the same time.
This is quite a common procedure, through tiny holes just below and on either side of the kneecaps. The inside of the joint can be examined thoroughly by this method and evaluated accordingly. Various problems like a cartilage tear, loose body, synovial inflammations, ligament tear, degeneration etc can be dealt with during knee arthroscopy quite efficiently.
Professor Purkayastha has a special interest in ankle arthroscopy, which is a relatively new procedure. Ankle arthroscopy is rather special as the joint is small, stiff, has recesses and is surrounded by important tendons, nerves and blood vessels. Obviously the important anatomical structures are marked prior to the operation and safe guarded during the procedure. Traction is required to increase the space of the ankle joint during the procedure. The operation helps to identify and treat many ankle problems especially following injury of inflammation.
OCD (osteo-chondral defect) – of either the talus or tibia are challenging problems of the ankle joint. It is not uncommon to have OCD following a trauma. This problem can be identified by X-rays and MRI, but direct evaluation of the lesion is achieved by ankle arthroscopy and subsequent treatment. Most early, moderate arthritis of the ankle joint can be treated by debridement to give some relief of pain and increase mobility.
The subtalar joint is the irregular joint below the ankle which could also be visualised by using a special small arthroscope. The tendons run inside a tendon sheath, especially around the ankle joint and these tendons could be visualised through a small scope and the procedure is called a tendonoscopy. Professor Purkaystha has a special interest in tendonoscopy and subtalar arthroscopy. These procedures are specially indicated in rheumatoid arthritis and tendonitis.