Patient Information - Soft Tissue Injuries

If you suffer from a soft tissue injury you are not alone as each year more than 12 million people visit orthopaedic surgeons because of knee and shoulder injury related problems.

Types of procedures for orthopaedic repair and reconstruction.

There are three approaches in surgical repair and reconstruction of soft tissue, muscle and ligaments.

Open procedure: Using a large incision to access the repair site.

Mini open procedure: Using one or more small incisions to access the repair site.

Athroscopic procedure: Arthroscopy is a minimally invasive or “keyhole” technique that allows surgeons to see inside a joint with a fiber-optic telescope called an arthroscope which projects an image onto an external television screen. Arthroscopy has the advantage of not only being a diagnostic procedure but also allows operations to be carried out within the joint cavities. These joints include the knee, shoulder, ankle, wrist, and hip 

Today many orthopaedic surgeons use the arthroscope to assist with numerous injury repairs. The arthroscopic procedure has continued to advance since its first use in the early 1970’s. Originally used as a diagnostic tool to determine the extent of injury, the scope has evolved into the preferred technique for many joint repairs. Advances in technology have allowed the orthopaedic surgeon to become more innovative in the use of the scope.

The word arthroscopy literally means "to look within the joint." In an arthroscopic examination, an orthopaedic surgeon makes a small incision in the patient's skin and then inserts pencil-sized instruments that contain a small lens and lighting system to magnify and illuminate the structures inside the joint. Light is transmitted through fiber optics to the end of the arthroscope that is inserted into the joint. By attaching the arthroscope to a miniature television camera, the surgeon is able to see the interior of the joint through this very small incision rather than a large incision needed for surgery.

The television camera attached to the arthroscope displays the image of the joint on a television screen, allowing the surgeon to look, for example, throughout the knee at cartilage and ligaments, and under the kneecap or the shoulder to assess the damage to the rotator cuff. The surgeon can determine the amount or type of injury, and then repair or correct the problem, if it is necessary.

Diagnosing joint injuries and disease begins with a thorough medical history, physical examination, and usually X-rays. Additional tests such as an MRI, or CT scan also may be needed. Through the arthroscope, a final diagnosis is made which may be more accurate than through "open" surgery or from X-ray studies.

X-ray - Often the first examination ordered by a doctor, an x-ray can visualize many different parts of the body, allowing for more accurate testing and diagnosis.

CT scan - CT (computed tomography) scan is a technologically advanced imaging tool that combines X-rays with computer technology to produce a more detailed, cross-sectional image of the body. CT scan lets your doctor see the size, shape and position of structures that are deep inside your body.

Magnetic Resonance Imaging (MRI) - MRI is another modern diagnostic imaging technique that produces cross-sectional images of your body. Unlike CT scans, MRI works without radiation. Instead, it uses magnetic fields and a sophisticated computer to take high-resolution pictures of bones and soft tissues. An MRI may help diagnose conditions such as torn knee ligaments, cartilage or rotator cuffs

Arthroscopic surgery, although much easier in terms of recovery than "open" surgery, still requires the use of anaesthetics and the special equipment in a hospital operating room or outpatient surgical suite. You will be given a general, spinal or a local anesthetic, depending on the joint or suspected problem.

A small incision (about the size of a buttonhole) will be made to insert the arthroscope. Several other incisions may be made to see other parts of the joint or insert other instruments.

When indicated, corrective surgery is performed with specially-designed instruments that are inserted into the joint through accessory incisions. Initially, arthroscopy was simply a diagnostic tool for planning standard open surgery. With the development of better instrumentation and surgical techniques, many conditions can now be treated arthroscopically.

• Craniomaxillofacial
• Trauma
• Spinal Surgery
• Knee Surgery
• Shoulder Surgery

• Foot and Ankle surgery
• Small Joint Surgery

• Repair of torn ligaments
• Removal of loose bone or cartilage in knee, shoulder, elbow, ankle, wrist.

Although arthroscopic surgery has received a lot of public attention because it is used to treat well-known athletes, it is an extremely valuable tool for all orthopaedic patients and is generally easier on the patient than "open" surgery. Most patients have their arthroscopic surgery as outpatients and are home a few hours after the surgery.

The small puncture wounds take several days to heal. The operative dressing can usually be removed the morning after surgery and adhesive strips can be applied to cover the small healing incisions.

Although the puncture wounds are small and pain in the joint that underwent arthroscopy is minimal, it takes several weeks for the joint to recover fully. A specific activity and rehabilitation program may be suggested to speed recovery and protect future joint function.