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Arthroscopy & Sports Injury

Arthroscopy & Sports Injury

Overview

Arthroscopy is a surgical procedure to visualise, diagnose and manage joint disorders. An arthroscopic examination involves a small incision in the skin, and pencil-sized instruments are inserted through it. The instruments contain a small lens and lighting system to magnify the view of the structures within the joint. The light is transmitted through fibre optics to the end of the arthroscope inserted into the joint.

Sports injuries are injuries not confined to the athletes alone. These can happen to anyone while playing indoor or outdoor sports, doing physical exercise, or even sustaining a trivial fall. In addition, these injuries may be a result of accidents, improper or inadequate use of protective gear, lack of training, or no stretching or warming up before beginning a sporting activity.

Benefits and Types

An orthopaedic surgeon or bone doctor may choose to specialise in a distinct branch of orthopaedic medicine. These branches are called subspecialties. Some orthopaedic subspecialties are:

  • hand and upper extremities
  • trauma surgery
  • foot and ankle or podiatry
  • paediatric orthopaedics
  • sports medicine
  • orthopaedic oncology, including tumour and cancer care
  • spine surgery
  • joint replacement surgery

The benefits of performing an arthroscopy procedure over open surgery are:

  • Smaller incisions
  • Less post-operative pain
  • Less invasive and involves lesser surrounding healthy areas of the joint
  • Minimal scarring
  • Early return to activity
  • Lesser hospitalisation time and rapid recovery
  • Lesser wound-related complications

Symptoms

Pain is the most common symptom of sports injuries. However, the type of pain can differ from one injury to the other. Acute injuries cause sharp, stabbing pain, for example, fractures. Depending on the type of injury, the pain is cramping, burning, dull, achy, or throbbing.

For some people, pain comes and goes. They experience certain activities that may worsen the pain, while rest may provide relief. Other symptoms include:

  • Bruising
  • Swelling or abnormal appearance at the site of injury, which is more likely with fractures and dislocations
  • Joint stiffness and limited range of motion
  • Muscle spasms
  • Difficulty in using a limb or putting weight on it
  • Numbness, tingling or weakness
  • Redness at the site of injury
  • Increased temperature at the site of injury

Some symptoms that may indicate a serious condition are:

  • Severe sports injuries like fractures and dislocations. These often cause complications and require immediate medical help.
  • Deformity or lump on the injured joint or bone.
  • Inability to move a joint.
  • An open wound on the skin.
  • Severe pain or swelling.
  • Hearing a grinding, snapping, or popping sound during the injury.

When to see an Orthopaedic Surgeon?

Orthopaedic surgeons or sports injury specialists are consulted when a person suffers a sports-related injury. Other reasons may be improving performance and fitness, routine checks ups or guidance regarding using safety gear for specific joints.

Sports medicine physicians initially provided high-quality and speciality medical care for professional athletes. However, nowadays, they help all individuals who:

  • Have a sports- or exercise-related injury
  • Wish to enhance their performance in their sport or activity of choice
  • Wish to improve their overall fitness level
  • Want to prevent sports-related injuries
  • Wish to maintain a healthy and active lifestyle

The common injuries that a sports medicine physician treats are:

  • Shoulder injuries like a torn rotator cuff
  • Knee injuries like torn ACL, PCL, or meniscus
  • Ankle injuries such as sprains, strains, or instability
  • Fractures
  • Elbow injuries like golfer's elbow, pitcher's elbow, and tennis elbow
  • Dislocated joints

The conditions can be described as follows:

  • Fractures: Fractures vary in severity and can range from a stress fracture to a simple hairline fracture. Fractures involving skin, muscles, and tendons are termed complex fractures and may require extensive surgeries for treatment.
  • Joint dislocations: Joints often dislocate when the bones of a joint slip out of their normal position due to serious injuries or trauma.
  • Ligament injuries: Ligaments hold bones together at a joint, and their injuries include sprains like an ankle sprain or a partial or complete ligament tear. Ligament tears are of two varieties - torn ACL or torn MCL.
  • Overuse injuries: This type of injury is also known as repetitive strain injury or RSI. It occurs from repetitive stresses or forces on muscles, joints, and other tissues over time, causing wear and tear.
  • Pulled muscles and other muscle conditions: A muscle pull is an injury to the soft tissue, a condition termed a strain. Some examples are a pulled groin muscle or hamstrings while exercising without adequate warm-up. Other muscle conditions include compartment syndrome, muscle spasms, and muscle contusions.
  • Tendon problems: Tendinitis is a common form of sports-related injury.

The various responsibilities of a sports injury specialist include the following:

  • Diagnosing and treating sports-related injuries
  • Treating musculoskeletal pain
  • Creating a personalised treatment and rehabilitation plan
  • Preventive care to lower the chance of injury
  • Coordinating support when required, such as with nutritionists, physical therapists, hand therapists and others
  • Regular evaluation and review of a patient's condition or injury
  • Providing or recommending therapeutic modalities
  • Patient Education

Diseases that Sports Specialists or Orthopaedic Surgeons treat:

Arthroscopy is a common diagnostic and management tool employed to perform knee and shoulder sports injuries such as:

  • ACL tears
  • AC joint arthritis and separations
  • Bursitis and impingement
  • Shoulder joint fractures
  • Torn rotator cuffs
  • Meniscus tears
  • SLAP and Bankart labral tears
  • Cartilage damage and ligament tears

Diagnosis

Doctors diagnose joint injuries and related diseases by recording a thorough medical history, followed by a physical examination and, finally, X-rays or diagnostic tests to view the joint anatomy. In addition, tests like an MRI or CT also scan may also be advised.

If the above tests prove insufficient in diagnosing a case, a final diagnosis is made using the arthroscope. Arthroscopic diagnosis is more accurate and preferred over open surgery or X-rays. The arthroscope shows nearly all joints but is commonly employed for studying the shoulder, elbow, knee, ankle, wrist and hip.

Review

Reviewed by Dr. Vikas Gupta, Director, Orthopaedics & Joint Replacement, Arthroscopy & Sports Injury on 13-Dec-2022.

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