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Surgical options for arthritis
Tuesday, May 29, 2007
In this article we will
briefly discuss the various surgical options for arthritis. One of the
most common questions I get regarding possible surgical treatment for
arthritis is “Doc, can't you just scope the knee and clean it out?”
is inserting a small fiberoptic camera into a joint, pumping fluid
through the joint and then performing various procedures through other
small portal site “poke holes.” It is very effective for trimming out
torn pieces of meniscus cartilage, removing loose bodies such as loose
pieces of cartilage or bone/bone spurs that have broken off.
It is also
very useful for various ligament reconstructions and several other
it is not very effective for the treatment of arthritis per se.
Arthritis is when the articular cartilage on the end of the bone starts
to wear down. We really don't have any good way at this stage to
“re-tread the tire” especially over large diffuse areas of wear and
tear. There are various surgical procedures, some of which can be done
arthroscopically, others through an arthrotomy, which is a larger
incision and opening into a joint that can replace, regenerate and/or
regrow new cartilage, but it is really only for very small areas of
articular cartilage wear or breakdown.
patients who have significant wear and tear/degeneration of their
joints, arthroscopy really only benefits them if they have some type of
mechanical symptoms that can be removed. The reason that arthroscopy is
generally not very effective and has not been shown to affect the
long-term outcome of arthritis is that once the arthroscopy is
performed, the wear and tear is still there with the exception of
perhaps cleaning out some loose particles. This is usually only
effective for a very short period of time.
Within several weeks
to months the arthritic symptoms usually come back. Sometimes the
surgery can even make them worse or cause other problems or
complications. The bottom line is, unfortunately, arthroscopy is really
not an effective form of treatment for generalized arthritis.
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