Arthroscopic Joint Repair

Our joints act as hinges within our body that allow us to move within our environment. For these hinges to be stable, several structures are present to provide the controlled movement patterns necessary for day-to-day life. Muscles and tendons are the movers of the joints, while the ligaments and capsules connect one bone to another. The labrum is a ring of fibrocartilage around that socket’s edge that deepens the joint allowing for better support of the joint during movement. Finally, cartilage can add shock absorption between the joint surfaces for repetitive activities like running, jumping, or throwing. Unfortunately, one or more of these structures can become damaged over time or with trauma and require surgical correction.

Arthroscopic surgery is a less invasive surgical option to evaluate, visualize, and treat these injuries. Two to three small incisions are made around the joint to allow access for a high definition camera, a light, and other tools to help repair the area in question. Arthroscopic repairs are used to correct ligament or cartilage tears, remove foreign or loose bodies, repair tendons tears, and remove or release inflamed joint structures. Arthroscopic surgeries allow for shorter healing times than open repairs and often allow for patients to have same-day surgery so they can be home within a few hours.

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Causes of Arthroscopic Joint Repair Surgeries and Joint Injuries

Joint injuries can occur over time from repetitive use and strain such as with baseball pitchers who continuously strain the ligament on the inside of the elbow with high velocity throws or runners who have consistent mileage each week leading to knee pain. Our weight-bearing joints such as our knees, ankles, and hips tend to see a greater breakdown over time than our shoulders, elbows, and wrists; however, all joints have the potential for overuse injuries and break down.

Trauma, or a single injuring event, is the number one reason an individual will have an arthroscopic procedure. For most, the injury occurs when the joint is stressed beyond its normal physiological range thus placing a greater amount of stress on the muscle/tendon, ligament, or cartilage than it can withstand. This leads to either partial or full tearing of that structure. This can happen due to a fall on an outstretched arm, twisting of the leg or knee when the foot is planted, or from accidents involving a vehicle, just to name a few.

More rarely, an individual may have an autoimmune disorder or another illness that places greater strain on joints or weakens the structures around the joints. Rheumatoid arthritis, polychondritis, Ehler-Danlos Syndrome, and Systemic Lupus Erythematosus are just a few examples.

  • Repetitive Use and Strain
  • Physical Trauma
  • Other Risk Factors
  • Medical Conditions

Types of Arthroscopic Joint Repairs

There are several different types of arthroscopic joint repairs including but not limited to:

  • Rotator Cuff Repair
  • Shoulder Labral Repair — SLAP or Bankhart Repair
  • Biceps Tenodesis
  • Biceps Tendon Repair
  • Ulnar Collateral Ligament (UCL) Repair
  • Hip Labral Repair
  • ACL or PCL Repair or Reconstruction
  • MCL or LCL Repair
  • Meniscus Repair
  • Achilles Tendon Repair

Symptoms of Arthroscopic Joint Repair and Joint Injuries

For a traumatic injury, the individual will often experience a popping or tearing sensation with an audible “pop” as well. Pain generally occurs immediately as does swelling of the involved joint. Use of the injured joint is severely limited due to instability and pain. Severe bruising can occur if the tear involves the muscle or tendon as it has a larger blood supply than ligaments or cartilage. Most individuals will be taken immediately to the Emergency Room or Orthopedic Urgent Care.

Overuse injuries tend to be more subtle in their presentation. Pain often comes on during activity and can calm with rest. Swelling may or may not be present depending on the intensity and duration of the activity. An individual may experience popping, catching, or clicking in the joint with certain motions that can be painful or just annoying. Also, a feeling of instability or too much movement is experienced when stress is placed on the damaged tissue. Overall symptoms are gradual in presentation and can build over time until it takes much longer recovery times to get back to activity. That is often when individuals visit their physician to find out what is going on.

  • Popping or Tearing Sensation
  • Swelling of the Joint
  • Limited Use of Joint Due to Pain
  • Severe Bruising
  • Pain During Certain activities
  • Popping, Catching, or Clicking with Certain Motions

Diagnosis of Arthroscopic Joint Repair and Joint Injuries

After taking a thorough history, your physician or physical therapist will take you through a series of orthopedic tests to examine your ligaments, muscles, tendons, cartilage, and labra to determine the area of injury. Often, imaging such as radiographs, or x-rays, are used to determine if there is any fracture of the bone present. Further imaging studies like an MRI or CT scan may be appropriate to determine if the soft tissue structures are damaged. Location, size of the injury, and impact on function will determine if an individual is a candidate for surgery or has a good potential of healing with physical therapy.

Treatment after Arthroscopic Joint Repair with Physical Therapy

Physical therapy is a large part of the healing process after an arthroscopic surgery. Results Physiotherapists and other physical therapists can help manage and reduce swelling around the injured joint to reduce pain, assess and improve joint mobility along the injured joint with specific mobilization and manipulation techniques, and promote normal range of motion at the joint with passive, active-assisted, and active range of motion techniques.

In addition, Results Physiotherapists will help to address soft tissue/muscle stiffness or guarding around the painful area, teach and train improved postures or positioning for functional activities, teach appropriate movement patterns to complete tasks safely and to avoid exacerbating symptoms, improve flexibility and body awareness, and teach an individualized home exercise program so you can control your own outcomes.

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Prevention Tips for Arthroscopic Joint Repair Injuries

There is no guaranteed way to prevent joint damage; however, there are more protective habits and movement patterns that you can incorporate into your daily routines to reduce further breakdown. For those individuals who are weekend warriors or are pursuing a more active lifestyle, shoe options, work surfaces, and protective landing for repetitive tasks can reduce the load on the joints that are taking the repetitive stresses from the activity. For day-to-day life, having strong and balanced muscles can reduce strain with daily tasks. All of these can be taught and/or modified for you by a physical therapist, so feel free to call us for an appointment!

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