Dr. Vinay Tantuway

M.S. (Orthopaedics)
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General Info About arthroscopy About joint replacement What is day care surgery?  

During the last three decades, the evolution of arthroscopy has been mercurial. This progress has led us to the threshold of Day Care Arthroscopic Surgery (Office arthroscopy). The first office arthroscopy was performed in December 1989, when a small flap tear of the posterior horn of medial meniscus was removed using basket forceps. Day care arthroscopic surgery is the demand of the day and could be performed for any of the problem of most of the joints of the body.

Patient can walk into the operating room from office examination table and can be discharged from there as well. Basic minimal blood investigations are required. For diagnostic arthroscopy: local anaesthesia, may be a little sedation, is the only thing required. Patient may need short general anaesthesia, especially of shoulder procedure and knee intervention. One shot of intra-operative antibiotics is usually used. Patients are discharged with compression dressings, which is changed on second postoperative day. Pain management is simple. For routine procedure of knee and shoulder usually local anaesthetic agent is injected into the joint, which gives good relief and if needed NSAID could be given as per requirement. For major procedures pain is taken care by pain management team headed by anaesthesiologist. Gradual physiotherapy and rehabilitation programme is used as per individual patient. Physiotherapy programme is to be followed rigidly during postoperative period. The entire success of these procedures depends on good rehabilitation. Office operative arthroscopy is obviously an efficient method of performing arthroscopic surgery for patient and surgeon. The cost saving of the third party payer and the patient are quite significant when compared to the traditional arthroscopic environment such as the hospital operating room and ambulatory surgery centre operating room. The advent of arthroscopic technique made rehabilitation easier and at least early in the course of recovery, because of a resultant decrease in postoperative pain and morbidity of adjacent tissues.