Arthroscopy of the hip

The hip joint is one of the joints that has only recently been treated by arthroscopy. Before the introduction of arthroscopy in this area, it was only possible to carry out small and larger repairs to the joint using highly complex methods. This led to long rehabilitation times and an increased number of complications due to the operation.

Today, arthroscopy of the hip is used for various indications. Mostly cartilage damage and impingement syndrome of the hip, but also slight arthroses, free joint bodies or for example a tear of the headgear (labrum) are repaired in this way. The operation is performed under general anaesthesia.

As with most arthroscopies, two access routes are provided through which surgical instruments can be inserted. For a positive outcome of the operation, mobile X-ray units provide precise information about the exact position of the instruments. In order for the surgeon to have a good view of the joint and to be able to assess damage, the affected leg must be placed under traction during arthroscopy of the hip.

The operation can be performed either in a lateral or supine position. After an operation, the joint must be protected for the time being. Depending on the healing process, full weight-bearing can be achieved in the first two weeks after the hip arthroscopy, but unusually high loads, such as those that occur during sports, should be avoided. During this time it may also be necessary to use crutches. Physiotherapeutic treatment with physiotherapy is advisable, since without exercises, there is a risk of restricted movement.

Arthroscopy of the elbow

Surgical intervention by means of arthroscopy on the elbow joint has gained significantly in influence in recent years. As with most arthroscopies, the procedure is performed through two incisions through which surgical instruments can be inserted. Elbow arthroscopy allows the diagnosis and treatment of some painful diseases of the elbow joint.

However, other structures in this area can also be examined by means of arthroscopy. These include endoscopy of the ulnar nerve and arthroscopy of the biceps tendon. There are many indications for an arthroscopy of the elbow.

For example, signs of wear and tear of the cartilage, inflammation of the bursa, infections and a rupture of the biceps tendon are treated in this way. Even if the pain is unclear, an arthroscopy may be performed under certain circumstances for clarification. The famous tennis elbow (medical term: epicondylitis), which is caused by irritation of the tendon attachments of the muscles of the forearm, can be treated by means of arthroscopy.

The procedure takes 10 to 60 minutes, depending on the indication, after the preparation of the patient. During the operation, the patient lies on his stomach or on his side. The patient can be given either a short general anaesthetic or a block anaesthetic.

The joint is not fixed during the entire time, so that the attending physician has the best possible overview of the damage. Overall, the operation by arthroscopy at the elbow is preferable to an open “classic” operation. The surrounding tissue is thus spared and the rehabilitation period is shortened. For this reason, arthroscopy of the elbow, after failure of the classic pharmacotherapy, is usually the method of choice. However, since the structures in the area of the elbow are very close to each other, a steady hand and an experienced surgeon is essential for the success of the operation.