Arthroscopy

Torn meniscus is one of the commonest knee injury. It is caused by twisting injury of knee. It presents with pain in knee, swelling, stiffness and some time with locking. Pain is usually localized around the knee joint. Patients feel pain while straightening of bent knee, while getting up or using stairs. Usually MRI is required to diagnose it. Conservative treatment with medicines, ice pack application and rest helps in reducing pain. Peripheral tears can heal but complex tears require meniscectomy. It is a keyhole surgery where torn portion of meniscus is removed with instruments through small hole.

ACL is important ligament of knee which gives anterior stability. ACL is usually injured in twisting injuries of knee, commonly in sports like football, tennis, basketball. Symptoms are pain, swelling, knee joint giving way (instability) during activities. MRI is usually used to diagnose it.  X ray is done to look for bony  injury/ avulsion fracture.

ACL reconstruction is required in treatment of full thickness ACL tear with instability. Nowadays anatomical ACL reconstruction with hamstring tendon graft is preferred treatment. One or two tendons from hamstring muscles, usually from same side, used to create new ligament. Graft is usually fixed with endobutton (small titanium button) on upper side on femur (thigh bone) and screw or suture disc on lower side in tibia (leg bone). Bio absorbable screws can also be used which dissolve automatically over period of time. Physiotherapy is important part in proper recovery.

Rotator cuff is a group muscles which surrounds the shoulder joint. It stabilizes shoulder joint and moves arm in various directions.

Rotator cuff injuries are common. Frequently occurs in age > 50 as tendons degenerate due to wear and tear over the time.

Often it develops with fall or trauma, but sometimes it can occur with trivial trauma like lifting or throwing.

Shoulder is the most common joint in the body to dislocate. Due to its ball and socket design we have a great deal of mobility within the shoulder, which is directly at the cost of stability.

Shoulder joint socket is formed by bony glenoid and labrum attached to it, while ball is formed by head of humerus (arm bone). Shoulder dislocates anteriorly far more commonly than posterior. Glenoid labrum is crucial stabilizing factor that tears when shoulder dislocates. It is known as Bankart tear or Bankart lesion. When shoulder dislocates it leads to cuticle depression injury on posterolateral portion of head of humerus known as Hill sach’s lesion.