Operative Spine – Cartilage Repair or Removal
Cartilage is a firm and flexible connective tissue located throughout the body in joints, between bones, in the intervertebral discs, in the rib cage, and in the ear, nose, elbow, knee, and ankle. Like other connective tissues cartilage is made of collagen fibers, but unlike other connective tissues it does not contain blood vessels. This causes cartilage to repair and re-grow slowly. Cartilage can be damaged or degenerate due to a number of different disorders, most notably osteoarthritis. When cartilage is damaged, arthroscopy may be used to repair or remove the damaged tissue to facilitate motion in joints.
Upper Extremity Cartilage Repair/Removal
What is Upper Extremity Cartilage Repair?
The upper extremities - the shoulders, elbows, wrists and hands - include many moving parts. Humans have joints of many different sizes and types that make it possible for us to lift, throw and catch, touch and grasp, hold and hug. Because we use them so much every day, it’s natural that normal wear and tear, plus injury, disease and age can result in pain and restrictions that interfere with normal movement of these important joints.
Upper extremity joints, their disorders and treatments
Shoulder Anatomy. Your shoulder is a ball-and-socket joint in which the upper arm bone (humerus) pivots against the shoulder blade (scapula) and the collar bone (clavicle). It’s the most flexible joint in the body, allowing arm motion in many different arcs. The top of your upper arm bone is surrounded and held in place in the shallow socket by tough, fibrous cartilage tissue called the joint capsule. A gel-like material called Synovial fluid helps lubricate the shoulder.
The rotator cuff, actually a bundle of four tendons which help keep your shoulder joint aligned , can be injured or can begin wearing out, in athletes and other very active individuals. Torn cartilage in the rotator cuff is sometimes reattached via arthroscopic surgery. Minor tears can be trimmed using a technique called debridement. Some people older than 50, particularly women, can develop pain, stiffness and eventually a severely restricted range of motion, called Frozen Shoulder. In extreme cases, arthroscopic surgery is recommended to cut through adhesions in the affected cartilage and tendon tissue, to relieve pain and stiffness and restore range of motion.
Shoulder Arthroscopy. The word arthroscopy comes from the Greek words “arthro” (joint) and “skopein” (look), which translate in modern medical terms to ‘look inside the joint.’ The surgeon inserts a small camera (an arthroscope) into your shoulder joint , which displays pictures on a television screen. Your surgeon uses these images to guide small, custom surgical instruments which can explore the affected areas, removing fragments of cartilage or bone.
Elbow Anatomy. The elbow joint is comprised of the three arm bones – upper arm (humerus) and lower arm (radius and ulna), joined and hinged at the elbow by tendons, cartilage and muscles.
Tennis Elbow. Tennis elbow (medical term: lateral epicondylitis) is a painful inflammation of the tendons of the elbow, which often occurs in people who play tennis and other racquet sports, but can be triggered by other activity – painters or plumbers can get it from the repetitive motions of their work.
Other Elbow Disorders. Wear and tear, Rheumatoid arthritis and injury can all result in inflammation, damage to cartilage, loose fragments of bone and cartilage, or a buildup of scar tissue in the tendons that bind your elbow joint, and the places they attach to the muscles that move that arm.
Elbow Arthroscopy. Open surgery is one option for repairing the damage of tennis elbow. Arthroscopic surgical procedures for tennis elbow involve removing diseased muscle and reattaching healthy muscle back to bone. Arthroscopic surgery is often used for removal of fragments and scar tissue, and for repairing injuries and wear related to gymnastics or throwing sports.
Wrist and Hand Anatomy
The wrist and hand involve a complex interaction of bones, muscles, tendons, cartilage and joints that combine dexterity, flexibility, twisting and considerable strength. Sports or work injury, wear and tear from repetitive motions, arthritis and age can all cause pain and impairment of the wrist and hand.
Wrist and Hand Disorders. Carpal tunnel syndrome is one common disorder, often caused by repetitive motion from using a computer keyboard, although the disorder is common in many other workers from cooks to chemists. Others include benign but obstructive cysts called ganglions, and trigger finger, an impairment of the tendons that run from wrist to finger.
Wrist Arthroscopy. Arthroscopy can be used in the wrist to visualize and repair fractures, trim or remove cartilage that impairs the movement of wrist or fingers, and to remove ganglion cysts.
Sources: American Academy of Orthopedic Surgeons - Elbow Arthroscopy http://orthoinfo.aaos.org/topic.cfm?topic=A00646 American Academy of Orthopedic Surgeons - Shoulder Arthroscopy http://orthoinfo.aaos.org/topic.cfm?topic=A00589 American Academy of Orthopedic Surgeons - Rotator Cuff Tears: Surgical Treatment Options http://www.orthoinfo.org/topic.cfm?topic=A00406 American Academy of Orthopedic Surgeons - Tennis Elbow http://orthoinfo.aaos.org/topic.cfm?topic=A00068 American Academy of Orthopedic Surgeons - Wrist Arthroscopy http://orthoinfo.aaos.org/topic.cfm?topic=A00001