Arthroscopy means looking into a joint. It implies making small cuts and through these introducing an optical system and operating instruments. The inside of the joint is clearly displayed and is relatively easy to find out what, if anything is wrong. At the same time it is possible to cut, sew, remove and repair structures within the joint.
The knee is composed of three separate compartments and these compartments can be affected by arthritis to varying extents. There is a compartment on the inside of the knee (medial). There is one on the outside of the knee (lateral compartment). There is also one between the knee cap (patella) and the thigh bone (femur). This is the patello-femoral compartment. The pattern of pain, the deformity produced and ultimately the surgical treatment, varies depending upon which of the compartments has been affected.
Joint replacement is one of many forms of treatment for arthritis. It implies the surgical removal of a diseased joint and its replacement by an artificial one. The artificial joint is usually made partly of metal and partly out of plastic. It is fixed to the bones of the patient, often, but not always, with a plastic cement (methylmethacrylate).
The hip is a major weight-bearing joint of the ball and socket variety, which is frequently affected by arthritis. Pain, usually the most prominent symptom, reduces the patient’s ability to walk, stand and even sleep. The rate of progression of pain is variable and it may take many years for arthritis it to become severely disabling. As the disease progresses deformity of the hip may result in shortening and external rotation of the affected limb so that the foot habitually points outwards. Severe arthritis limits activities of daily living such as climbing stairs, rising from a chair and dressing (particularly shoes and socks). Progressive pain becomes a distraction, and when regular night pain sets in and the patient can no longer walk reasonable distances or unaided, the time has come to consider definitive surgery.