Arthroscopy of the shoulder is performed under a regional block and sedation in an outpatient surgical setting. The anesthesiologist administers an injection, which numbs the arm, and then sedation is given to induce a light sleep. Patients quickly awaken when the medication is turned off but there is no or little pain because the nerve block lasts from 6 to 24 hours.
Common procedures include removal of bone spurs, repair of partial or complete rotator cuff tears and reconstruction for unstable shoulders. Postoperative activities depend on the diagnosis and the type of surgery performed. Total shoulder replacement is performed as an inpatient procedure.
Arthroscopy of the knee is a surgical procedure to correct mechanical problems causing pain and dysfunction that have not responded to conservative management such as medication, exercise, physical therapy or rest.
I perform this outpatient procedure under local anesthesia (unless ligament reconstruction is the procedure). An anesthesiologist injects I.V. medication for temporary sedation. The knee is then injected with local anesthetic. The procedure is then performed with or without further sedation. At the conclusion of the surgery, the sedation is turned off and the patient quickly becomes normally alert. Because long acting local agents are used, there is rarely any postoperative pain for 8 to 24 hours. The patient returns home after surgery and patient satisfaction is very high.
The most common procedures are to remove or repair torn cartilage (meniscus), clean-up damaged joint surfaces (articular cartilage) or realign a damage kneecap (patella). Ligament reconstruction (torn anterior cruciate ligament) can also be performed arthroscopicaly and frequently as an outpatient procedure. Total knee replacement is performed as an inpatient procedure.
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