Latest Minimally Invasive Surgery Options in Orthopedics

Over the past few decades, minimally invasive surgery has become increasingly common across all medical specialties and the orthopedics field is no exception. New research and technologies have led to improved methods of joint replacement, arthroscopic repairs of sports injuries and microscopic treatment of complex musculoskeletal conditions, among other things.

While some orthopedic practices are known solely for their patient care and great patient outcomes, others are known for their innovation and research as well. By focusing on research, they ensure that patient care and outcomes continue to improve. Founded by Dr. Stephen Nicholas, NY Orthopedics has been committed to research since its inception. The practice builds on a tradition of excellence, starting with the first hospital-based facility in the country dedicated solely to the study of sports medicine and trauma. This facility, founded by Dr. Nicholas’s father in the 1970s, is now known as the Nicholas Institute of Sports Medicine and Athletic Trauma (NISMAT).

Today, NY Orthopedics continues to lead the way in research, with continuous improvement in patient care and patient outcomes as its guiding principal. Minimally invasive surgical techniques are one form that this improvement in care has taken. In this blog, our fellowship-trained orthopedic surgeons will address some of the new minimally invasive orthopedic surgery options offered, what they entail and what conditions they treat.

What is minimally invasive surgery?

Minimally invasive surgery is exactly what it sounds like. Whereas traditional surgery often requires a large incision and significant trauma to soft tissue surrounding an injury, minimally invasive surgery attempts to minimize both the size of surgical incisions as well as the trauma to surrounding soft tissues while accomplishing the same surgical goal. In orthopedics, this can mean the difference between exposing the entire joint through a large, open incision and using small, targeted incisions to address only the problem area. This results in less risk during surgery, less post-operative pain and shorter recovery times.

What are some of the latest minimally invasive orthopedic surgery options?

Just as there are many different types of orthopedic injuries, there are also a wide variety of minimally invasive surgery options available.

Knee Arthroscopy

This minimally invasive surgery involves making two or more small incisions in the knee, then using a camera mounted on a thin, flexible tube—a tool called an arthroscope—to visualize the interior of the joint. Small surgical tools are inserted through the other incisions, and the entire operation is broadcast to a television screen. The surgeon uses this enlarged image on the screen to guide the instruments and make whatever repairs are necessary.

Knee arthroscopy is commonly used for:

• ACL tear reconstruction
• Meniscal tear repair or trimming
• Loose body removal
• Removal of inflamed synovium

Hip Arthroscopy

In this procedure, an arthroscope is inserted into the hip joint through a small incision, while surgical tools are inserted through other incisions. As with other types of arthroscopy, the surgeon views the joint and manipulates the instruments using the enlarged images provided by the arthroscope. Hip arthroscopy can help relieve painful symptoms of many problems impacting the labrum, articular cartilage, or other soft tissues surrounding the hip joint.

Hip arthroscopy may be used to treat:

• Hip injuries
• Hip dysplasia
• Femoroacetabular impingement
• Loose bodies in joint
• Synovitis
• Hip joint infection

Shoulder Arthroscopy

A common minimally invasive surgery, shoulder arthroscopy also uses an arthroscope and specialized tools to visualize the joint and perform repairs. It is used to relieve painful symptoms caused by damage to the rotator cuff tendons, labrum, articular cartilage, and other soft tissues surrounding the joint.

Some uses for shoulder arthroscopy include:

• Rotator cuff repair
• Bone spur removal
• Shoulder instability repair
• Labral repair or removal
• Removal of inflamed tissue

Wrist Arthroscopy

Although not as common as some other types of arthroscopic surgery, wrist arthroscopy may be a viable alternative to conventional surgery for wrist injuries and other painful wrist conditions.

It is widely used for carpal tunnel release procedures, and may also be used for:

• Fracture repair
• Ligament/TFCC tear repair
• Diagnosing or treating chronic wrist pain

Minimally Invasive Spine Surgery

Traditionally, spine surgery has been performed as an open surgery. However, technological advances now allow more back and neck conditions to be treated with minimally invasive surgical techniques in cases where a doctor can pinpoint the exact source of your pain.

Minimally invasive spine surgery (MISS) uses the same underlying principles as arthroscopic surgery—however, the tools used are slightly different. Instead of an arthroscope and video monitor, MISS uses fluoroscopy, which is a type of real-time X-ray imaging used to visualize and guide the surgeon to the area being treated.

Reasons that minimally invasive spine surgery may be used include:

• Herniated disc treatment
• Spinal stenosis treatment
• Spinal decompression
• Spinal fusion

Minimally Invasive Total Joint Replacement

Many different types of joint replacement—including hip, knee, and shoulder—can now be performed through minimally invasive surgery. In a total joint replacement, the damaged or worn surfaces of the joint are removed and replaced with artificial joint components that are cemented or screwed into place. In traditional joint replacement surgery, a large incision is necessary in order to expose the entire joint. It may also mean detaching and reattaching soft tissues such as muscles and tendons in order to access the joint.

Minimally invasive joint replacement, on the other hand, uses small incisions and disturbs the surrounding soft tissue as little as possible. Not all patients who are considering a joint replacement are candidates for a minimally invasive joint replacement, but it is an option worth discussing with your orthopedic surgeon.

Am I a candidate for a minimally invasive orthopedic surgery?

For many orthopedic injuries and conditions, nonoperative management and traditional surgery are still the preferred methods of treatment. The physicians at NY Orthopedics are trained in the full spectrum of treatment options and will help guide you to the best treatment for your individual needs.

If you’re considering surgery for an orthopedic condition, schedule an appointment at NY Orthopedics today to learn more about our minimally invasive surgery options and to find out whether you are a good candidate for this type of surgery.