tissue, and NERVE structure and function. These
impairments secondarily affect joint function.
About 30 percent of arthrogryposis is heredi-
tary, though affected parents may have such mild
symptoms that they do not know they have the
condition. When one or both parents have arthro-
gryposis, there is increased risk the infant will also
have the condition. GENETIC TESTINGand GENETIC
COUNSELINGmay help such parents evaluate their
risk and make FAMILY PLANNINGdecisions.
See also CONGENITAL ANOMALY; CONTRACTURE;
GENETIC DISORDERS; LIGAMENT; SURGERY BENEFIT AND
RISK ASSESSMENT; TALIPES EQUINOVARUS; TENDON.
arthroscopy A MINIMALLY INVASIVE SURGERYproce-
dure that allows an orthopedic surgeon to view
the inside of a JOINTusing a lighted, flexible endo-
scope adapted for this use, called an arthroscope.
Arthroscopy, also called arthroscopic surgery, has
both diagnostic and therapeutic applications.
Inserted into the joint through a small incision,
the arthroscope has a tiny camera at its tip that
sends images to a monitor. The orthopedic sur-
geon manipulates the arthroscope and specially
designed instruments to examine the joint and
repair damage to CARTILAGE, LIGAMENT, TENDON, and
other tissues. Arthroscopy has largely replaced
OPEN SURGERYfor most operations on the joints
exceptJOINT REPLACEMENT.
Surgical Procedure
The orthopedic surgeon performs arthroscopy in a
hospital operating suite or an AMBULATORY SURGERY
facility. Most arthroscopies are same-day (outpa-
tient) procedures, with the person arriving a few
hours before the scheduled arthroscopy and going
home a few hours after the surgeon completes the
procedure. ANESTHESIA may be regional (a NERVE
block that numbs the limb) or general (puts the
person to sleep). The orthopedic surgeon makes
two or more small incisions around the JOINT: one
for the insertion of the arthroscope, one for inser-
tion of the irrigating catheter, and others for inser-
tion of the arthroscopic instruments. Most
arthroscopic procedures take 20 to 60 minutes.
After the arthroscopic operation, the person
rests in the recovery area until the anesthetic is
fully worn off and the person is comfortable
enough to go home. Generally the person receives
mild to moderate ANALGESIC MEDICATIONSfor PAIN
relief, depending on the extent of discomfort he or
she feels. Because the entry into the joint is mini-
mal, many people experience little discomfort or
pain after the procedure.Risks and Complications
As with any surgical procedure, arthroscopy has a
risk for excessive bleeding and INFECTION. However,
these complications are uncommon. Soreness and
bruising at the incision sites is common though
usually mild. When the arthroscopic examination
reveals more extensive damage than the orthope-
dic surgeon can repair arthroscopically, the opera-
tion may become an open surgery with longer
recovery and rehabilitation periods.Outlook and Lifestyle Modifications
Most people recover from arthroscopic procedures
fully and without complications, returning to their
regular activities within several days to two
weeks, depending on the surgeon’s recommenda-
tion and the type of procedure. Arthroscopic pro-
cedures generally repair injuries that have limited
the person’s mobility or function, so most people
are much improved after their operations and may
return to activities their injuries had prevented
them from performing.
See also ENDOSCOPY; MENISCECTOMY; SURGERY BEN-
EFIT AND RISK ASSESSMENT.athletic injuries ACCIDENTAL INJURIESthat occur
during athletic activities or sporting events. Though
a certain degree of risk is inherent in athletic
events, particularly competitions, most athletic
injuries occur for three main reasons. They are- inadequate CONDITIONINGor TRAINING
- insufficient WARM-UPand pre-event preparation
- inappropriate or improperly fitted clothing,
shoes, equipment, or protective gear
Athletic injuries may be acute (occur suddenly)
or chronic (develop over time). The most common
acute injuries are SPRAINS AND STRAINS—damage to
the soft tissue structures of the musculoskeletal sys-
tem. Also common are fractures and open wounds
(cuts and scrapes). Chronic injuries among recre-
ational, collegiate, and professional athletes gener-304 The Musculoskeletal System