Dr. Nolan specializes in the treatment of sports related injuries in the knee and shoulder and has vast experience treating these injuries with arthroscopy, a common minimally invasive procedure. Arthroscopic procedures can be performed either to evaluate or to treat many knee and shoulder conditions including torn floating cartilage, torn surface cartilage, ACL reconstruction and trimming damaged cartilage.
AN OVERVIEW OF ARTHROSCOPY
Arthroscopy (also called arthroscopic surgery) is a minimally invasive surgery in which an examination and sometimes treatment of damage of the interior of a joint is performed using an arthroscope, a type of endoscopy that is inserted into the joint through a small incision. The surgical instruments used are smaller than traditional instruments. Surgeons view the joint area on a video monitor, and can diagnose and repair torn joint tissue, such as ligament and meniscus or articular cartilage repair.
The advantage of arthroscopy over traditional open surgery is that the joint does not have to be opened up fully. Irrigation fluid is used to distend the joint and make a surgical space. Only two small incisions are made - one for the arthroscope and one for the surgical instruments to be used in the knee or shoulder cavity. This reduces surgical recovery time and may increase the rate of surgical success due to less trauma to the connective tissue. It is especially useful for professional athletes, who frequently injure knee and shoulder joints and require fast healing time. There is also less scarring, because of the smaller incisions.
ARTHROSCOPY WITH DR. NOLAN
Diagnosing joint injuries begins with a thorough medical history, physical examination, and usually X-rays, magnetic resonance imaging (MRI) or computed tomography (CT) scan also may be needed. Dr. Nolan may determine that it is necessary to perform arthroscopy to reach a final diagnosis and/or treatment of your condition. For diagnostic purposes, arthroscopy can be more accurate than through "open" surgery or from X-ray studies.
Arthroscopic surgery, although much easier in terms of recovery than "open" surgery, still requires the use of anesthetics and the special equipment in a hospital operating room or outpatient surgical suite. You will be given a general, spinal, or a local anesthetic, depending on the joint or suspected problem.
Dr. Nolan will make small incisions in your knee or shoulder. A sterile solution will be used to fill the joint and rinse away any cloudy fluid. This helps him see the joint clearly and in great detail.
The first task is to properly diagnose your problem. Dr. Nolan inserts the arthroscope and uses the image projected on the screen to guide it. If surgical treatment is needed, he will insert tiny instruments through another small incision. The instruments used to treat your condition might be scissors, motorized shavers or lasers.
The incisions are closed with a stitch or steri-strips (small bandaids) and covered with a soft bandage. You will be moved to the recovery room and should be able to go home within 1 or 2 hours. Be sure to have someone with you to drive you home.
Arthroscopy for the knee is most commonly used for:
- Removal or repair of torn meniscal cartilage
- Reconstruction of a torn anterior cruciate ligament
- Trimming of torn pieces of articular cartilage
- Removal of loose fragments of bone or cartilage
- Removal of inflamed synovial tissue
Arthroscopy for the shoulder is most commonly used to treat:
- Impingement
- Partial and Full-Thickness Rotator Cuff Tears
- Instability
- Tendinitis
