Orthopedic patients have benefitted from technological advances such as joint replacement and the arthroscope, which allows the orthopedist to look inside a joint. The visit will start with a personal interview and physical examination. This may be followed by diagnostic tests such as blood tests, x rays, or other tests. The treatment may involve medical counseling, medications, casts, splints, and therapies such as exercise, diet changes or surgery. For most orthopedic diseases and injuries there is more than one form of treatment. The orthopedist will discuss the treatment options with the patient and help select the best treatment plan that will enable the patient to live an active and functional life.
Many orthopedic surgical procedures no longer require an open incision to fully expose the joint. Now flexible arthroscopes can be inserted into a joint, such as the knee, and can be manipulated through the joint to locate and identify the nature of the injury. Arthroscopy can be used to look into many joints of the body. In fact orthopedic surgeons often speak of "scoping the joint", meaning looking into the joint. These include knees, shoulders, ankles, wrists, elbows, etc. Surgeons even use arthroscopes to look in and operate on the small joints of your jaw.
In arthroscopic surgery, the surgeon inserts the arthroscope (about the size of a pencil) into the joint through a small cut about 0.25 in (0.64 cm) in length. The arthroscope carries fiber-optic lights, is attached to a video camera, and the image is seen on a TV screen, which the patient can also watch if he or she desires. Through two or three other similar 0.25 in (0.64 cm) incisions the surgeon passes other instruments into the joint with which he will manipulate and repair structures in the joint capable of repair in this fashion. The procedure is usually performed in an operating room to maintain maximum sterility but it is an outpatient procedure, meaning the patient goes home the same day, usually one hour after surgery. Anaesthesia is needed and can be either general anaesthesia, epidural anaesthesia or local anaesthesia. The first two are the preferred methods and with epidural anaesthesia the patient can watch the procedure on the TV screen if desired. Physical therapy often is required after surgery to restore flexibility and strength to the joint and prevent muscle mass loss.