Dr Shreyash Gajjar

Persistent Impingement: Pain or limited motion caused by inflamed soft tissue or bone spurs (osteophytes) that have not responded to physical therapy.

Mechanical Symptoms: Feeling the joint "lock," "catch," or "click," often due to free-floating fragments of bone or cartilage.

Cartilage Damage: Treatment of Osteochondral Lesions of the Talus (OLT) where the smooth surface of the joint has been chipped or worn down.

Chronic Synovitis: Recurring inflammation of the joint lining caused by trauma, overuse, or rheumatoid arthritis.

Joint Instability: Evaluation and repair of torn ligaments (such as the ATFL) when the ankle feels "loose" or gives way frequently.

Debridement: Trimming away inflamed tissue or smoothing out frayed cartilage to reduce pain and friction.

Microfracture: Making tiny holes in the bone to stimulate a healing response and the growth of new fibrocartilage.

Synovectomy: Removing the diseased or inflamed lining of the joint.

Ligament Stabilization: Using arthroscopic techniques to tighten or reattach torn ligaments to restore joint stability.

Bone Spur Removal: Shaving down bony growths that pinch the joint during movement (anterior or posterior impingement).

Portal Creation: The surgeon makes 2–3 tiny incisions (less than 1 cm each), typically at the front of the ankle (anteromedial and anterolateral portals).

Joint Distention: The ankle is expanded with sterile saline or a mechanical distraction device to create a clear workspace for the camera.

Visualization: A miniature high-definition camera (arthroscope) is inserted to project live images of the joint internal structures onto a monitor.

Surgical Intervention: Miniature shavers, burrs, and graspers are inserted through the other portals to repair or remove damaged tissue.

Closure: Once the repair is complete, the fluid is drained and the tiny portals are closed with a single stitch or sterile tape.

Diagnostic confirmation through physical exams and imaging to identify the specific source of joint pain.

Fasting (NPO) as directed by the surgical team prior to the procedure.

Evaluation for regional anesthesia, which numbs the leg and provides several hours of pain relief after the surgery.

Arrangement for a post-operative walking boot or splint, depending on the anticipated type of repair.

Ankle MRI: The primary tool for assessing soft tissue damage, ligament tears, and cartilage lesions.

X-rays: Used to identify bone spurs or loose bone fragments that may be contributing to mechanical joint issues.

CT Scan: Occasionally used to provide a detailed view of complex bone anatomy or "bony" impingement.

Blood Panels: Routine testing to ensure the patient is fit for general anesthesia and outpatient surgery.

Almost always an outpatient (daycare) procedure, with patients returning home the same day.

Strict elevation of the ankle above the heart for the first 2–3 days is critical to minimize swelling and pain.

Weight-bearing status varies: simple trimming allows immediate walking, while cartilage repairs may require crutches for 4–8 weeks.

Physical therapy typically begins around 2 weeks post-op to regain range of motion and ankle strength.

Return to desk work is often possible in 1–2 weeks, while high-impact sports usually take 3 to 6 months.

Minimally invasive nature results in significantly less post-operative pain and swelling than traditional open incisions.

Tiny incisions lead to a lower risk of infection and faster overall healing of the surgical site.

Provides a dynamic and comprehensive view of the joint, allowing the surgeon to address multiple issues in one session.

High success rates for resolving mechanical symptoms like locking or catching in the ankle.

Persistent knee pain that has not responded to rest, physical therapy, or injections.

Mechanical symptoms such as the knee "locking," "catching," or "giving way" during movement.

Swelling and stiffness caused by loose fragments of bone or cartilage within the joint.

Confirmed soft tissue injuries, such as a meniscus tear or a ligament injury (ACL/PCL).

Chronic inflammation of the joint lining (synovium) that requires surgical removal.

Diagnostic Arthroscopy: A procedure focused on exploring the joint to identify the source of unexplained pain or instability.

Meniscectomy: Trimming away the damaged or frayed edges of a torn meniscus.

Meniscal Repair: Suturing a torn meniscus back together to preserve the natural cushioning of the knee.

Chondroplasty: Smoothing out damaged or irregular articular cartilage to improve joint glide.

Loose Body Removal: Extracting floating bits of bone or cartilage that cause painful mechanical interference.

Portal Creation: The surgeon makes two or three tiny incisions, or portals (about 0.5 cm each), around the kneecap.

Saline Insufflation: The joint is expanded with sterile saline to stretch the capsule, providing a clear view and space for the tools.

Visualization: A high-definition fiber-optic camera (arthroscope) is inserted through one portal to project live images onto a monitor.

Surgical Intervention: Miniature specialized tools, such as shavers or probes, are used to repair, trim, or remove damaged tissue.

Closure: After the saline is drained, the tiny portals are closed with a single stitch or sterile tape (Steri-Strips).

Fasting (NPO) for 6–8 hours prior to the surgery to ensure safety during anesthesia.

Evaluation of current medications; blood thinners are typically only stopped if significant bleeding is anticipated.

Choosing the most appropriate anesthesia option, which may include general, spinal, or a regional nerve block.

Diagnostic confirmation through physical stability tests and imaging to map out the internal damage.

MRI Scan: The primary imaging tool used to visualize soft tissues like ligaments, tendons, and cartilage.

X-rays: Used to rule out significant bone-on-bone arthritis or fractures that may not be treatable via arthroscopy.

Physical Stability Exams: Specialized maneuvers (like the Lachman or McMurray tests) to assess ligament and meniscus integrity.

Blood Panels: Routine screens to ensure general health and fitness for an outpatient surgical procedure.

Almost always an outpatient procedure, with most patients returning home 2–3 hours after waking up.

Adherence to the R.I.C.E. protocol (Rest, Ice, Compression, Elevation) is critical for the first 48–72 hours.

Weight-bearing status depends on the procedure: simple trimming allows walking in days, while repairs may require crutches for 4–6 weeks.

Driving is typically restricted for 1–2 weeks, particularly if the surgery was on the right leg or the patient drives a manual vehicle.

Physical therapy focuses on restoring range of motion and strengthening the muscles surrounding the knee joint.

Minimally invasive nature results in significantly less post-operative pain and swelling than open surgery.

Tiny incisions lead to faster wound healing and minimal surgical scarring.

High success rates for resolving mechanical issues like joint locking or catching.

Reduced risk of infection and lower blood loss compared to traditional joint procedures.

Persistent shoulder pain that has not improved with physical therapy, rest, or injections.

Loss of range of motion or weakness, often associated with a torn rotator cuff.

Recurrent shoulder dislocations or a feeling of "looseness" in the joint (instability).

Mechanical symptoms such as painful catching, clicking, or "locking" of the shoulder.

Presence of bone spurs that cause "impingement," where tendons are pinched during overhead movement.

Rotator Cuff Repair: Reattaching torn tendons to the humerus (arm bone) using specialized suture anchors.

Labral Repair (Bankart or SLAP Repair): Stitching the cartilage ring (labrum) back to the socket to restore stability.

Subacromial Decompression: Shaving down bone spurs and inflamed tissue to create more space for the tendons to move.

Biceps Tenodesis: Relocating a damaged biceps tendon to a new attachment point to relieve pain.

Capsular Release: Surgically stretching or cutting tight tissue to treat severe "frozen shoulder."

Fluid Insufflation: The surgeon injects sterile saline into the shoulder to inflate the joint capsule, providing a clear workspace and view.

Portal Placement: Two to three small incisions (0.5–1 cm) are made around the shoulder to serve as entry points for the camera and tools.

Joint Inspection: The arthroscope is inserted to project high-definition images of the tendons, ligaments, and cartilage onto a monitor.

Specialized Repair: Miniature tools, such as shavers or suture passers, are used to trim damaged tissue or anchor tendons back to the bone.

Portal Closure: Once the repair is complete, the saline is drained and the tiny incisions are closed with a single stitch or sterile tape.

Diagnostic confirmation through MRI or X-rays to map the internal damage and plan the surgical approach.

Fasting (NPO) for 6–12 hours prior to the procedure to ensure safety during anesthesia.

Coordination of a regional nerve block, which numbs the entire arm for up to 24 hours to assist with immediate pain control.

Pausing certain medications, such as blood thinners or anti-inflammatories, as directed by the surgical team.

Shoulder MRI: The gold standard for visualizing soft tissue injuries like rotator cuff tears and labral damage.

MRI Arthrogram: An MRI where dye is injected into the joint to highlight small tears that might be missed on a standard scan.

X-rays: Used to identify bone spurs, arthritis, or fractures that may contribute to shoulder pain.

Physical Strength Testing: Assessing the deltoid and rotator cuff muscles to determine the functional impact of the injury.

This is typically an outpatient procedure, allowing most patients to return home the same day.

A shoulder sling is mandatory for 1 to 6 weeks, depending on the complexity of the repair (e.g., longer for a rotator cuff repair).

Pendulum exercises, involving gently swinging the arm, are often started within days to prevent "frozen shoulder" stiffness.

Driving is generally restricted for at least 1 week, or until the patient has stopped taking narcotic pain medications.

Heavy lifting and overhead sports are avoided for 3 to 6 months while the repaired tendons fully bond to the bone.

Significantly less post-operative pain and swelling compared to traditional "open" shoulder surgery.

Smaller incisions result in minimal scarring and a lower risk of wound-related complications.

High success rate for restoring shoulder stability and relieving chronic pain.

Allows for a more precise diagnosis by giving the surgeon a dynamic, 360-degree view of the internal joint structures.