The term "minimally invasive surgery" is a buzzword in medicine at present. Many common procedures are now being performed using new techniques that allow smaller incisions, less tissue dissection and lower morbidity. This allows a shorter hospital stay, quicker recovery and a more cosmetic result.

One way to achieve this in orthopaedic surgery is to do "arthroscopically assisted" open surgery. Cruciate ligament reconstruction is a good example. The graft (hamstring tendons or patellar tendon) can be harvested by open surgery using small transverse incisions, then the reconstruction itself is performed arthroscopically. Similarly, rotator cuff repair can be done with a "mini deltoid split" when combined with arthroscopic acromioplasty. An open acromioplasty requires detachment of part of the deltoid. Preserving the deltoid attachments improves rehabilitation and recovery.

Endoscopic carpal tunnel decompression is another example of arthroscopic surgical techniques resulting in improved recovery times. Not all patients are suitable for this procedure. Arthroscopic assistance in reduction of intra-articular fractures can improve the quality of reduction, and may permit percutaneous fixation rather than open surgery.

All new techniques require careful evaluation Only when they allow us to perform the same operation with lower morbidity and fewer complications should they be adopted. The benefit to the patient is then a shorter hospital stay and quicker rehabilitation.

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