Arthroscopy
Arthroscopy
PRODUCTS FOR SALE:
1. Artroscopic scissors;
2. Forcepts
3. Graspers;
4. Arthroscopic guides;
5. Cutters;
6. Medical titanium anchors;
7. Resorbable anchors (PLLA, PLDLA, TCP and PLLA);
8. Polyether ketone (PEEK) anchors;
9. Medical Titanium Interference Screws;
10. Resorbable Interference Screws (PLLA, PLDLA, TCP and PLLA);
11. Polyether Ketone (PEEK) Interference Screws;
What is arthroscopy?
The knee joint is the largest in the human body. In addition to clinical examination, instrumental examinations such as examination, palpation, assessment of movement function, radiography, ultrasound, CT, NMR, arthroscopy are also used to assess knee injuries.
Arthroscopic surgeries are performed under general, spiral, wired, and local anesthesia. In Western countries, arthroscopies are performed on an outpatient basis. More than 90% of arthroscopies are both diagnostic and therapeutic and only 10% of arthroscopies are purely diagnostic. When evaluating a clinic before surgery, it is difficult to say which arthroscopy will be therapeutic and which is only diagnostic. There is no strict boundary between diagnostic and therapeutic arthroscopy. Initially, all arthroscopies are diagnostic. Only when a certain pathology is found and surgery is performed does arthroscopy become curative. In the absence of pathology, or insignificant, without the need for additional manipulations, such arthroscopy is considered to be purely diagnostic.
The examination follows the clockwise principle, as it is not the sequence that matters, but the examination of the entire joint.
Do not limit yourself to a simple inspection. It must also be checked with a hook (2 or 4 mm). A rupture can be detected by lifting the meniscus with the hook. The posterior horn of the meniscus should be checked with a hook to make sure it is firmly attached to the capsule. The hook determines the type and size of meniscus rupture and assesses the degree of chondromalacia of the joint surfaces. Knowing that the curved part of the hook is 2 mm, it is possible to measure the rupture or the size of the cartilage defect. The hook also checks the stability of the anterior cruciate ligament.
Incisions are made according to the principle: the lateral joint space is inspected from the medial side, that is, the incision is made from the inside, and vice versa. Two (4-5 mm) incisions are usually used.
Operation process:
• Arthroscopic surgeries are performed under wire, spinal and general anesthesia
• Preparation for surgery
• Incisions
• Introduction of instruments
• Inspection process
• Diagnosis and selection of treatment tactics
• Wound healing
Diagnostic value of arthroscopy: This is a very informative examination that allows the joint to be examined from the inside and the condition of the soft tissues to be assessed, which is difficult to assess by X-ray CT.
Arthroscopic diagnostic capabilities allow:
• Accurately diagnose the nature and location of damage to the soft tissues of the knee joint (meniscus, cruciate ligament, joint capsule).
• Diagnose rheumatoid arthritis (enlarged, rounded, hyperemic capsule lobes).
• To diagnose gouty arthritis after finding gouty knee damage: crystals on the joint capsule and cartilage.
• Diagnose osteoarthritis in the early stages of cartilage damage.
• Diagnose various chondropathies, chondromalacia.
• Diagnose and remove foreign bodies.
• Take a biopsy of a joint capsule or cartilage.
• Diagnose pathological wrinkles in the joint capsule.
Indications for arthroscopy:
• Acute knee injury accompanied by bleeding into the knee joint.
• Acute joint blockage.
• Unclear clinic and vague complaints.
• At the site of an arthrotomy or after persistent pain after a previous arthrotomy.
• If chondropathy is suspected.
• For the removal of loose bodies.
• For the removal of foreign bodies.
• Knee synovectomy (in RA, gouty arthritis).
• Meniscus ruptures.
• Pussy gonitis of the knee joint.
• For osteosynthesis of the femoral tuberous fracture.
• For osteosynthesis of a tibial fracture of the tibia.
Arthroscopy – a method of treatment:
• Meniscus resection
• Meniscus stitching
• Cross ligament plastics (patches with their own ligament, m. Gracilis and semitendinosus transplant, donor ligament graft)
• Kelio sąnario sinovektomija (sergant RA, podagriniu artritu).
• Removal of free bodies, removal of foreign bodies
• Mosaic chondroplasty
• Recanalization
• Meniscus transplantation *
• Osteosynthesis of femoral and tibial fractures
Principles of surgical treatment:
• Taking into account the function of the meniscus as an organ (shock absorber, stabilizes the joint), efforts are made to preserve it as much as possible, i.e. to perform its resection – to remove only the part of the meniscus that caused (ruptured) the pathology.
• Aim: to make the part of the meniscus left after resection only narrower in the shape of a healthy meniscus.
• There are many different types of meniscus resection to choose from depending on the type of meniscus rupture.
Why arthroscopy instead of arthrotomy?
• Great possibilities for diagnostic and surgical treatment
• Mini-invasive treatment
• Lower risk of infection
• Rapid wound healing
• Faster rehabilitation
• Long-term immobilization is not required