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PubMed · 2666347

[Arthroscopic surgery--current status and perspectives].

Abstract

The morbidity after arthroscopic surgery is low; a hospitalization is not necessary in most patients. The possible operations of the knee joint include removal of loose bodies, resections on meniscus, plicae and synovium as well as more complicated procedures as suturing of a meniscus, total synovectomy and operations in patients with osteoarthritis. The advantage of the arthroscopic operation compared with arthrotomy is well documented in meniscal resection (shorter treatment, stay in the hospital and sick leave, reduced costs, and nevertheless excellent results) whereas the indication and clinical value of other arthroscopic procedures (i.e. suturing of a meniscal tear, lateral release, abrasion-arthroplasty) still are discussed. Diagnostic and operative arthroscopy of the shoulder joint has found its place and will certainly improve our knowledge on significance and treatment of disorders and injuries of this joint. In selected cases, an arthroscopy of the elbow, the hip, the ankle, the wrist or the temporomandibular joint offers important diagnostic information and may allow operative treatment. Arthroscopic surgery is technically difficult and not without problems. However, the rate of complications is extremely low (0.56%). Infections occur in significantly less than 1% of the cases. In veterinary medicine, therapeutic arthroscopy is used mainly in horses, but arthroscopies have been performed in the ox, the cow, the pig, the dog, the cat, and the rabbit. Modern joint surgery includes arthroscopic techniques; the training of trauma surgeons and orthopedic surgeons in arthroscopy is therefore mandatory.

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BibTeXRIS

W Glinz. 1989. [Arthroscopic surgery--current status and perspectives].. https://pubmed.ncbi.nlm.nih.gov/2666347/

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[Indications and techniques for wrist arthroscopy].

After considering the anatomy of the wrist, the technical requirements for wrist arthroscopy are discussed. This method is used as an additional diagnostic procedure and staging procedure as well as a therapeutic technique. Complications, which are rare, most commonly involve nerve irritation, damage to cutaneous nerves and extensor tendons. Lose bodies can be removed arthroscopically, however, arthroscopically assisted fracture treatment or the removal of ganglions are uncommon. Approaches are lateral and oriented on the extensor tendons or other anatomical landmarks. Arthroscopy is especially useful by carpal instability as it offers many possibilities, not only diagnostically but also therapeutically.

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[Percutaneous perforation of the posteromedial capsuloligamentous structures to avoid cartilaginous damage due to arthroscopic intervention at the medial meniscal posterior horn in narrow joints].

THE PROBLEM: Irreversible cartilaginous damage to the femur and tibia due to resection and suture instruments in arthroscopic surgery at the posterior horn of the medial meniscus in narrow knee joints or in the presence of contracted medial capsuloligamentous structures. THE SOLUTION: Enlargement of the medial joint space by repeated percutaneous perforation of the posteromedial capsuloligamentous structures under consistently applied valgus stress. SURGICAL TECHNIQUE: With the knee joint almost in full extension and with simultaneous, uniformly applied valgus stress, repeated percutaneous perforation of the posteromedial capsuloligamentous structures with a sharp-tipped cannula until perceptible enlargement of the medial joint compartment is achieved. POSTOPERATIVE MANAGEMENT AND RESULT: Uneventful healing of the posteromedial capsuloligamentous structures without the need for any special postoperative treatments.

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