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Arthroscopic Debridement

- Sep 12, 2018 -


Plane the hyperplastic synovial villi, remove the exfoliated articular cartilage; grind the articular surface, remove the epiphysis; remove the joint free body and remove the inflammatory mediator, and repair the damaged meniscus, which can effectively reduce the synovial irritation. The joint is continuously flushed during the operation. Synovial resection has the effect of reducing swelling, relieving pain and improving joint function; removing pathological cartilage can regenerate cartilage surface; intra-articular irrigation not only removes necrotic tissue, inflammatory mediators, but also maintains a large amount of perfusion physiology Brine adjusts the osmotic pressure, pH and electrolytes of the joints, improves the internal environment of the joints, causes the synovial inflammation to rapidly resolve, and normal synovial secretion is restored; the bare hardened bone holes can induce fiber cartilage regeneration through drilling. Stem cells from the bone marrow cavity are differentiated into fibroblasts and chondrocytes under the stimulation of transforming growth factors to form a layer of fibrocartilage-like tissue, repairing the original cartilage defect area.

The best indications: knee joint pain, swelling, effusion, dysfunction, twisted or stuck, after 3-6 months of rest, physiotherapy, medication, poor performance.

Relative indications: Symptoms that have been symptomatic for many years, repeated onset, and refused to be treated by other surgical methods have poor long-term effects and can only temporarily relieve pain and improve part of joint function.

Before the treatment, explain to the patient that there must be psychological preparation for joint replacement.

Application principle

The role of arthroscopy in the treatment of arthritis

Diagnostic effect

First, arthroscopy can be used to examine various lesions in the joint cavity, and to evaluate and record the condition of various tissue structures in the joint. Some joint lesions, such as pigmented villonodular synovitis, have characteristic arthroscopy. A diagnosis can almost be made. At the same time, the joint fluid or diseased tissue can also be obtained, and the pathological tissue is biopsied under the arthroscopy monitoring, and further laboratory examination and pathological examination are performed.

However, in recent years, various non-invasive examinations have been developed, especially the development of imaging examinations such as B-ultrasound, CT and MRI. Arthroscopy, which is purely for diagnostic purposes, has been used less and less. However, arthroscopy can observe and explore the lesion under direct vision, and it has a certain amplification effect. It can also be observed dynamically and has irreplaceable advantages. Therefore, patients who have not been able to determine the cause for a long time after clinical examination and various auxiliary examinations are still Has application value.

Therapeutic effect

In addition to its therapeutic effects on a variety of sports injuries, arthroscopic techniques can also play an important role in the surgical treatment of arthritis. Arthroscopy has been reported in the literature for the diagnosis of various arthritis such as osteoarthritis, inflammatory joints, pigmented villonodular synovitis, crystalline arthropathy, infectious arthritis and traumatic arthritis. treatment. For example, for various types of synovitis, synovectomy can be performed under arthroscopy, and the synovial tissue in the posterior joint capsule can be removed through the posterior approach in the knee joint to achieve the purpose of synovectomy of the total joint capsule. For the bone joints, joint removal can be performed, the free body is removed, the torn meniscus is removed, and the cartilage surface is trimmed.



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