From the Department of Orthopaedic Surgery, Yale Medicine, Orthopaedics, and Rehabilitation, New Haven, CT (Dr. Gianakos), and the Department of Orthopaedic Surgery, NYU Langone Health, New York, NY (Dr. Kennedy).
J Am Acad Orthop Surg Glob Res Rev. 2024 Feb 22;8(2). doi: 10.5435/JAAOSGlobal-D-23-00124. eCollection 2024 Feb 1.
In-office needle arthroscopy (IONA) has gained increased attention as a minimally invasive alternative to standard arthroscopy performed in the operating room (OR) setting. IONA uses instrumentation that is markedly smaller in size and diameter making arthroscopy less invasive. Less OR equipment and less OR staff are required resulting in procedures that may be more accessible and less expensive. IONA is typically performed using local intra-articular blocks, thereby reducing the need for regional anesthesia or general anesthesia along with its associated risks. Using a clinic setting rather than an OR reduces the cost and increases the efficiency of the procedure. This article will present the indications for IONA in upper and lower extremity injuries and will describe the best practice office setup. Technical pearls and pitfalls will also be discussed.
门诊关节内镜检查(IONA)作为一种微创替代方案,越来越受到关注,其与在手术室(OR)环境下进行的标准关节镜检查相比,具有侵入性更小的优势。IONA 使用的器械尺寸和直径明显更小,使关节镜检查的侵入性更小。因此,所需的 OR 设备和 OR 工作人员更少,这可能会使手术更易进行,且费用更低。IONA 通常使用局部关节内阻滞来完成,从而减少了对区域麻醉或全身麻醉的需求,以及其相关风险。使用诊所环境而不是 OR 可以降低成本并提高手术效率。本文将介绍 IONA 在上下肢损伤中的适应证,并描述最佳的诊室设置。还将讨论技术要点和陷阱。