Liu Mingda, Yan Ming, Xu Jianwen, Zeng Qinghui, Zhu Kai, Zhao Shuai, Diao Wenbo, Wang Yueying, Leng Xiangyang
Changchun University of Chinese Medicine, Bo-Shuo Road 1035, Changchun, 130117, China.
Changchun University of Chinese Medicine, Bo-Shuo Road 1035, Changchun, 130117, China; Northeast Asian Institute of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Bo-Shuo Road 1035, Changchun, 130117, China.
Comput Biol Med. 2025 May;190:110112. doi: 10.1016/j.compbiomed.2025.110112. Epub 2025 Mar 31.
Currently, the diagnosis of orthopedic joint diseases relies mainly on magnetic resonance imaging (MRI), which is valuable for detecting bone injuries, as well as lesions in intra-articular cartilage, ligaments, bone marrow, synovium, and other areas. However, MRI has significant drawbacks. Firstly, MRI cannot provide detailed pathological assessments of joint interiors comparable to arthroscopic examination results. Secondly, MRI is costly, imposing substantial financial burdens on patients with each additional site examined clinically. Lastly, MRI resources are scarce in medical institutions due to widespread applications beyond joint examinations, requiring appointments days in advance. Each examination is limited to one site, taking approximately 20-30 min per session; multiple sites necessitate sequential examinations, entailing considerable time costs and potentially delaying diagnoses. The development of needle arthroscopy (NA) for outpatient knee joint examinations offers more accurate and detailed visualization of knee joint pathologies compared to traditional MRI imaging, with lower economic and time costs. Moreover, NA provides a valuable diagnostic alternative for patients unsuitable for MRI examinations. In-office needle arthroscopy (IONA) also enables orthopedic surgeons to deliver more comprehensive medical services beyond diagnostic examinations. Based on this theory, we have designed and manufactured a 2 mm-diameter lens arthroscope useable under local anesthesia in outpatient settings to examine tissue injuries within knee joints. The needle arthroscope objective 2 mm has an 85°field of view, a 30°viewing angle, and an imaging resolution of 10 lp/mm. This device provides clear imaging of cartilage surfaces, ligaments, synovium, and other soft tissues inside cadaveric knee joints, enabling more detailed and accurate evaluations of knee joint tissue pathologies. This method facilitates convenient, efficient joint examinations with lower economic and time costs, serving as a viable alternative to knee joint MRI examinations.
目前，骨科关节疾病的诊断主要依赖于磁共振成像（MRI），它对于检测骨损伤以及关节内软骨、韧带、骨髓、滑膜和其他部位的病变很有价值。然而，MRI有明显的缺点。首先，MRI无法提供与关节镜检查结果相当的关节内部详细病理评估。其次，MRI成本高昂，临床上每增加一个检查部位都会给患者带来沉重的经济负担。最后，由于MRI在关节检查之外的广泛应用，医疗机构中的MRI资源稀缺，需要提前数天预约。每次检查仅限于一个部位，每次检查约需20 - 30分钟；多个部位需要依次检查，这需要相当多的时间成本，并且可能会延迟诊断。用于门诊膝关节检查的针式关节镜（NA）的发展，与传统的MRI成像相比，能提供更准确、详细的膝关节病变可视化，且经济和时间成本更低。此外，NA为不适用于MRI检查的患者提供了一种有价值的诊断选择。门诊针式关节镜检查（IONA）还使骨科医生能够在诊断检查之外提供更全面的医疗服务。基于这一理论，我们设计并制造了一种直径为2毫米的透镜关节镜，可在门诊局部麻醉下使用，用于检查膝关节内的组织损伤。针式关节镜物镜2毫米具有85°视野、30°视角和10 lp/mm的成像分辨率。该设备能清晰成像尸体膝关节内的软骨表面、韧带、滑膜和其他软组织，从而能够更详细、准确地评估膝关节组织病变。这种方法便于进行便捷、高效的关节检查，经济和时间成本更低，可作为膝关节MRI检查的可行替代方案。
