Willems W J, van Kampen A, Verhaar J A
Medisch Centrum Alkmaar, afd. Orthopedie, Alkmaar.
Ned Tijdschr Geneeskd. 1998 May 9;142(19):1064-73.
Since the early eighties arthroscopy has become an important part of orthopaedics. Virtually every joint can be examined with an arthroscope. Apart from the diagnostic possibilities, an increasing number of arthroscopically guided surgical operations are possible. Knee arthroscopy can be used therapeutically for many conditions, including meniscal lesions, refractory synovitis, cruciate ligament lesions, tibial plateau fractures and osteochondral defects; in the shoulder it can be applied to lesions of the glenoid lip or the rotator cuff; in the ankle and foot, for osteochondral fractures and creation of an arthrodesis; in the wrist, for treatment of instability, intra-articular distal fractures of the radius and the carpal tunnel syndrome; in the hip, for removal of loose bodies and in the spine, for the performance of discectomy. Advantages over conventional open operations are smaller proportions of complications (< 2%), shorter hospital stay and more rapid rehabilitation. The areas of indication are defined in guidelines issued by the orthopaedic societies themselves; most orthopaedic surgeons follow these guidelines. A possibility for the future is use of laser in interventions on joints.
自20世纪80年代初以来,关节镜检查已成为骨科的重要组成部分。几乎每个关节都可以用关节镜进行检查。除了具有诊断可能性外,越来越多的手术可以在关节镜引导下进行。膝关节镜检查可用于治疗多种病症,包括半月板损伤、难治性滑膜炎、十字韧带损伤、胫骨平台骨折和骨软骨缺损;在肩部,可用于治疗盂唇或肩袖损伤;在踝关节和足部,可用于治疗骨软骨骨折和进行关节固定术;在腕部,可用于治疗不稳定、桡骨远端关节内骨折和腕管综合征;在髋部,可用于取出游离体;在脊柱,可用于进行椎间盘切除术。与传统的开放手术相比,其优点是并发症比例较小(<2%)、住院时间较短且康复更快。适应证领域由骨科协会自己发布的指南界定;大多数骨科医生遵循这些指南。未来的一种可能性是在关节干预中使用激光。