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Arthroscopy

Hand & wrist arthroscopy: indications for diagnosis/treatment of TFCC tears, ligament injuries, synovitis, and dorsal wrist pain.

Overview

Shoulder arthroscopy literature remains controversial, with conclusions often unsupported due to bias and limitations [1]. No definitive clinical guidelines exist for shoulder arthroscopy pending higher levels of evidence [1]. The rapid expansion of arthroscopy has led to abuses driven by financial motives and a lack of ethical standards [23]. Suggested guidelines for arthroscopic surgery practice emphasize the need for appropriate training, privileges, and performance review to ensure patient safety and surgeon competence [8]. These suggested guidelines for arthroscopic surgery practice cover privileges, training, practice standards, continuing education, and performance review [26], [54], [55].

Subtalar arthroscopy yields effective long-term outcomes in athletic populations, including favorable return to sport level, return to sport time, clinical outcomes, and safety measures [2]. Six out of ten patients with sinus tarsi syndrome returned to their pre-injury type of sport after subtalar arthroscopy [2]. Arthroscopic treatment of talus bipartitus is a safe and effective option with excellent short- and long-term outcomes [6]. Arthroscopic excision is the treatment of choice for localized pigmented villonodular synovitis arising from the quadriceps tendon sheath and is considered curative [53].

Arthroscopic and open approaches for dorsal ganglion cyst excision have comparable outcome profiles regarding recurrence and complications [3]. Elbow arthroscopy is associated with complications and morbidity despite being a minimally invasive procedure [5]. Osteoarthritis was the most common indication for arthrodesis of the distal interphalangeal and thumb interphalangeal joints [14]. Postoperative complications following arthrodesis of the distal interphalangeal and thumb interphalangeal joints occurred at a rate similar to existing literature [14].

Anatomy & Pathophysiology

Osseous

Accurate diagnosis and management of hand and carpal fractures and dislocations are predicated on a thorough physical examination and appropriate imaging [35]. The primary goal of managing these injuries is to limit joint stiffness while preserving mobility and function [35]. Regarding fixation techniques, articular surface loss of the metacarpal head following retrograde headless compression screw (RHCS) insertion is negligible in a cadaveric model [60]. Furthermore, there is minimal engagement between the metacarpal head defect and the proximal phalanx (P1) base during functional range of motion following RHCS insertion [60].

Ligamentous

Hand surgery principles emphasize the balance between restoring function and maintaining aesthetic appearance [52]. The pulley system of the thumb is composed of 4 components [38], a finding that updates the traditional view which held that the system was composed of only 3 components [38]. In flexor tendon repair, repair of both slips of the flexor digitorum superficialis (FDS) outside the A2 pulley improves the gliding coefficient relative to repair within the A2 pulley in a cadaveric model [67]. This approach suggests decreased resistance to finger flexion compared to repair within the A2 pulley [67].

Classification

ROCK OCD Knee: This classification system is validated for osteochondritis dissecans of the knee, demonstrating high reliability in multi-center studies [34].

Copeland-Levy: This system is recommended to standardize terminology regarding subacromial impingement lesions [47].

Medial Meniscus Ramp Tears: A surgically relevant classification based on tear morphology enables the evaluation of differing repair patterns and their subsequent effects on postoperative clinical outcomes [36].

Clinical Presentation

Shoulder arthroscopy literature remains controversial, with conclusions often unsupported due to bias and limitations [1]. No definitive clinical guidelines exist for shoulder arthroscopy pending higher levels of evidence [1]. Suggested guidelines for arthroscopic surgery practice emphasize the need for appropriate training, privileges, and performance review by the Arthroscopy Association of North America [8].

Subtalar arthroscopy yields effective long-term outcomes in athletic populations, including favorable return to sport level and time [2]. Six out of ten patients with sinus tarsi syndrome returned to their pre-injury type of sport after subtalar arthroscopy [2].

Elbow arthroscopy is associated with complications and morbidity despite being a minimally invasive procedure [5]. Delayed subcutaneous emphysema following arthroscopy with a fluid medium is a rare presentation that must be recognized by orthopaedic surgeons [21].

Diagnostic arthroscopy is a useful diagnostic tool for periprosthetic shoulder infection (PPSI) in patients with suspicion but no clear evidence of the condition [11]. Needle-based diagnostic imaging used in the office setting is statistically equivalent to surgical diagnostic arthroscopy for diagnosing intra-articular, nonligamentous knee joint pathology [13]. Needle arthroscopy is a promising diagnostic modality for intra-articular shoulder pathologies with accuracy comparable to MRI [19]. Needle arthroscopy is a simple, safe, and well-tolerated technique for synovial biopsy of metacarpophalangeal joints, though arthroscopic experience is necessary [18].

Patients with rotator cuff tendinopathy undergoing arthroscopy should be informed that the presence and severity of glenohumeral cartilage lesions may be underestimated on noncontrast MRI [20]. 0.2-Tesla magnetic resonance imaging of internal knee joint lesions can be performed within 30–45 minutes at a lower cost than diagnostic arthroscopy [7].

The 70° arthroscope demonstrates technical advantages over the 30° arthroscope, including a wider field of view and less image distortion at the periphery [22]. Seven disturbances have been identified that serve as measures for arthroscopic image quality [4].

Arthroscopy provides direct visualization and accurate restoration of articular congruity in the treatment of trapezium fractures, yielding excellent results [9]. Osteoarthritis is likely the most common indication for basal joint (trapeziometacarpal) arthroscopy [25]. Chronic pain and inflammation are useful indications for metacarpophalangeal joint arthroscopy [25].

Investigations

Shoulder arthroscopy literature remains controversial, with conclusions often unsupported due to bias and limitations [1]. No definitive clinical guidelines exist for shoulder arthroscopy pending higher levels of evidence [1]. Diagnostic arthroscopy is a useful diagnostic tool for patients with suspected but unclear evidence of periprosthetic shoulder joint infection (PPSI) [11].

MRI: 0.2-Tesla magnetic resonance imaging of internal knee joint lesions can be performed within 30–45 minutes at a lower cost than diagnostic arthroscopy [7]. The presence and severity of glenohumeral cartilage lesions may be underestimated on noncontrast MRI in patients with rotator cuff tendinopathy undergoing arthroscopy [20]. Even the best preoperative imaging may not demonstrate the degree of local tissue involvement in invasive synovial chondromatosis of the metacarpophalangeal joint [57].

Arthroscopy: Needle-based diagnostic imaging used in the office setting is statistically equivalent to surgical diagnostic arthroscopy for diagnosing intra-articular, nonligamentous knee joint pathology [13]. Needle arthroscopy is a promising diagnostic modality for intra-articular shoulder pathologies with accuracy comparable to MRI [19]. Needle arthroscopy is a promising technology with advantages in minimally invasive access and good visibility of anatomical landmarks in the knee joint [71]. Subtalar arthroscopy yields effective long-term outcomes in athletic populations, including favorable return to sport level, return to sport time, clinical outcomes, and safety measures [2]. Six out of ten patients with sinus tarsi syndrome returned to their pre-injury type of sport after subtalar arthroscopy [2]. Arthroscopy provides direct visualization and accurate restoration of articular congruity for trapezium fractures, yielding excellent results [9].

Equipment and Image Quality: Seven disturbances have been identified that serve as measures for arthroscopic image quality [4]. The 70° arthroscope demonstrates technical advantages over the 30° arthroscope, including a wider field of view and less image distortion at the periphery [22]. Arthroscopic image distortion increases with greater lens reflecting angles and oblique viewing angles [69]. Surgeons should carefully select the arthroscope and portal to minimize image distortion and ensure accurate surgical procedure [68].

Other Considerations: There is an inherent small error of approximately 4% when arthroscopically determining anterior-inferior glenoid bone loss in the intact state [30]. Potential pitfalls and complications during hip arthroscopy, such as fluid extravasation, should be acknowledged prior to attempting the first case [12]. The journal Arthroscopy publishes clinically relevant research, while Arthroscopy Techniques focuses on surgical techniques [10].

Treatment

Non-Operative

Treatment options for hallux rigidus and osteoarthrosis of the first metatarsophalangeal joint range from non-operative measures to surgical procedures including cheilectomy, arthroplasty, and arthrodesis [76]. Selection of treatment for hallux rigidus depends on disease stage and patient factors [76].

Operative

Indications: Osteoarthritis is likely the most common indication for basal joint (trapeziometacarpal) arthroscopy [25]. Chronic pain and inflammation are useful indications for metacarpophalangeal arthroscopy [25]. Simultaneous bilateral hip arthroscopy is indicated for symptomatic, bilateral femoroacetabular impingement [33].

Surgical Approach / Technique: Arthroscopic treatment of talus bipartitus is a safe and effective option with excellent short- and long-term outcomes [6]. Arthroscopy provides direct visualization and accurate restoration of articular congruity in the treatment of trapezium fractures, yielding excellent results [9]. Arthroscopic abrasion arthroplasty is not superior to ligament reconstruction and tendon interposition for thumb carpometacarpal arthritis [15]. Poor results in arthroscopic abrasion arthroplasty for thumb carpometacarpal arthritis may be secondary to inherent joint instability and lack of biological or artificial interposition material [15]. Arthroscopic autologous osteochondral transplant (OAT) for capitellum osteochondritis dissecans provides encouraging mid-term outcomes and reduces procedural invasiveness [73]. Arthroscopic treatment is an easy and safe method for managing primary synovial chondromatosis of the shoulder, with no recurrence observed at 2-year follow-up [40]. Needle arthroscopy for synovial biopsy of metacarpophalangeal joints is a simple, safe, and well-tolerated technique requiring arthroscopic experience [18].

Adjuncts: Platelet-rich plasma (PRP) in arthroscopic repair for discoid lateral meniscus tears has a similar effect on pain relief and functional improvement to non-PRP groups at mid-term follow-up [74].

Pain Management: Intra-articular analgesia is safe and effective for arthroscopic knee surgery and arthroscopy-assisted anterior cruciate ligament reconstruction [37].

Setting of Care: Needle-based diagnostic imaging used in the office setting is statistically equivalent to surgical diagnostic arthroscopy for diagnosing intra-articular, nonligamentous knee joint pathology [13].

Other Considerations: Shoulder arthroscopy literature remains controversial, with conclusions often unsupported due to bias and limitations [1]. No definitive clinical guidelines exist for shoulder arthroscopy pending higher levels of evidence [1]. Suggested guidelines for arthroscopic surgery emphasize appropriate training, privileges, and performance review to ensure patient safety and surgeon competence [8]. Suggested guidelines for arthroscopic surgery cover practice standards and continuing education [26]. The expansion of arthroscopy has led to abuses driven by financial motives and lack of ethical standards [23]. Subtalar arthroscopy yields effective long-term outcomes in athletic populations, including favorable return to sport level, return to sport time, clinical outcomes, and safety measures [2]. Six out of ten patients with sinus tarsi syndrome returned to their pre-injury type of sport after subtalar arthroscopy [2]. Arthroscopic and open excision approaches for dorsal ganglion cysts have comparable outcome profiles regarding recurrence and complications [3]. Elbow arthroscopy is associated with complications and morbidity despite being a minimally invasive procedure [5]. Arthrodesis of the distal interphalangeal and thumb interphalangeal joints is indicated most commonly for osteoarthritis, with postoperative complication rates similar to existing literature [14]. Needle arthroscopy shows promise as a diagnostic, scientific, and possibly therapeutic tool in rheumatic diseases [18]. Osteochondral grafting of the metacarpophalangeal joint in rheumatoid arthritis results in stable, painless joints with acceptable outcomes despite some loss of motion [45]. Open surgery for paediatric trigger thumb results in more reliable and rapid outcomes compared with nonoperative treatment, based on low-level evidence [63]. Despite the low incidence of thromboembolic complications after simple arthroscopy, clinicians should reconsider thromboprophylaxis necessity and preoperative risk factor screening due to the life-threatening nature of these events [29]. Simultaneous bilateral hip arthroscopy for symptomatic, bilateral femoroacetabular impingement is a safe and effective treatment option with outcomes comparable to staged procedures [33]. Arthroscopy is as effective as arthrotomy in treating septic arthritis of the knee in adults [39]. Arthroscopy for septic arthritis of the knee demonstrates a lower reinfection rate and less frequent clinical signs of initial inflammatory reaction compared to arthrotomy [39]. Arthrotomy and arthroscopic surgery have similar efficacy in treating septic shoulders, with similar rates of reoperation, postoperative complications, and 30-day readmissions [24].

Complications

General Literature Quality: Shoulder arthroscopy literature remains controversial, with conclusions often unsupported due to bias and limitations [1]. No definitive clinical guidelines exist for shoulder arthroscopy pending higher levels of evidence [1]. The average quality of literature regarding age and outcomes in hip arthroscopy is only fair [31].

Thromboembolism: Thromboembolic complications, including deep vein thrombosis and pulmonary embolism, can occur after arthroscopic meniscus surgery [29]. The incidence of thromboembolic complications after simple arthroscopy surgery is low [29]. However, these complications after simple arthroscopy are life-threatening and devastating [29].

Infection: Arthrotomy and arthroscopic surgery for septic shoulders have similar rates of reoperation, other postoperative complications, and 30-day readmissions [24].

Joint-Specific Complications: Elbow arthroscopy is associated with complications and morbidity despite being a minimally invasive procedure [5]. Hip arthroscopy carries potential pitfalls and complications that must be recognized prior to attempting the first case [12]. Fluid extravasation is a specific complication/pitfall in hip arthroscopy [12]. Arthroscopic treatment of talus bipartitus is associated with excellent short- and long-term outcomes, indicating safety [6]. The severity of preoperative bone marrow oedema negatively influences short-term clinical outcomes following arthroscopic bone marrow stimulation for osteochondral lesions of the talus [62]. Arthroscopic resection of dorsal wrist ganglion is associated with specific recurrence and complication rates over a minimum follow-up of 4 years [28]. Arthroscopic and open approaches for dorsal ganglion cysts have comparable outcome profiles regarding recurrence and complications [3]. Arthrodesis of the distal interphalangeal and thumb interphalangeal joints has postoperative complication rates similar to those reported in existing literature [14]. Arthroscopic abrasion arthroplasty for thumb carpometacarpal arthritis yields poor results, potentially secondary to inherent instability of the CMC joint and lack of biological or artificial interposition material [15].

Other Considerations: It remains difficult to determine if age 40 is a definitive cutoff for successful outcomes in hip arthroscopy due to complex interactions of multiple patient factors [31]. There is an inherent small error of approximately 4% when arthroscopically determining bone loss in the intact state [30]. Seven disturbances were identified that serve as measures for arthroscopic image quality [4].

Recovery

Light activity (weeks): Evidence does not specify a week range for light activity or desk work in the provided data.

Full activity (months): Subtalar arthroscopy yields favorable return to sport time in the athletic population [2]. Six out of ten patients with sinus tarsi syndrome returned to their pre-injury type of sport after subtalar arthroscopy [2]. Ankle arthroscopy for osteoid osteoma excision allows for an early return to full activity [78].

Complete recovery / outcome plateau (months): Arthroscopic treatment of talus bipartitus allows for excellent short- and long-term outcomes [6]. A patient with a locked knee caused by an intraarticular ganglion remained asymptomatic with a full range of motion for 10 months postoperatively [79].

Rehabilitation protocol: The provided evidence does not specify physical therapy phasing, immobilisation duration, or weight-bearing progression.

Functional milestones: Arthroscopic treatment of talus bipartitus allows for excellent short- and long-term outcomes [6]. A patient with a locked knee caused by an intraarticular ganglion remained asymptomatic with a full range of motion for 10 months postoperatively [79].

Other Considerations: Six out of ten patients with sinus tarsi syndrome returned to their pre-injury type of sport after subtalar arthroscopy [2]. Subtalar arthroscopy yields favorable return to sport time in the athletic population [2]. Ankle arthroscopy for osteoid osteoma excision allows for an early return to full activity [78].

Key Evidence

  • [L5] The editorial states that shoulder arthroscopy literature remains controversial, conclusions are often unsupported due to bias and limitations, and no clinical guidelines are definitive pending higher levels of evidence. (10.1016/j.arthro.2012.07.001)
  • [L4] Subtalar arthroscopy yields effective outcomes at long-term follow-up concerning patient-reported outcome measures in athletic population, with favorable return to sport level, return to sport time, clinical outcomes and safety outcome measures. (10.1007/s00167-020-06385-8)
  • [L2] Arthroscopic and open approaches have comparable outcome profiles regarding recurrence and complications. (10.1177/1753193417734428)
  • [L4] Seven disturbances were identified that serve as measures for arthroscopic image quality. (10.1007/s00167-007-0299-7)
  • [L3] Elbow arthroscopy is not without complications and morbidity despite being a minimally invasive procedure and advances made in surgical technique. (10.1177/17585732241249393)
  • [L4] Arthroscopic treatment can be a safe and effective option with excellent short- and long-term outcomes. (10.1007/s00167-017-4613-8)
  • [L2] The examination can be performed within 30–45 min at lower cost than diagnostic arthroscopy. (10.1007/s001670050118)
  • [L5] This statement outlines suggested guidelines for the practice of arthroscopic surgery, emphasizing the need for appropriate training, privileges, and performance review by the Arthroscopy Association of North America. (10.1016/s0749-8063(14)00453-8)
  • [L4] Arthroscopy provides direct visualization and accurate restoration of articular congruity, yielding excellent results. (10.1016/j.arthro.2006.07.051)
  • [L5] The editors state that Arthroscopy and Arthroscopy Techniques are complementary, with the former publishing clinically relevant research and the latter focusing on surgical techniques. (10.1016/j.arthro.2015.05.001)
  • [L3] Diagnostic arthroscopy is a useful diagnostic tool in patients with suspicion but no clear evidence of PPSI. (10.1016/j.arthro.2019.03.058)
  • [L5] Full recognition of the potential pitfalls and complications during hip arthroscopy should be acknowledged prior to attempting the first case. (10.1016/j.arthro.2017.01.052)
  • [L2] Needle-based diagnostic imaging that can be used in the office setting is statistically equivalent to surgical diagnostic arthroscopy with regard to the diagnosis of intra-articular, nonligamentous knee joint pathology. (10.1016/j.arthro.2018.03.010)
  • [L3] Osteoarthritis was the most common indication for arthrodesis and postoperative complications occurred at a rate similar to that reported in the existing literature. (10.1186/s12891-024-07361-w)
  • [L3] The poor results in the arthroscopy group may be secondary to the inherent instability of the CMC joint and lack of use of any biological or artificial interposition material. (10.1177/1558944718778405)
  • [L4] The needle arthroscopy is a simple, safe, and well tolerated technique, with promise as a diagnostic, scientific, and possibly therapeutic tool in rheumatic diseases, but arthroscopic experience is necessary for this procedure. (10.1007/s00167-002-0329-4)
  • [L2] Needle arthroscopy is a promising diagnostic modality for intra-articular shoulder pathologies with comparable accuracy to MRI. (10.1016/j.arthro.2021.03.006)
  • [L1] Patients with rotator cuff tendinopathy undergoing arthroscopy should be informed that the presence and severity of cartilage lesions may be underestimated on MRI. (10.1016/j.jse.2014.01.048)
  • [Case_report] This rare presentation of delayed subcutaneous emphysema following arthroscopy with a fluid medium must be recognised by all orthopaedic surgeons practising arthroscopic surgery. (10.1007/s00167-001-0264-9)
  • [L5] The 70° arthroscope demonstrates technical advantages over the 30° arthroscope, including a wider field of view and less image distortion at the periphery. (10.1007/s00167-014-3452-0)
  • [L5] The paper argues that while arthroscopy has grown rapidly and offers significant benefits through minimally invasive techniques, its expansion has led to abuses driven by financial motives and lack of ethical standards. (10.2106/00004623-199274100-00019)
  • [L3] Arthrotomy and arthroscopic surgery have similar efficacy in treating septic shoulders, as demonstrated by similar rates of reoperation, other postoperative complications, and 30-day readmissions. (10.1016/j.arthro.2019.02.036)
  • [L5] Osteoarthritis will likely remain the most common indication for basal joint arthroscopy while chronic pain and inflammation are useful indications for metacarpophalangeal arthroscopy. (10.1016/j.jhsa.2007.02.020)
  • [L5] This statement outlines suggested guidelines for the practice of arthroscopic surgery, covering privileges, training, practice standards, continuing education, and performance review to ensure patient safety and surgeon competence. (10.1016/s0749-8063(14)00850-0)
  • [L4] The outcomes, recurrence, and complications rates after 4 years of follow-up presented in this study support the use of arthroscopy as a treatment for dorsal wrist ganglion. (10.1177/1558944717743601)
  • [L4] Despite the low incidence of thromboembolic complications after simple arthroscopy surgery, its life-threatening and devastating property make clinicians rethink the necessity of thromboprophylaxis and importance of preoperative relative risk factors screening. (10.1186/s12891-017-1919-0)
  • [L5] As shown in the intact state, there is an inherent small error of approximately 4% when arthroscopically determining bone loss. (10.1016/j.arthro.2009.05.019)
  • [L5] The editorial commentary notes that while hip arthroscopy use is growing, the average quality of literature regarding age and outcomes is only fair, and it remains difficult to determine if age 40 is a definitive cutoff for successful outcomes due to the complex interaction of multiple patient factors. (10.1016/j.arthro.2016.12.002)
  • [L3] Simultaneous bilateral hip arthroscopy for FAI is a safe and effective treatment option with outcomes comparable to staged procedures. (10.1016/j.arthro.2016.03.065)
  • [L4] The ROCK OCD Knee arthroscopy classification system demonstrated high reliability. (10.1177/2325967113s00074)
  • [L4] This classification system allows for the ability to evaluate differing repair patterns and their effects on postoperative clinical outcomes. (10.1177/2325967125s00101)
  • [L1] Intra-articular analgesia is safe and effective for arthroscopic knee surgery. (10.1007/s001670050051)
  • [L4] The pulley system of the thumb is composed of 4 components, as opposed to the traditional view of only 3. (10.1016/j.jhsa.2012.08.005)
  • [L1] Arthroscopy is as effective as arthrotomy in the treatment of septic arthritis of the knee in adults, but arthroscopy has demonstrated a lower reinfection rate and less frequent clinical signs of initial inflammatory reaction. (10.1007/s00167-015-3918-8)
  • [L4] Arthroscopic treatment is an easy and safe method for management of primary synovial chondromatosis of the shoulder, with no recurrence observed at 2-year follow-up. (10.1007/s00167-004-0608-3)
  • [L4] The procedure resulted in stable, painless joints with acceptable outcomes despite some loss of motion. (10.1054/jhsb.2002.0839)
  • [L4] Hence, we suggest the Copeland-Levy classification be used to standardize terminology of the subacromial impingement lesion. (10.1016/j.jse.2017.07.018)
  • [L4] Arthroscopic excision is the treatment of choice and is currently thought to be curative. (10.1016/j.arthro.2005.12.035)
  • [L5] This statement outlines suggested guidelines for the practice of arthroscopic surgery, covering privileges, training, practice standards, continuing education, and performance review to ensure patient safety and surgeon competence. (10.1016/s0749-8063(11)00686-4)
  • [L5] This statement outlines suggested guidelines for the practice of arthroscopic surgery, covering privileges, training, practice standards, continuing education, and performance review to ensure patient safety and surgeon competence. (10.1016/s0749-8063(13)01336-4)
  • [L4] Synovial chondromatosis can be invasive, and even the best preoperative imaging may not demonstrate the degree of local tissue involvement. (10.1054/jhsb.2001.0677)
  • [L5] Articular surface loss of the metacarpal head following RHCS insertion is negligible in a cadaveric model, with minimal engagement between the corresponding defect and the P1 base during functional ROM. (10.1016/j.jhsa.2022.05.010)
  • [L3] The severity of the preoperative bone marrow oedema negatively affected short‐term clinical outcomes following arthroscopic BMS for OLTs. (10.1002/ksa.12355)
  • [L4] Based on the low level of evidence available, it seems that open surgery resulted in more reliable and rapid outcomes compared with nonoperative treatment. (10.1177/1753193414523245)
  • [L5] In this cadaveric model, repair of both slips of the FDS outside the A2 pulley improved the gliding coefficient relative to repair within the A2 pulley, which suggests decreased resistance to finger flexion. (10.1016/j.jhsa.2014.12.045)
  • [L5] Surgeons should carefully select the arthroscope and portal to minimize image distortion and ensure accurate surgical procedure. (10.1007/s00167-014-3268-y)
  • [L5] Arthroscopic images are subject to distortion that increases with greater lens reflecting angles and oblique viewing angles. (10.1007/s00167-014-3336-3)
  • [L4] Needle arthroscopy is a promising technology with advantages in terms of minimally invasive access and good visibility of anatomical landmarks. (10.1186/s12891-024-07346-9)
  • [L4] Despite being more demanding, the arthroscopic approach is a valuable tool if the surgeon aims to reduce the invasiveness of the procedure. (10.1007/s00167-019-05568-2)
  • [L3] PRP group had similar effect in pain relief and functional improvement to non-PRP group at mid-term follow-up. (10.1186/s12891-019-2500-9)
  • [L5] Treatment options range from non-operative measures to various surgical procedures including cheilectomy, arthroplasty, and arthrodesis, with selection depending on disease stage and patient factors. (10.2106/00004623-199806000-00015)
  • [L4] Ankle arthroscopy has little morbidity, permits exact localization and complete excision of the nidus, and allows treatment of accompanying synovitis with an early return to full activity. (10.1007/s00167-003-0413-4)
  • [L4] The patient remained asymptomatic with a full range of motion for 10 months postoperatively. (10.1007/s00167-005-0017-2)

See Also

References

[1] Shoulder Arthroscopy Literature Remains Controversial. Arthroscopy. 2012. DOI: 10.1016/j.arthro.2012.07.001

[2] Six out of ten patients with sinus tarsi syndrome returned to pre‐injury type of sport after subtalar arthroscopy. Knee Surgery, Sports Traumatology, Arthroscopy. 2020. DOI: 10.1007/s00167-020-06385-8

[3] Arthroscopic versus open excision of dorsal ganglion cysts: a systematic review. Journal of Hand Surgery (European Volume). 2017. DOI: 10.1177/1753193417734428

[4] Disturbances in the arthroscopic view defined with video analysis. Knee Surgery, Sports Traumatology, Arthroscopy. 2007. DOI: 10.1007/s00167-007-0299-7

[5] 30-Day complications, operative time, and overnight admission following elective elbow arthroscopy. Shoulder & Elbow. 2024. DOI: 10.1177/17585732241249393

[6] Talus bipartitus: a systematic review and report of two cases with arthroscopic treatment. Knee Surgery, Sports Traumatology, Arthroscopy. 2017. DOI: 10.1007/s00167-017-4613-8

[7] 0.2‐Tesla magnetic resonance imaging of internal lesions of the knee joint: a prospective arthroscopically controlled clinical study. Knee Surgery, Sports Traumatology, Arthroscopy. 1999. DOI: 10.1007/s001670050118

[8] Suggested Guidelines for the Practice of Arthroscopic Surgery. Arthroscopy. 2014. DOI: 10.1016/s0749-8063(14)00453-8

[9] Arthroscopy in the Treatment of Fracture of the Trapezium. Arthroscopy. 2007. DOI: 10.1016/j.arthro.2006.07.051

[10] Our Journals Arthroscopy and Arthroscopy Techniques Are Complementary. Arthroscopy. 2015. DOI: 10.1016/j.arthro.2015.05.001

[11] Diagnostic Arthroscopy for Detection of Periprosthetic Infection in Painful Shoulder Arthroplasty. Arthroscopy. 2019. DOI: 10.1016/j.arthro.2019.03.058

[12] Editorial Commentary: Fluid Extravasation in Hip Arthroscopy—A Tough Case Just Got Much Worse. Arthroscopy. 2017. DOI: 10.1016/j.arthro.2017.01.052

[13] A Prospective, Blinded, Multicenter Clinical Trial to Compare the Efficacy, Accuracy, and Safety of In‐Office Diagnostic Arthroscopy With Magnetic Resonance Imaging and Surgical Diagnostic Arthroscopy. Arthroscopy. 2018. DOI: 10.1016/j.arthro.2018.03.010

[14] Arthrodesis of distal interphalangeal and thumb interphalangeal joint: a retrospective cohort study of 149 cases. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07361-w

[15] Arthroscopic Abrasion Arthroplasty Is Not Superior to Ligament Reconstruction and Tendon Interposition for Thumb Carpometacarpal Arthritis. HAND. 2018. DOI: 10.1177/1558944718778405

[18] Technique of synovial biopsy of metacarpophalangeal joints using the needle arthroscope. Knee Surgery, Sports Traumatology, Arthroscopy. 2002. DOI: 10.1007/s00167-002-0329-4

[19] Needle Diagnostic Arthroscopy and Magnetic Resonance Imaging of the Shoulder Have Comparable Accuracy With Surgical Arthroscopy: A Prospective Clinical Trial. Arthroscopy. 2021. DOI: 10.1016/j.arthro.2021.03.006

[20] Diagnostic accuracy of noncontrast MRI for detection of glenohumeral cartilage lesions: a prospective comparison to arthroscopy. Journal of Shoulder and Elbow Surgery. 2014. DOI: 10.1016/j.jse.2014.01.048

[21] Extensive subcutaneous emphysema following arthroscopy: a case report. Knee Surgery, Sports Traumatology, Arthroscopy. 2002. DOI: 10.1007/s00167-001-0264-9

[22] Comparative analysis of visual field and image distortion in 30° and 70° arthroscopes. Knee Surgery, Sports Traumatology, Arthroscopy. 2014. DOI: 10.1007/s00167-014-3452-0

[23] Uses and abuses of arthroscopy. The Journal of Bone & Joint Surgery. 1992. DOI: 10.2106/00004623-199274100-00019

[24] Surgical Treatment of Septic Shoulders: A Comparison Between Arthrotomy and Arthroscopy. Arthroscopy. 2019. DOI: 10.1016/j.arthro.2019.02.036

[25] Arthroscopy of the Trapeziometacarpal and Metacarpophalangeal Joints. The Journal of Hand Surgery. 2007. DOI: 10.1016/j.jhsa.2007.02.020

[26] Suggested Guidelines for the Practice of Arthroscopic Surgery. Arthroscopy. 2014. DOI: 10.1016/s0749-8063(14)00850-0

[28] Arthroscopic Resection of Dorsal Wrist Ganglion: Results and Rate of Recurrence Over a Minimum Follow-up of 4 Years. HAND. 2017. DOI: 10.1177/1558944717743601

[29] An unusual case of symptomatic deep vein thrombosis and pulmonary embolism after arthroscopic meniscus surgery. BMC Musculoskeletal Disorders. 2018. DOI: 10.1186/s12891-017-1919-0

[30] A New Arthroscopic Technique to Determine Anterior‐Inferior Glenoid Bone Loss: Validation of the Secant Chord Theory in a Cadaveric Model. Arthroscopy. 2009. DOI: 10.1016/j.arthro.2009.05.019

[31] Editorial Commentary: 40 the New 30? Maybe Not for the Hip. Arthroscopy. 2017. DOI: 10.1016/j.arthro.2016.12.002

[33] A Comparison of Staged vs Simultaneous Hip Arthroscopy for Selected Patients With Symptomatic, Bilateral Femoroacetabular Impingement. Arthroscopy. 2016. DOI: 10.1016/j.arthro.2016.03.065

[34] Reliability of the ROCK Osteochondritis Dissecans Knee Arthroscopy Classification System - Multi-center Validation Study. Orthopaedic Journal of Sports Medicine. 2013. DOI: 10.1177/2325967113s00074

[35] Chapter 29 Hand/Carpal Fractures and Dislocations. 2021.

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