By Hans-Rudolf Henche Dr. med., Jörg Holder Dr. med. (auth.)
Rapid advancements during this profitable diagnostic and operative approach have known as for a brand new variation of Arthroscopy of the Knee Joint. This moment variation has been thoroughly revised and keeps little or no fabric from the 1st variation. The diagnostic part has been significantly accelerated and elucidated and the operative part tailored to trendy know-how. the 1st a part of the booklet offers the exterior stipulations and pre-requisites for diagnostic arthroscopy. The endoscopic anatomy and pathology of the knee joint are coated intimately. specific emphasis is put on useful tricks for actual arthroscopic approaches. the second one half then discusses operative options. The reader discovers step by step how and which pathological findings may still, within the author's opinion, be taken care of. right here, too, the issues and attainable issues of arthroscopic surgical procedure suitable to the person suggestions are handled intimately. built with this e-book, the reader should be completely knowledgeable on all present arthroscopic equipment and possibilities.
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Extra info for Arthroscopy of the Knee Joint: Diagnosis and Operative Techniques
Detectable and may lead the surgeon, especially if inexperienced in arthroscopy, to diagnose severe cartilage damage (Figs. 3032). Hence the maxim of the experienced: "The knee joint distended with fluid appears more diseased than it really is. " The insertion of a small hook under water greatly helps to clarify the picture and suspected ruptures or partial ruptures of the cruciate ligaments can be assessed more realistically. Fig. 30. Image of a minimal cartilage defect at the back of the patella using a fluid medium Fig.
Penetration of the joint capsule by the trocar point is clearly felt, but on no account must the pointed trocar be allowed to penetrate the joint completely. Should this nevertheless occur, the surgeon will often detect a minor injury at the attachment of the posterior cruciate ligament to the inner aspect of the medial femoral condyle. Aiming in this direction will in any case prevent damage to the articular cartilage. Once the surgeon feels that the joint capsule has been pierced, the pointed trocar is exchanged for the blunt one.
The cable to the camera must be carried across the patient to the surgeon's side, most suitably by a suspension-pulley system. The camera itself and at least 1 meter of the camera cable towards the monitor are enclosed in sterile wrapping. This wrapping also surrounds the eyepiece of the arthroscope, so no nonsterile part of the equipment becomes involved during arthroscopy using a video camera. With the surgeon viewing directly through the arthroscope, the black portion (eyepiece) must be regarded as nonsterile.