Arthroscopic Knee Synovectomy
Suitable for synovectomy, rheumatoid arthritis, degenerative arthritis, and tumor or tumor-like diseases, such as villonodular synovitis, chondromatosis, and the like. Conventional surgical resection of the synovial membrane, often incomplete resection, long hospital stay, postoperative joint function may be limited. Arthroscopic surgery can completely remove the synovial membrane, and the additional damage to the surrounding tissue is small, the hospital stay is short, and the postoperative knee joint function is rarely restricted. Even if there is recurrence after surgery, secondary surgery is still feasible. The synovial membrane can be completely removed by 6 ways of the knee joint. Curing disease: Indication Arthroscopic knee synovectomy for rheumatoid arthritis, psoriatic arthritis, reiter syndrome, pigmented villonodular synovitis, osteochondroma disease, chronic synovitis and other synovial inflammation The joint pain is swollen for more than half a year, and non-surgical treatment is invalid. Contraindications Joint space has been significantly narrowed, bone destruction is more, and joint activity has been significantly restricted. Preoperative preparation X-ray films of the knee before surgery. Surgical procedure 1. The external approach was placed into the arthroscopy, and the synovial tissue of the superior and inferior sulcus was removed with a pituitary forceps or an electric planer. The two synovial membranes are rich in tissue, and the synovial membrane on the top and side walls of the supraorbital sac is very thin. The method of biting the forceps with the pituitary is to avulsion the synovial tissue after biting the synovial tissue, which is often more effective than an electric planer. 2. The synovial tissue at the edge of the femoral condyle, humerus and intercondylar cartilage must be removed, and the synovial tissue near the joint line can be removed through the anterior and anterior approach. 3. The posterior capsule rupture of the posterior capsule is 90°, and the anterior medial approach leads to the posterolateral joint space through the intercondylar recess. Under the observation of 70° arthroscopy, a long needle was inserted through the posterior lateral approach into the posterior joint cavity. Pull out the needle and insert the No. 15 blade to enlarge the incision, then insert the planer, rotate the arthroscope, see the planer head, and cut the synovial membrane of the joint capsule. The same method is used to cut the synovium of the medial joint space. Place a negative pressure drainage and pressurize the knee. 4. If conditions permit, the radiofrequency knife can be used for synovial membrane cleaning and hemostasis, which can greatly reduce the intra-articular fluid accumulation during and after surgery, without having to place negative pressure drainage. complication Intra-articular hematoma. Pay attention to keep the negative pressure drainage tube unobstructed and postoperative pressure bandage to prevent intra-articular hematoma.
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