arthroscopy

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arthroscopy

[är′thrä·skə·pē]
(medicine)
Visual examination of the interior of a joint by means of an arthroscope.
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The researchers identified considerable practice variation in the national distribution of surgeons by the proportion of knee arthroscopies that they performed that were APM-only procedures.
(63) reported on risk factors for revision surgery or conversion to THA after hip arthroscopy in 3,957 patients and found that patients undergoing hip arthroscopy by a surgeon performing less than 40 hip arthroscopies annually were at higher risk for revision or conversion to total hip arthroplasty.
This resulted in considerable decline in diagnostic arthroscopy procedures by 54%, where- as therapeutic arthroscopies increased by 27%.12 The use of MRI to establish or confirm a diagnosis of meniscal tear has become a routine practice, and the accuracy of this imaging modality for diagnosing meniscal tears has been extensively reported in the literature.13 In our study medial meniscus tears were more common (36.7%) than lateral meniscus.
The theory of labrum tear due to psoas impingement as a distinct entity was originally suggested by surgeons during revision arthroscopies. (12) Leaving the more medial labrum tear or non-arthroplasty psoas impingment lesion untreated could be a potential source of continuing hip pain and failed initial hip arthroscopy.
[6-10] Although experienced surgeon can determine the presence of meniscal and ligament injuries through physical examination, MRI is recommended to avoid unrequired arthroscopies which results from false positive physical tests, especially in presence of multiple injuries.
Symptomatic pulmonary embolism after outpatient arthroscopic procedures of the knee: the incidence and risk factors in 418,323 arthroscopies. J Bone Joint Surg Br.
All hip arthroscopies were performed by one of four surgeons (T.Y., R.M., S.B., and R.D.) on one of two standard hip traction tables (HANA, Mizuho OSI, Union City, CA, Smith and Nephew, Memphis, TN).
Many arthroscopies which may not be required will be performed if every HRUS report is taken at face value.
Philippon and coworkers (15) performed second-look arthroscopies on nine acetabular chondral lesions that were microfractured and noted a 91% fill rate at 20 months.
If MRI is used as the pre-operative screening tool for internal derangement of knee, then there may be significant reduction in unnecessary diagnostic arthroscopies. In a study done by Imhoff et al, (5) the negative predictive value for meniscal tears was 94% and the positive predictive value was 54%.
(5) The only published criteria addressing competence is that of the German Speaking Association of Arthroscopy, which requires 50 diagnostic arthroscopies, 120 partial meniscectomies, and 80 ACL reconstructions to become an instructor.