At the present stage of development, medical science offers a number of effective diagnostic methods for studying large joints. One of them is arthroscopy.
Arthroscopy is carried out both for the purpose of diagnosis and treatment. The method is invasive, that is, it is an operative intervention with a violation of the integrity of tissues. With a minimal shoulder injury, you can look inside the joint and visually see everything that happens.
Arthroscopy of the shoulder joint helps:
- to clarify the diagnosis;
- take the material for the study;
- to resolve the issue of the need and method of operation;
- determine the exact location of the pathological focus.
Indications and contraindications
Frequent injuries of the shoulder joint are due to its anatomical features. The shoulder produces a large volume of movements with a relatively small area of contact between the head of the shoulder and the joint surface.
Indications for primary arthroscopy are:
- habitual dislocation or subluxation of the shoulder;
- disease and damage to the synovium;
- damage to tendons;
- shoulder cuff rupture;
- joint surface damage;
- subacromenal bursitis;
- limitation of mobility;
- posttraumatic arthrosis;
- chondromatosis( the presence of intraarticular bodies).
Repeated arthroscopy is indicated when new clinical signs of the disease appear and when the disease recurs.
- acute and chronic shoulder joint infections;
- contraindications to anesthesia;
- pustular lesions of the skin in the joint region;
- reduction of the joint cavity;
- bone and fibular ankylosis.
Diagnosis and treatment do not require complicated preliminary training. The patient should visit a doctor-orthopedist and anesthesiologist in advance. If there are results from other methods of examination of the shoulder joint, they should be carried. You will also have to pass tests for HIV infection, the presence of hepatitis B and C, syphilis. In addition, you need a biochemical blood test, a fresh ECG with a decoding, a coagulogram.
Course of operation
Operation on the shoulder is usually performed under general mask or endotracheal anesthesia. The following tools are used:
- arthroscope - metal rigid tube with lens system;
- trocar - a tool that pierces the fabric;
- cannula for the supply and discharge of fluid to and from the joint;
- arthroscopic probe - a metal rod with marks for spreading the joint tissues.
Moment of stitching of the shoulder tissues in arthroscopy
During arthroscopic surgery on the shoulder joint, the surgeon should gain free access to the joint. The most optimal position of the patient is selected.
Classical posture. The patient usually lies on a healthy side. The sore arm is upward and slightly out of the way through the block system.
Axis traverse along two axes .The patient's hand is fixed in two places. At an angle of 90 degrees to the axis of the shoulder through the block with a load of 2 - 3 kg and for the limb with a load of 1 kg.
Position of the "beach" armchair or chaise longue .The patient is sitting half-sitting, bending forward. The joint hangs over the edge of the table.
Position "chaise lounge" in front of arthroscopy
The operating area is disinfected and labeled. The location of the individual parts of the joint and the place where the instruments are inserted are noted. A puncture needle punctures the joint cavity. When the synovial fluid expires, 50-60 ml of physiological solution( 0.9% sodium chloride solution) is injected into the joint.
A small incision of 5 mm is made at the access point. Through it, using the trocar, the arthroscope case is inserted. Troakar is retracted and replaced by an arthroscope with an optical camera. Through another incision, a plastic cannula is inserted for subsequent removal of the liquid. Through the cannula, the necessary tools are delivered to the joint. The further course of the examination and the choice of tactics of treatment are determined by the surgeon.
Manipulation in the arthroscopic joint area available for review on the
computer monitor. Advantages of the
method. The arthroscopy of the shoulder joint( and other joints) in the world is recognized as the best method of diagnosis and treatment. Positive aspects are:
- short stay in the hospital( 1, maximum 4 days);
- rapid examination - 30 - 60 minutes;
- reliable accurate diagnosis;
- minimally invasive - minor tissue damage;
- shortened rehabilitation period.
Arthroscopy is not an emergency method of treatment, it is not carried out for life indications. Arthroscopy on the shoulder joint can significantly alleviate the condition of the patient. The terms of remission for chronic diseases are extended. A special method of therapy makes it possible to eliminate the cause of habitual dislocations. After treatment, permanent pain disappears, mobility of the shoulder is restored.
Arthroscopic surgery on the shoulder joint
After arthroscopy of complications, not too much. You can say they are reduced to zero. But sometimes they arise during the operation and after it. There are superficial hematomas, swelling or swelling of the tissues of the shoulder. Some time remains painful in the joint area. All the symptoms pass fairly quickly and do not require special treatment.
Deep vein damage is extremely rare. In a number of cases, there is local inflammation, neurological complications, articular cartilage damage.
The first seven days after the operation of arthroscopy on the shoulder joint, it is advisable not to remove the bandage to create a joint rest. To avoid infection of the wound wound, the health worker should do it. Rehabilitation is accompanied by the following manipulations:
- with the preventive purpose of injecting antibiotics;
- if necessary, prescribe pain medication;
- on the joint area put the cold;
- shoulder is fixed first time bandage, later you can use different devices;
- LFK is shown from the first day until complete recovery;
- physical activity is reduced for a period of 4 to 6 months.
Arm position during rehabilitation
If you follow all the doctor's recommendations, recovery after diagnosis or treatment will go without complications and result in complete recovery.
Cost of operation
The total cost of the operation consists of:
- the number of days in hospital;
- cost of disposable materials;
- method of anesthesia;
- of the actual operation;
- the cost of medicines;
- power supply, care and stuff.
The cost of diagnostic arthroscopy, depending on the complexity of the procedure, ranges from 3 100 to 63 000 rubles. Prices for different types of treatment also vary greatly between 40 000 - 87 000 rubles. Treatment and diagnostic examination is done free of charge by quota.
Arthroscopy is a unique informative method of research and an effective way of treating joints with minimal tissue trauma. It restores the functional mobility of the organ and returns the person to a healthy healthy life.
- What is the use of
- Indications and contraindications
- Preparation of
- Procedure of
- Advantages of method
- Complications of
- Recovery of
- Cost of operation