Loose Body Arthroscopy By Dr. Shekhar Srivastav
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Transcript of Loose Body Arthroscopy By Dr. Shekhar Srivastav
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Loose bodies- Arthroscopic Removal
DR SHEKHAR SRIVASTAV
Consultant- Knee & Shoulder Surgery
Sant Parmanand Hospital, Delhi
Free loose bodies- single or multiple
Fixed loose bodies
Presentation-
-Intermittent catching & Pain
-Recurrent effusion
-Limitation of motion
-Feeling of instability
Loose bodies
Loose Bodies Causes- -Degenerative
chondral/osteophytes -Osteochondral fragment-
traumatic -Meniscal fragment -Fibrosed synovial villi -Broken implants/instruments -Bone cement residue
Diagnosis - Clinical - X-rays if calcified or metal - MRI
Management Dignostic arthroscopy
commonly located in supra-patellar pouch, ant. Intercondylar area, poster-medial & posterolateral recess, Gutters, beneath meniscus
Reduce inflow to decrease turbulence
Percutaneously fix with needles
Make appropriate portal
Remove under vision
Loose bodies
Loose bodies in knees can present as Pain , Locking Sensation, Instability or Loss of Extension
Diagnostic Arthroscopy to look into every corner
Localise & Fix the Loose Bodies
Determine accurate portal placement with the help of a needle
Must follow loose body going out of the joint
Take Home Message
Synovial Chondromatosis Knee ,Shoulder ,Ankle
Male more affected than females
Metaplasia of synovial villi into cartilage
Treatment-
arthroscopic removal of loose bodies,partial synovectomy
Diagnosis