.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.gif)
.jpg)
The Future is Here
Keywords:
arthroscopy, keen ArthrexAbstract
We live in an amazing world at amazing times as we are in the evolutionary stages of Orthobiologics. Now we are increasingly looking for biological solutions of biological problems and the best news is that it has gone from science fiction to a very real entity. Similarly access to investigations for previously impossible tasks have become a reality. Imagine a scenario when one is playing sports and hurts his shoulder and we would like to investigate him after a thorough clinical assessment. We would like to order a Magnetic Resonance Imaging (MRI) to exclude soft tissue injuries and we run into a well as the patient is claustrophobic, has a pacemaker or is overweight or has metal inside his body.1,2 Although clinical examination and MRI play a key role in diagnosis, sometimes interpretation can be unclear or even wrong.3,4 Nothing is more accurate than direct visualization, particularly when we have to determine if the patient need surgery.5,6With forward thinking and innovation technology there is now a real solution Office -Based Needle Arthroscopy.7 It is a small Gadget that will make a Big Difference to the clinical practice.8 (Fig IA, IB, IC, ID)
Clinic or of?ce based arthroscopy is by no means a new idea but it has previously failed to become widely used. This is probably due the dif?culties in transferring the type of required equipments (which closely mirrored that used in operating theatres) to the clinic environment.
References
Murphy KJ, Brunberg JA. Adult claustrophobia, anxiety and sedation in MRI. Magn Reson Imaging. 1997;15(1):51-4.
Wollman DE, Beeri MS, Weinberger M, Cheng H, Silverman JM, Prohovnik I. Tolerance of MRI procedures by the oldest old. Magn Reson Imaging. 2004;22(9):1299-304.
Behairy NH, Dorgham MA, Khaled SA. Accuracy of routine magnetic resonance imaging in meniscal and ligamentous injuries of the knee: comparison with arthroscopy. Int Orthop. 2009;33(4):961-7.
Chambers, S, Jones, M, Michla, Y, Kader, D. The accuracy of magnetic resonance imaging in detecting meniscal pathology. Orthop Proc. 2012;94-B(suppl XXIX):61-67.
El-Liethy, N, Kamal, H, Elsayed, RF. Role of conventional MRI and MR arthrography in evaluating shoulder joint capsulolabral-ligamentous injuries in athletic versus non-athletic population. Egypt J Radiol Nucl Med. 2016;47(3):969-984.
Gramas DA, Antounian FS, Peterfy CG, Genant HK, Lane NE. Assessment of needle arthroscopy, standard arthroscopy, physical examination, and magnetic resonance imaging in knee pain: A pilot study. J Clin Rheumatol. 1995;1(1):26-34.
Szachnowski P, Wei N, Arnold WJ, Cohen LM. Complications of of?ce based arthroscopy of the knee. J Rheumatol. 1995;22(9):1722-1725.
Baeten D, Van den bosch F, Elewaut D, Stuer A, Veys EM, De keyser F. Needle arthroscopy of the knee with synovial biopsy sampling: technical experience in 150 patients. Clin Rheumatol. 1999;18(6):434-41.
Voigt JD, Mosier M, Huber B. Diagnostic needle arthroscopy and the economics of improved diagnostic accuracy. 2014;12(5):523-535.
Kreuz PC, Steinwachs M, Angele P. Single-dose local anesthetics exhibit a type-, dose-, and time-dependent chondrotoxic effect on chondrocytes and cartilage: A systematic review of the current literature. Knee Surg Sports Traumatol Arthrosc. 2018;26(3):819-830.
McMillan S, Chhabra A, Hassebrock JD, Ford E, Amin NH. Risks and complications associated with intra-articular arthroscopy of the knee and shoulder in an office setting Orthop J Sports Med. 2019;322-329.
Crawford R, Walley G, Bridgman S, Maffulli N. Magnetic resonance imaging versus arthroscopy in the diagnosis of knee pathology, concentrating on meniscal lesions and ACL tears: A systematic review. British Medical Bulletin. 2007;84(1):5-23.
Bert JM, Bert TM. Management of infections after arthroscopy. Sports Med Arthrosc Rev. 2013; 21(2):75-9.
Gill TJ, Safran M, Mandelbaum B, Huber B, Gambardella R, Xerogeanes J. A Prospective, Blinded, Multicenter Clinical Trial to Compare the Efficacy, Accuracy, and Safety of In-Office Diagnostic Arthroscopy With Magnetic Resonance Imaging and Surgical Diagnostic Arthroscopy. Arthroscopy. 2018;34(8):2429-2435.
Halbrecht JL, Jackson DW. Office arthroscopy: A diagnostic alternative. Arthroscopy. 1992;8(3):320-6.
