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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

Loose Body

Loose Body

28 yr old

TBW patella -3 yrs back

C/O locking & instability episodes

Foreign body removal

Foreign body removal

Foreign Body Removal

Foreign Body Removal

Foreign Body Removal

Post-op

20 yr old male

Pain, effusion, locking sensation- Rt. Knee

Inability to fully extend knee

Problem

Diagnostic Arthroscopy

Post Compartment

Biopsy

Loose body

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

Visit www.delhiarthroscopy.com

Thank You

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

Synovium

Synovium