Arthroscopy

Definition

Disruption of the normal smooth motion of the scapulothoracic joint

- posterior scapula pain with overhead motion

Etiology

1.  Bony abnormalities

- osteochondromas

- prominence of the superior medial border of the scapula / Luschka tubercle

2.  Soft tissue abnormalities

- bursitis / scar tissue

- muscular weakness

3.  Masses

Location

Krudwig et al KSSTA 2004

- 85 intra-articular ganglions

- 49 ACL, 16 PCL

- 12 from anterior horn meniscus, 3 posterior horn meniscus

- 3 from fat pad

Cruciate ligament ganglion

Technique

Surgical technique PDF using trans-septal portal

Medial femoral condyle

Technique

Arthroscope in lateral portal

Clear fat pad

Ensure can see entire dimensions of OCD

If fragment is displaced, reduce and pin with accessory K wire

Indications

Engaging Hill Sachs

Clinically

Unwell / irritable

Fever

Not feeding

Unable to weight bear / limp

Knee pain

Examination

Fever

Limited / painful ROM

Hip held flexed and externally rotated

- maximises volume of capsule

Lab tests

WCC > 12 000

ESR > 40

CRP > 10

Blood cultures

Definition

Present with pain but not instability

Types

Traumatic

Degenerative

Different treatment algorithms for each

History

Ulna side wrist pain

- may be worse with rotation

- opening doors and jars

History of trauma

Examination

Local tenderness DRUJ

Definition

Pigmented Villo-Nodular Synovitis

- benign inflammatory process that arises in synovial tissues

- contains significant amounts of hemosiderin

Epidemiology

Age: 20 - 50

Sex: M > F

Types

A.  Diffuse

- throughout joint synovium

- more difficult to treat / excise fully