關節鏡技術在風濕科醫師的應用

Arthroscopy for Rheumatologists

Arthroscopy has been widely used in orthopedic surgery as a less invasive treatment for more than twenty years. Minor intra -articular operations, such as synovectomy, menisectomy, meniscal repair, chondroplasty, acromioplasty etc. have been largely modified into this close procedure. Arthroscopy has also played an important role for even more complex knee surgeries, such as ACL reconstruction, PCL reconstruction, and proximal realignment. For rheumatologists, arthropathy has usually been investigated by blood chemistry, synovial fluid analysis and X -ray examination. Visual identification of the intra -articular pathology was difficult to access. Subtle changes in synovium, cartilage, or menisci, could be easily missed in clinical practice. With the help of arthroscopy, minor changes in intra-articular soft tissue architecture can be clearly seen under scope and viewed as a guideline for medication adjustment. Also tissue proof for various drug effects will be more easily established by arthroscopic biopsy. In up-dated rheumatology, arthroscopy should be more widely used for clinical practice and study.