Chirurgia mini-invasiva articolare ed extra-articolare assistita dall’endoscopia.


COD: 329-334 Categorie: ,

Francesco Sadile, Fabrizio Cigala, Antonio Lambiase, Luca Maddaluno, Mario Cigala

Ann. Ital. Chir., 2006; 77: 329-333

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The minimally invasive and arthroscopically assisted surgery is a new therapeutic resource in the surgical treatment of
degenerative and prosthetic orthopaedic pathology; in the field of neoplastic one it is just dawning. In this work the AA.
report the technique and results of the arthroscopically assisted percutaneous arthrodesis of the ankle and of the arthroscopically
assisted percutaneous curettage of epiphyseal chondroblastoma (E.C.) and osteoid osteoma (O.O.) of skeleton.
From 1992 to 2002 they treated 12 selected cases: 4 affected by E.C., 3 located at proximal tibia and 1 at proximal
humerus, in patients aged from 13 to 16 years and evaluated at a follow-up ranging from 7 to 3 years, with a 75%
of good results; 4 affected by osteoid osteoma of proximal femur (2) and tibia (2), in patients aged from 13 to 18
years, evaluated at a follow-up ranging from 12 to 3 years with very good results (75%); 4 cases of ankle’ painful stiffness,
with 1 case of severe weightbearing instability, in patients aged from 17 to 75 years, evaluated at final bone fusion,
radiographically observed at a average of 3.2-month follow-up from operation. All cases were treated by MIS criteria
under accurate radiographic and CT-3D pre-operative planning, endoscopic (trans-osseous tunnels) and/or arthroscopic
(ankle arthrodesis) continuous assistance under fluoroscopy. Two cases received cortico-cancellous bone autografts. All neoplastic
cases had histologic confirmation by excision biopsy. They report 2 cases of failure, 1 in the E.C. series (25%)
and 1 among the O.O. (25%), respectively at 6 and 12 months from the operation. In conclusion the authors report
good results in 75% of cases together with very good aestheticism, well accepted by patients, and with articular function
not minimally altered by the technique.


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