ARTHROSCOPY IN DIAGNOSTICS OF GONARTHROSIS

Abstract

Aim: Analysis of arthroscopy importance of knee joints for characteristics of stage of cartilage destruction and synovitis in gonarthrosis cases. Material and methods: Arthroscopical study included 24 gonarthrosis pts (I-III degree by A.Larsen) by "STORZ ” apparatus with photoinstrumental set. Six basic zones of knee joint were analyzed: patella, trochlear are, a lateral and medial articular tibial and femoral surfaces. Criteria of assessment included presence and distribution of cartilage damage according to 5 degrees: normal cartilage (0), fibrillar cartilage (I degree), surface fissures and/or surface erosions (2 degree), deep cartilage tissures and/or erosions baring subchondral bone (3 degree), baring subchondral bone (4 degree). Synovitis intensity was analyzed by three degrees: low, moderate or high. Results: It was determined that in different zones of knee joint the character and depth of cartilage destruction is not the same. In 100% of patients with gonarthrosis independently of radiological stage there were changes in patellar cartilage. Pathology' of articular cartilage in the area of lateral condyle of the femur in the lateral and medial areas of the tibia was found in the I-st, Il-nd and Ill-d stages with the same incidence. Development of fissures of cartilage was found in all gonarthrosis stages and even in the 1-st stage the incidence was the same as in the 111-d disease degree. Erosions were found in more than a half of pts with the I-st and Il- nd stages of gonarthrosis (57% and 67% correspondingly). Even in the I-st gonarthrosis stage in all areas of knee joint excluding lateral articular surface of the tibia changes characteristic for the Ill-d degree of cartilage destruction were found with different frequency. Incidence of subclinical synovitis according to arthroscopy data in the /, 11, III radiological stages of gonarthrosis was 57%, 33.5% and 100% correspondingly. Fissures and erosions were found in all pts with expressed synovitis. Conclusion: In our study no correlation was found between the stage of cartilage destruction (according to arthroscopy data) and early (1 and 11) radiological gonarthrosis stages: Ill-d stage of gonarthrosis is corresponding with the Ill-d stage of cartilage destruction.