{"id":13769,"date":"2023-10-26T09:58:44","date_gmt":"2023-10-26T09:58:44","guid":{"rendered":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/?p=13769"},"modified":"2023-10-26T09:58:47","modified_gmt":"2023-10-26T09:58:47","slug":"llr-policy-for-hip-arthroscopy","status":"publish","type":"post","link":"https:\/\/leicesterleicestershireandrutland.icb.nhs.uk\/ro\/llr-policy-for-hip-arthroscopy\/","title":{"rendered":"Politica LLR pentru artroscopia \u0219oldului"},"content":{"rendered":"

<\/p>\n\n\n\n

Categoria<\/strong><\/p>\n\n\n\n

Criterii de prag<\/p>\n\n\n\n

Artroscopia de \u0219old este o tehnic\u0103 care permite inspec\u021bia interiorului \u0219oldului. Instrumentul folosit este un tip de endoscop, care este un instrument \u00een form\u0103 de tub introdus \u00eentr-o cavitate a corpului pentru a investiga \u0219i trata tulbur\u0103rile. Este flexibil si dotat cu lentile si sursa de lumina. Este o procedur\u0103 dificil\u0103 din punct de vedere tehnic, care ar trebui efectuat\u0103 numai \u00een unit\u0103\u021bi specializate de echipe cu preg\u0103tire specific\u0103 \u00een tehnici.<\/p>\n\n\n\n

Eligibilitate<\/strong><\/p>\n\n\n\n

LLR ICB va finan\u021ba aceast\u0103 procedur\u0103 dac\u0103 sunt \u00eendeplinite urm\u0103toarele criterii<\/strong>
Impingement femoro-acetabular (FAI)<\/strong>

\u00b7 Diagnosticul FAI definit prin investiga\u021bii adecvate \u2013 radiografii, RMN \u0219i CT

\u00b7 Un chirurg ortoped care este specializat \u00een chirurgia \u0219oldului tinerilor a pus diagnosticul. Aceasta ar trebui s\u0103 includ\u0103 discu\u021bii cu un specialist radiolog musculo-scheletic.

\u00b7 Simptome severe tipice de FAI cu o durat\u0103 de cel pu\u021bin 6 luni \u00een care diagnosticul de FAI a fost pus ca mai sus

\u00b7 E\u0219ecul de a r\u0103spunde la toate op\u021biunile de tratament conservator disponibile, inclusiv modificarea activit\u0103\u021bii, interven\u021bia farmacologic\u0103 \u0219i kinetoterapie de specialitate

\u00b7 Func\u021bie compromis\u0103 care necesit\u0103 tratament urgent \u00een intervalul de timp de 6-8 luni sau \u00een care e\u0219ecul de a trata precoce este probabil s\u0103 compromit\u0103 semnificativ op\u021biunile chirurgicale la o dat\u0103 viitoare.

\u00b7 Tratamentul cu proceduri chirurgicale mai consacrate nu este viabil din punct de vedere clinic
\u00a0<\/strong>

Sepsisul articula\u021biei \u0219oldului<\/strong>

Artroscopia de \u0219old este sus\u021binut\u0103 \u00een eliminarea unei articula\u021bii de \u0219old infectate la urm\u0103torii pacien\u021bi:

\u00b7 Pacien\u021bi care nu au r\u0103spuns la managementul medical
\u00b7 Pacien\u021bi cu boal\u0103 de baz\u0103
\u00b7 Pacien\u021bi care sunt imunodeprima\u021bi

Corpuri libere<\/strong>
Artroscopia de \u0219old este sus\u021binut\u0103 pentru \u00eendep\u0103rtarea corpurilor libere dovedite radiologic din articula\u021bia \u0219oldului cu un episod traumatic acut asociat. Artroscopia nu este acceptat\u0103 ca instrument de diagnostic \u00een cazul \u00een care exist\u0103 suspiciunea de corpuri libere.

Excizia\/repararea rupturii labrale dovedite radiologic \u00een absen\u021ba osteoartritei (OA) sau a sindromului de impingement femoro-acetabular:<\/strong>

Artroscopia de \u0219old este sus\u021binut\u0103 pentru excizia rupturii labrale dovedite radiologic asociate cu un episod traumatic acut \u00een absen\u021ba sindromului OA sau FAI
<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

<\/p>\n\n\n\n

LLR ICB NU va finan\u021ba artroscopia de \u0219old la pacien\u021bii cu impact femoro-acetabular dac\u0103 se aplic\u0103 oricare dintre urm\u0103toarele:<\/strong>

\u00b7 Pacientul are modific\u0103ri osteoartritice avansate la radiografie preoperatorie (gradul Tonnis 2 sau mai mult) sau leziuni ale cartilajului serverului (gradul III sau IV Outerbridge)

\u00b7 Pacientul are un spa\u021biu articular pe radiografia simpl\u0103 a pelvisului, care este mai mic\u0103 de 2 mm l\u0103\u021bime oriunde de-a lungul sursului

\u00b7 Pacientul este candidat pentru protec\u021bia \u0219oldului

\u00b7 Pacient cu displazie sever\u0103 de \u0219old sau cu o clasificare Crowe de 4

\u00b7 Pacient cu laxitate articular\u0103 generalizat\u0103 \u00een special \u00een boli legate de hipermobilitatea articula\u021biilor, cum ar fi sindromul Marfins \u0219i sindromul Ehlers-Danlos

\u00b7 Pacient cu osteogenez\u0103 imperfect\u0103<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n
Data revizuirii ARP 54: 2026<\/td><\/tr><\/tbody><\/table><\/figure>","protected":false},"excerpt":{"rendered":"

Category Threshold Criteria Hip arthroscopy is a technique which allows for the inspection of the interior of the hip. 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