As noted earlier arthroscopy is not a substitute for sound clinical judgment. Surgical intervention is proscribed for joint conditions amenable to medical management, such as the arthralgias associated with hepatitis or colitis. Similarly, hip pain referred from other sources precludes surgery, such as compression fracture of L1. (See Chapters 2 and 4.)
Certain joint conditions, in the absence of mechanical symptoms, do not warrant arthroscopy. These include os-teonecrosis and synovitis.
Acute skin lesions or ulceration, especially in the vicinity of anterior or lateral portals, would proscribe arthroscopy. In addition, sepsis with accompanying osteomyelitis or abscess formation requires open surgery.
Morbid obesity is a relative contraindication for arthros-copy, not only because of distraction limitations but also because of the requisite length of the instruments necessary to access and maneuver within the deeply receded joint. Finally, advanced osteoarthritis is, in the author's opinion, a contraindication for arthroscopy, as noted earlier.
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