Loose Body Removal, Treatment, Surgery

The best treatment and surgery for the removal of a loose body is decided based on a few important factors, including age, current and past health, the extent of the loose body to be removed, the location of the loose body and any history with other medications and treatments. Loose body removal is done following sports or work injuries that cause small fragments of bone or cartilage to break free and float through the body, catching or locking in the joints.

Loose Body Removal Diagnosis

If a person requires the removal of a loose body, that body can create a feeling of locking in a person’s joint, making it difficult to move or fully extend the joint because of the loose particles. If you have any reason to think you may have a loose body in one of your joints, or have had multiple injuries in the same area, it is important to seek medical attention. To diagnose your condition, your doctor will ask questions regarding your past and current health, as well as perform a physical exam. To determine if you need any procedures for the removal of a loose body, the following exams will be performed:

  • X-Ray (Radiograph) – This is typically the first test performed when looking for a loose body. An X-ray is done by sending radiation through the affected joint. The bone then absorbs the radiation, which allows it to appear in a black-and-white image. Because the majority of the particles that break free have some bone or cartilage in them, they can be seen using this imaging technique fairly clearly.
     
  • Computed Tomography Scan (CT or CAT scan) – A CAT scan combines X-ray and computer technology to deliver an enhanced image of the bone in the affected joint. This test provides a higher-definition image, allowing for more detail to be seen. 
     
  • Magnetic Resonance Imaging (MRI) – An MRI, unlike a CAT scan or X-ray, does not use radiation. Instead, you will be placed inside a vessel with electromagnetic radio waves. These waves cause vibrations, which create a resonance that can be turned into a high-definition image. This test allows the doctor to see particles that do not contain any bone and would not show up on the other imaging tests.
     
  • Arthrography – On some occasions, arthrography may be used to see the joint in better detail. This test is performed by injecting a dye into the affected area and taking an X-ray. The dye then shows up as a contrast in the soft tissue and cartilage in the area, which creates a more detailed image. CAT scans and MRIs have taken the place of this technology for imaging in some areas of the body, but this test is still used in smaller joints, such as the wrist.
     

Nonsurgical Treatment for Loose Body Removal

In most instances, removal of a loose body must be done surgically. However, for less severe cases, some people are able to use physiotherapy and anti-inflammatory painkillers to help with symptoms and to keep the joint flexible and mobile. When a loose body is treated non-surgically, it is important to continue being aware of your symptoms and follow up with your doctor regularly so the condition does not worsen.

Surgery for Loose Body Removal

In most cases, removal of a loose body requires surgery. The aim of loose body removal surgeries is to remove the cartilage or bone that has broken free during injuries, causing the joints to be less mobile and stiffer. The majority of loose body removal procedures are done using one of the following techniques:

  • Arthroscopy – This has become the surgery of choice for many doctors. This surgery requires only a very small incision, and so is minimally invasive, leading to fewer complications. A camera is placed through the incision to allow the doctor to see the area he or she is working with. The loose body is then removed through a suction cup that is placed inside the body through another small incision.
     
  • Arthrotomy – For large loose bodies that cannot be removed via arthroscopy, a more extensive surgery may be needed. Instances of this are rare. This procedure uses a larger incision to get a better image inside the joint and allows the doctor to remove the loose body more easily.
     

Loose Body Removal Research

Many instances of loose body removal are required because of degenerative diseases, such as osteoarthritis. These diseases are oftentimes found in people who use one or more of their joints an extraordinary amount, such as athletes or people whose jobs require extensive lifting, particularly overhead.

Research is now focused on supplements to help prevent these degenerative diseases from occurring or to slow their progression, allowing for better results from non-surgical techniques. The glucosamine supplement in particular is of interest because it is generated naturally in the fluids surrounding the joints. Therefore, it makes sense that taking supplements of this natural substance could help reduce the effects of osteoarthritis and ease pain in the joints.

Studies have shown mixed results in this regard. While many osteoarthritis sufferers have noticed significant pain relief in their joints when taking this supplement, some have not. This is likely due to the extent of the osteoarthritis. Because of this, research continues to try to determine its effectiveness and when and who should consider taking this supplement to prevent degeneration of the joints and formation of loose bodies.

As research on glucosamine and other supplements is ongoing, it is a good idea for your conversation about it with your doctor to be ongoing as well.            

The multidisciplinary team of orthopaedic experts at North Shore-LIJ Orthopaedic Institute's Trauma Services in New York performs loose body removal surgery as well as a broad range of nonsurgical and surgical treatments for conditions that affect the bones. 

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