Office-Based Needle Arthroscopy: A Standardized Diagnostic Approach to the Knee

McMillan, Sean; Saini, Sundeep; Alyea, Eric; Ford, Elizabeth

doi:10.1016/j.eats.2017.03.031

Cited by 38 publications

(51 citation statements)

References 6 publications

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“…The calibration pattern was imaged using 30˚ arthroscope through AM, AL and TT portal at seven different angles (30˚, 50˚, 70˚, 90˚, 110˚ and 130˚) of knee position. We used the 30˚ arthroscopy who is the most used nowadays [13]. The distances for seven selected dots in fifth row and fifth column Open Access Library Journal in deep and shallow region of calibration pattern and corresponding dot in vertical and horizontal direction were measured.…”

Section: Methodsmentioning

confidence: 99%

Radial Distortion of the Arthroscopic Transtibial Portal: A 2-Dimensional in Vitro Model

Vranješ¹,

Cvejić²,

Todorović³

et al. 2020

OALib

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Purpose: To make the positioning of the anterior cruciate ligament (ACL) transplants as precise as possible, it is necessary to better visualize the footprint. Identifying anatomic sites is complicated by image distortion inherent in arthroscopy. The standard "Outside-In" ACL reconstruction technique involves drilling a tunnel, i.e. an aperture on the surface of the tibia for the purpose of placing the bone-tendon-bone transplant. This operative technique opens another approach to the inside of the knee, through the tibial plateau (Transtibial-TT). The aim of this manuscript is to assess optimal arthroscopic visibility by calculating radial distortion, arthroscopy insertion positions and different knee bending angles. Methods: We used a standard dot array calibration pattern, an arthroscopic imaging system and Sawbones® knee models. The standard deviation and relative standard deviation of distances obtained at distortion of the images were calculated. Results: All captured imagines have shown the effect of distortion so called fish-eye view, i.e. the imagines at periphery were more curved and compressed. Conclusion: The least distorted arthroscopic image of the femoral ACL footprint can be obtained when using the TT portal and by bending the knee between 90˚ and 130˚ with a 30˚ arthroscope. Also, the best visualization is performed by drilling the tibia under the angle 0˚ in the sagittal plane and 23˚ in the coronal plane in comparison to the tibial surface.

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Section: Methodsmentioning

confidence: 99%

Radial Distortion of the Arthroscopic Transtibial Portal: A 2-Dimensional in Vitro Model

Vranješ¹,

Cvejić²,

Todorović³

et al. 2020

OALib

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“…Erste klinische Daten von 30 Patienten deuten auf eine einfache Anwendung und valide Ergebnisse im Rahmen der präoperativen Diagnostik einer PPI der Hüfte hin [46]. Bei der "office-based-needle"-Arthroskopie handelt es sich um eine Technik, bei der ein kleinlumiges Arthroskop mit Mikrokamera die Durchführung der arthroskopischen Probenentnahme in einem normalen Untersuchungsraum unter Lokalanästhesie ermöglicht [47]. Zwar wird bei dieser Methode keine operative Infrastruktur benötigt, jedoch ist eine apparative Ausrüstung in Form eines speziellen Arthroskops erforderlich.…”

Section: Gezielte Probengewinnungunclassified

Guided and Unguided Biopsy in the Diagnostic of Periprosthetic Infections of the Knee – Evaluation of an Evidence-based Algorithm

et al. 2019

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Background Periprosthetic joint infection (PPI) is one of the most common reasons for revision in total knee arthroplasty (TKA). Percutaneous synovial biopsy is considered as a well-established diagnostic tool in ambiguous cases of chronic pain after TKA. The exact number of undetected low-grade infections remains unclear. Objectives The aim of this prospective study was to compare the diagnostic accuracy of arthroscopically guided and unguided synovial biopsy. Additionally, the prevalence of initially undetected PPI during synovial biopsy and revision surgery was assessed. Materials and Methods 40 patients suffering from chronic pain after TKA and the clinical suspicion of PPI were included in the study. Synovial biopsies were collected in a standardized manner first without and then with arthroscopic visual control. Using both techniques, six samples were collected each (5 for microbiology, 1 for histology). 19 patients, initially classified aseptic, underwent revision surgery later. Results The diagnosis of PPI was made in 10.0% of unguided biopsies (4 cases, 2× microbiologically, 2× histologically), 7.5% of arthroscopic biopsies (3 cases, 3× histologically) and 12.5% (5 cases, 3× histologically, 2× microbiologically) of all cases. Only histologic evaluation led to concordant positive findings using both techniques in two patients. The proportion of non-representative biopsies was twice as high after unguided tissue collection than after arthroscopic biopsy (30.0 vs. 15.0%). Microbiologic evaluation of arthroscopically collected biopsies did not lead to the diagnosis of PPI, which might have been essential to the selection of the appropriate antimicrobial therapy. During revision surgery the diagnosis of PPI was made in 22.2% of cases. Conclusions In patients suffering from chronic pain after TKA, periprosthetic low-grade infection was diagnosed in a relevant proportion of cases. Therefore, synovial biopsies for histological and microbiological evaluation should be collected whenever thereʼs clinical suspicion of PPI. For histological evaluation, samples should be collected using arthroscopic control and ideally multiple biopsies should be taken. For microbiological evaluation, excessive joint lavage should be avoided.

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“…The procedure is performed by using a high definition camera attached to a 0° to 10° angle semirigid arthroscope of 1.2‐mm diameter (18‐gauge needle equivalent) and 65‐ or 100‐mm length that connects to a tablet screen. Benefits compared with conventional arthroscopy include the portability of the equipment, the ability to perform the procedure with the horse standing, and the minimal morbidity because of the small‐diameter arthroscopic portal, ultimately reducing recovery time . Previous descriptions of needle arthroscopy performed in horses have been limited to the stifle joint and the navicular bursa .…”

Section: Introductionmentioning

confidence: 99%

“…Previous descriptions of needle arthroscopy performed in horses have been limited to the stifle joint and the navicular bursa . The technique is increasingly used in humans undergoing minimally invasive orthopedic procedures and has the potential to be useful in all routine equine arthroscopic procedures.…”

Section: Introductionmentioning

confidence: 99%

“…Benefits compared with conventional arthroscopy include the portability of the equipment, the ability to perform the procedure with the horse standing, and the minimal morbidity because of the small-diameter arthroscopic portal, ultimately reducing recovery time. [12][13][14] Previous descriptions of needle arthroscopy performed in horses have been limited to the stifle joint and the navicular bursa. 11,15 The technique is increasingly used in humans undergoing minimally invasive orthopedic procedures [12][13][14] and has the potential to be useful in all routine equine arthroscopic procedures.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the caudal cervical articular process joints by using a needle arthroscope in standing horses

et al. 2020

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Objective To determine the safety and efficacy of caudal cervical articular process joint arthroscopy by using needle arthroscopy in standing sedated horses. Study design Prospective experimental case series. Animals Six adult horses. Methods Three horses underwent exploration of bilateral C5‐6 vertebral articular process joints and three bilateral C6‐7 articular process joints by using a 1.2 × 65‐mm needle arthroscope under standing sedation. The 16‐gauge arthroscopic trocar and canula assembly was inserted in the desired articular process joint under ultrasonographic guidance without distention of the joint. Results All 12 articular process joints were successfully explored. Entering the joint on the first attempt was achieved in 10 of 12 joints. A craniodorsal approach for arthroscope insertion allowed evaluation of the most cranial aspect of the articular cartilage surface. Triangulation with a spinal needle was determined to be difficult and resulted in a limited space for movement. Conclusion Needle arthroscopy of the caudal cervical facet joints was performed safely and efficiently in standing sedated horses. Clinical significance Standing cervical articular process needle arthroscopy is a minimal morbidity technique with the potential to be an advantageous technique for the diagnosis and treatment of cervical articular process pathology.

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Office-Based Needle Arthroscopy: A Standardized Diagnostic Approach to the Knee

Cited by 38 publications

References 6 publications

Radial Distortion of the Arthroscopic Transtibial Portal: A 2-Dimensional in Vitro Model

Radial Distortion of the Arthroscopic Transtibial Portal: A 2-Dimensional in Vitro Model

Guided and Unguided Biopsy in the Diagnostic of Periprosthetic Infections of the Knee – Evaluation of an Evidence-based Algorithm

Evaluation of the caudal cervical articular process joints by using a needle arthroscope in standing horses

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