Through the use of a newly developed needle arthroscope, incisionless and single-incision surgical procedures are possible for repairing certain types of knee and shoulder injuries, suggests a series of Marshall University studies published in Arthroscopy Techniques, a companion to Arthroscopy: The Journal of Arthroscopic and Related Surgery.
Arthroscopy is a procedure used to diagnose and treat joint problems through the use of an arthroscope, a narrow tube with a fiber-optic camera attached. A surgeon inserts this tube through a small incision to gather images and determine next steps. Repairs can sometimes be made during the procedure.
Similar to traditional arthroscopes, the NanoScope needle arthroscopy system, developed by Arthrex, is both diagnostic and therapeutic. In the Arthroscopy Techniques articles, Chad D. Lavender, M.D., lead author and assistant professor of orthopaedic surgery at the Marshall University Joan C. Edwards School of Medicine, and his team used the NanoScope to perform three types of repair procedures. Two procedures were in the shoulder—a single-incision rotator cuff and a single-incision anterior labrum repair—and one was in the knee—an incisionless partial medial meniscectomy.
When compared to traditional arthroscopies, key differences were found. The 1.9 mm NanoScope may allow for fewer to no incisions, possibly result in decreased loss of and need for fluid, less swelling and pain and decreased risk of wound infection. However, viewing angles were found to be more limited, meaning the use of a traditional arthroscope may be needed during certain procedures.
“We have yet to fully realize the full potential of the NanoScope as its small size and function make it a prime candidate for other procedures,” Lavender said. “Future studies will explore these possibilities.”
To date, Lavender and his team have successfully completed more than 15 NanoScope procedures. Patients have reported less pain as well as earlier recovery and return to function.
Additional team members include Dana Lycans, M.D., assistant professor of orthopaedic surgery at the school of medicine, and orthopaedic residents Syed Ali Sina Adil, M.D., Galen Berdis, M.D., Adam Kopiec, M.D., Ardalan Sayan, M.D. and Thomas Schmicker, M.D.
For questions about the procedure or to schedule a consultation, call Marshall Orthopaedics in Teays Valley at 304-691-6710.
To read the articles in their entirety, please visit:
- Nanoscopic Single-Incision Anterior Labrum Repair: https://doi.org/10.1016/j.eats.2019.10.010
- Incisionless Partial Medial Meniscectomy: https://doi.org/10.1016/j.eats.2019.11.003
- Single-Incision Rotator Cuff Repair With a Needle Arthroscope: https://doi.org/10.1016/j.eats.2019.11.012
Photos: (Above) Dr. Chad Lavender holds the NanoScope and regular arthroscope side by side to show how they vary in size. (Below) Due to the small size of a nanoscopic procedure incision, patients will often experience less scarring, as shown by this patient, who underwent labrum repair surgery.