Fuß & Sprunggelenk

Hochfrequenzablation

Die von Arthrex angebotene CoolCut-Produktlinie für Bildgebung und Resektion umfasst das CoolCut-Hochfrequenz-Ablationssystem und die Hochfrequenz-Ablationsprodukte der Serie&nbsp;9700.

Foot and Ankle

Product

Die Apollo&lt;sup&gt;RF&lt;/sup&gt; SJ50 Sonde ist die erste optimierte Sonde mit Absaugung, die für enge Gelenkräume wie Fuß, Sprunggelenk, Ellenbogen, Knie und Nano-Arthroskopie entwickelt wurde.
<ul>
 <li>360°-Kantenkontrolle für präzises Debridement; entwickelt, um die Auswirkungen auf das angrenzende Gewebe zu minimieren</li>
 <li>Die anatomisch geformte 50°-Spitze ermöglicht einen besseren Zugang zu engen Gelenksbereichen</li>
 <li>Reduzierte Länge und Durchmesser der Sonde sind 17&nbsp;% kleiner als beim Apollo&lt;sup&gt;RF&lt;/sup&gt; MP50-Design</li>
 <li>Niedrige Grundeinstellung der Ablationsenergie zur reduzierten Energieabgabe</li>
 <li>Optimierte Absaugung zur Entfernung von Gewebepartikeln und Erhaltung der optimalen Flüssigkeitstemperatur1</li>
</ul>
 
Literatur
1. Arthrex, Inc., Archivdaten (APT05034). Naples, FL; 2020.

Imaging and Resection

Kaitlin Neary, MD (Boise, ID), demonstrates how to prepare the ankle joint for arthroscopic procedures using the ApolloRF® SJ50 probe.

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Human

SpeedPearl: Arthroscopic Debridement of the Ankle Using the ApolloRF® SJ50 Probe

The Apollo Sf50 probe is an essential device in my practice for ankle arthroscopy due to its precision in debriding, the joint allowing for optimal visualization and precise ablation. Visualization can sometimes be a challenge in the confined working area of the ankle joint. A key pearl when using the Apollo sf50 probe is to utilize its contained plasma field, particularly when debriding the anterior compartment. The controlled plasma edge feature on the 3.3mm electrode is designed to minimize the potential for impact to the neurovascular structures at the anterior aspect of the ankle, such as the anterior tibial artery and deep peroneal nerve. Its optimized aspiration and precise ablation allow for targeted removal of synovitis and scar tissue without excessive tissue disruption. This precision enhances surgical efficiency, providing a clear operative field while preserving vital structures essential for ankle function and recovery.

This animation highlights various features and clinical applications of the ApolloRF® SJ50 probe, the first probe for foot and ankle arthroscopy with optimized fluid management for debris and bubble control.

ApolloRF® SJ50 Probe

Carl T. Hasselman, MD (Pittsburgh, PA), demonstrates the effectiveness of the ApolloRF® SJ50 probe in various ankle procedures. Dr. Hasselman highlights the probe’s benefits, including low default settings, optimized aspiration, and 50° curvature.

ApolloRF® SJ50 Probe in Ankle Arthroscopy

Hi, I'm Doctor Carl Hausmann. I'm from the University of Pittsburgh in Pittsburgh, Pennsylvania. What we're going to do is we're going to go over ankle arthroscopy with the use of the Arthrex S-50 Apollo probe. So I put my curve, the tip of my probe, 90 degrees into the joint. And then I lift my hand and it just goes in very quickly and easily. And that keeps you from struggling with the probe. Because once the probe is in, it will do the work for you. It also has hand control. So you'll have blue, which is just like on most instruments. It's going to be your coagulation and you're going to have yellow which will be kind of your cut and rapid cut. It comes with factory settings. I can tell you right now, 98% of the time the factory settings are more than enough to accomplish everything I need to do. But the nice thing is, is you can actually increase or decrease the intensities from the factory setting on the probes. With this probe at the factory setting, it really takes a matter of a second, and you can get a lot of this tissue out of the way. The neat thing about this is you'll notice it has the suction, so that if I do get an air bubble or two, it quite quickly alleviates them. And that's what I like about this probe more than the others. And so the nice thing is this thing is keeping the area cool while I'm doing my ablation of that area. Most probes, as they're straight when they come in, that's what you're going to get. So you're going to actually have to take your hand and bend your probe. And most of the probes are too stiff. So you end up using a pair of pliers or something to bend it. Then you ruin the sheath on the probe. You end up throwing them away. This probe has that hook so you literally can come in. And then when you rotate it, actually look at that. It matches the shape of the talus. So it is designed to let you go back all the way to the back of the ankle. And you can see I am literally basically almost at Subtalar joint. I'm so far back in the ankle. In fact, there's the posterior tibiofibular ligament. And you can see this probe can get all the way down to the posterior part of the ankle. So if you're trying to get an Ars trigonum out arthroscopically, I am literally right where the eyes would sit. So you could actually do your complete synovectomy with this probe and you can get all the way back. The other beauty is that two things of this probe, it actually has a 360 degree cutting edge on it, which is quite nice because you can actually use the edges just as much as the surface to do ablation. So one of the things you can watch is if for some reason you wanted to take down one of the ligaments in the back, I can literally put it in there and I can actually just hit and you can see that it's starting to actually cut using the edge of the probe. And you can see how I'm already starting. I'll go in close. You can see how the edge is literally cutting the ligament for me. But at the same time, if I didn't want to cut the ligament, say it was just hypertrophied and thick and frayed. I can also use my COAG. And if you watch when I see these frayed edges, I can literally just use my COAG and it will just get rid of the frayed edges. So it's basically getting rid of those frayed edges without really damaging the fibers, because you can see the see the fibers are still not hurting or not being damaged. They're staying perfectly nice. Now, for example, in arthritis, a lot of times we all see this shag carpet appearance and you want to get rid of this, but you can literally take this probe, putting it on COAG and just kind of come in and clean those areas up and see how I can just nicely get rid of that shag carpeting by kind of just mowing along it. But if you look down at the cartilage, you'll notice that I really haven't damaged the cartilage in any way. My probe is now between the anterior capsule of the ankle and the anterior edge of the tibia. And very commonly, we want to get rid of all the synovitis if we're doing an anterior colectomy. And so the beauty of this probe is you can actually get right up in that area. And then with my probe on cut, I can literally clean this whole area up. The one thing I have found is that a lot of times I'll give it a second breath after about 5 or 6 seconds, I'll like take a one second just to let the aspiration get rid of any warm fluid. And that way I can keep the whole joint space nice and Nice and cool. So I'm at the anteromedial gutter of the ankle. There's going to be some fibers of the anterior deltoid that I can clean out. But you can see, I can rapidly clean out all of the tissue in the anteromedial ankle. And the other nice thing about the probe is when I'm in here with this probe is because it's hooked. One of the other things I can actually use is use the hook to my benefit. So I can actually come in, and I can hook that tissue and pull it away from the cartilage surface. And once I have it pulled away from the cartilage surface, then I can hit my cut and I can actually cut the tissue. And that way I'm really staying away from my articular area so the hook actually can use it as an advantage, just like a nerve hook to get rid of this tissue. If you're getting nervous that you're getting a little too close. Now, what I could do is if I wanted to get rid of this, I could literally use my probe because of that hook, and I could breed all the tissue around it quite quickly. The nice thing is, I can respect that cutting of the 360 cutting. You'll notice how I'm literally taking off this tissue right around it, and not a single bit of damage to the lateral wall or the medial wall of the talus. And so I can ablate this. And I can also use the hook action to pull it away in a blade. And you can actually see how I've completely loosened this. So the neat thing is, is I've done a complete using the Sf50 probe. And now I'm just going to use one of the Arthrex Graspers. And I can come in and literally grab that piece. And the thing is I can pull it out. And now there's just a small piece left. And I'm not going to belabor the point, but you can see how easily I did that. But the really neat thing is with that probe is I just put this in and I'll pull the tissue back and we'll look. You do not see any damage. We did a complete synovectomy and Dyneema of the medial gutter. And there's not a single burn mark, not a scuff mark, not a single mark on that talus showing you that the probe didn't hurt the articular cartilage in any way, shape or form. And that's really neat about this because you literally just took out all that synovitis, and there's just a small piece of that medial malleolus left. This person has a cartilage lesion and it's an anterior lateral OCD, which is not uncommon. So a lot of times after we've done our microfracture, a lot of times we'll have those edges. This is the other place the ss50. So now you've microfracture you're quite happy. But you'll notice one of the things that we have left now is we have this rough edges right in here, and we worry about those breaking off. A lot of times people will put a shaver in, but this is actually one of my favorite tricks, is you can actually bring the ss50 in. And with the COAG just slowly, gently hit these areas and it actually kind of just takes off any of the rough edges. So just using the probe and little blasts, I can clean up any of those rough edges. But I'm not hurting the cartilage. Some of the key tricks to remember one. When you're inserting it, always insert the probe so probe so that the tip goes in first at a 90 degree. So you notice how my hand is held. So I'm going in first. Then I rotate my hand. Don't try to go straight in. It's not going to work because unless you want to make huge incisions it's not going to work. You want to keep your incision small, put the probe in, get into just the edge of the capsule, then rotate your hand. It comes in quite quickly. Number two respect the curve. Remember, when you're going back into the back of the ankle, you have to keep it turned at a 90 degree only as it goes past the talus. Then I rotate it and it respects it. And so now I can go into the back of the ankle and I'm in the back of the ankle. I can do all my work. And that actually is the safety probe and a lot of things I like about it. Again, I have that COAG function works great for osteochondral lesions, and you'll ablate it within a matter of seconds. And it's beautiful. It saves you a lot of time. And that's kind of the reasons, all the reasons that I like this probe because it has all the functions you could possibly need.

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ApolloRF® SJ50 Probe for the Ankle

Imaging & Resection: New Product & Technique Highlights

ApolloRF® SJ50 Sonde

Die Apollo&lt;sup&gt;RF&lt;/sup&gt; SJ50 Sonde ist die erste optimierte Sonde mit Absaugung, die für enge Gelenkräume wie Fuß, Sprunggelenk, Ellenbogen, Knie und Nano-Arthroskopie entwickelt wurde.

Child (D)

Die OPES-CoolCut™-Serie hat einen innovativen ergonomischen Handgriff mit Tastensteuerung. Die 90° Elektrode bietet durch eine besondere Formgebung einen maximalen Abstand vom Schaft zur Elektronenspitze und passt durch eine 5 mm Kanüle. Die neue Beschichtung des Schafts erleichtert das Einbringen in die Arbeitskanüle sowie in subkutanes Gewebe. Das einzigartige Design der CoolCut-Elektrodenspitze ermöglicht einen Einsatz mit extrem niedrigen Energieeinstellungen und erhöht somit die Patientensicherheit ohne Leistungsverlust. Die Verringerung der Energieeinstellungen ermöglicht des Weiteren den Verzicht auf den Keramikring und somit eine ideale Ausnutzung der Elektroden- spitze. Gewebe im anatomisch engen Raum kann leicht erreicht werden.

Hochfrequenzablation

ApolloRF® SJ50 Sonde

CoolCut™-Hochfrequenzablation für Kleingelenke