Beim ApolloRF-Tasthaken kommt eine kontrollierte bipolare Hochfrequenztechnologie auf Plasmabasis für eine schnelle Gewebeablation zum Einsatz.
<ul>
 <li>Robuste, einteilige Aktivelektrode</li>
 <li>Die Sonde mit Absaugung verfügt für eine effektive Absaugung über mehrere Ports</li>
 <li>Ergonomische Handsteuerungen</li>
 <li>Mechanisch verstärkt, um den zusätzlichen Zugkräften bei Hüftarthroskopien zu widerstehen</li>
 <li>Kante zur Ablation für eine präzise Gewebeformung</li>
</ul>

Travis Menge, MD (Grand Rapids, MI), demonstrates the use of an ApolloRF® H50 probe and a 5 mm curved burr for arthroscopically resecting a cam lesion.

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Cam Resection Using the ApolloRF® H50 Probe and 5 mm Curved Burr

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Abrasion Resistance of the Arthrex ApolloRF® H50 and Smith & Nephew HipVac® 50 Ablation Probes

Travis Menge, MD (Grand Rapids, MI), demonstrates acetabuloplasty preparation prior to labral repair using the curved hip-length Torpedo™ shaver blade, curved hip-length round burr, and ApolloRF® H50 device.

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Acetabuloplasty Preparation for Labral Repair

My name is Doctor Travis Mensch from Grand Rapids, Michigan. Today we're going to be looking at Hip and how we use the H50 RF wand to help develop and separate our capsule labral plane between the capsule of our proximal leaflet and the labrum. And this is going to be the zone or the area where we're going to be able to resect some of the acetabular rim and then perform our labor repair. As you'll see, I'll use the RF wand, which has a 50 degree angle to help better elevate this capsule off of the labrum and really separate and create that plane. I typically switch between Cut and COAG to help maintain hemostasis, as well as create a clear plane between the two tissue paths as I'm working. You can see this is a right hip, and we're viewing through the anterolateral portal and working through the mid anterior portal. With this 50 degree angle, I'm able to work all the way around from that 12:00 position anteriorly down to about the 3 or 4:00 position, without any difficulty in reaching the areas that I that I need to get to. Another benefit with this wand is it's a sturdy device that doesn't bend or deform, as I'm really cranking on the wand to get more posterior. And again, switching between the cut and koheiji. Also, using the koheiji to help bring this labral tissue. Make it a little more taut for our repair. Now again I'm elevating this proximal leaflet and I'm going to switch portals here shortly so you can see it from a different angle. But as I work, I'm bringing that proximal capsule off of that acetabular rim. And this is going to be where we're going to be able to perform the acetabular plasty followed by the labor repair. We've really developed a nice plane between that capsule and that labrum. And that's going to help not only with visualization for our resection as well as our labor repair, but that's also going to help in terms of our capsular closure at the end of the case to really help get a nice tight capsular closure or capsular plication, depending on the patient. So now I'm going to switch portals. We're going to move our viewing from the From the anterolateral to the mid anterior. All right. So in this view this is a right hip. We are viewing from the mid anterior portal looking posterior. And we're working through our anterolateral portal with our H50 RF wand. We are now above the labrum which is right here the proximal leaflet of the capsule. And we're working between these two structures to identify and evaluate that lateral acetabular rim. And we're using cut to cleanly elevate this proximal capsular leaflet. And we're also separating out our space to be able to identify and create our resection of our alloplasty, which then will create a nice bed for our labor repair. So now we've got this over the top view where we're working underneath that proximal leaflet. And we're working above the labrum from an anterior to posterior direction. So again we're working from an anterior to posterior direction. We are now above or proximal to the labrum working in this capsule labral space. I switch between Cut and COAG again to help elevate this tissue, as well as cauterize any bleeders and help maintain visualization throughout the case. Now, at this point, you can see as we move down the labrum, which is down here, we have our labral tear. And as we work underneath the labrum, you can see the tearing between the edge of the acetabulum and the labrum. At this point, I also switch between the RF and the shaver to help clean up some of the debris within the hip joint, as well as improve our visualization. So right now what we're going to do is we're going to use a slotted cannula, and we're going to switch between this H 50 RF wand. And we're going to go to the curved Torpedo. And one thing that's great about the Torpedo, especially in the hip, is it allows very detailed resection. You'll see, as we kind of clean up just a little bit of this frayed edge of the proximal leaflet, it allows a very accurate resection without taking too much tissue. And again, if you go in and take too much of this tissue, you're going to have a difficult time performing the capsular repair or plication at the end of the case. So we're going to clean a little bit of this tissue up in preparation for our acetabular plasty. And again, it's a it's a very fine and controlled resection along the edge of this capsule. And you can see how nice when we come at the end of the case to repair this capsule. That's going to be a nice edge that's going to repair beautifully. We'll move back into the central compartment. And within the joint you can see some of that labral tearing. And this is also a great time where I'll clean up some of the labral tear again using this curved Torpedo with some very accurate and specific resection. Because again, we don't want to take too much of our labral tissue, but we want to clean up some of that tissue. That's not going to be repairable. We're looking above the labrum. So we have the labrum here. We have the proximal capsular leaflet from the acetabulum here. We're working in this space. And what I like to call the over the top view. And we're gently peeling the capsule off that acetabular rim. This is going to help with our tuberoplasty to get a very precise and accurate bony resection as we resect this plane between the capsule and labrum. This angle really allows you to work in this space, which sometimes can be very tight and difficult to get, and helps resect the tissue that you want to resect without overly resecting that capsule and other surrounding healthy tissues. So now we're working above the labrum and below the capsule, and we're using the curved 5.0mm burr to do our acetabular resection. Now, one thing I like to do is use the burr in reverse in this space. And that's going to help protect the labrum from any iatrogenic damage, while also providing a more fine or polished resection of our acetabular rim. I'll typically switch once we develop this plane between forward and reverse once again, to help clear off some of this underlying tissue. You can see as we develop this plane, you've got the capsule proximally the labrum distal. And now we're working on that lateral acetabular rim. And as we work with the curved burr we're again viewing from the mid anterior portal. We're working through the anterolateral portal and we are above the labrum. And again I'm running the burr in reverse. And that's helping to push that labral tissue away from me and not cause any iatrogenic damage to the labrum. By the birth. And at this point, once we get further posterior, I'm going to switch back to the curved Torpedo to help debride and remove some of this tissue that's currently blocking our view as we work further and further posterior. So again, we're getting a nice resection on that acetabular rim working above the labrum. And you can see we're controlling and using the outflow to help remove some of that debris from the hip joint as we work posterior and really elevate that tissue off of that acetabular rim. Now the key here with that curve is it helps to elevate that proximal capsular leaflet without resecting or causing damage to it. That's important. At the end of the case when we go to do our capsular repair. Now again I'm working both with the bur and forward as well as reverse and clearing off this tissue from the acetabular rim. And now we're going to switch. We've got some extra tissue in there. We're going to switch back to the curved Torpedo. And again, we've got the curve Torpedo now that we're going to use to work in this space and really help with our visualization. Again, we're underneath that proximal capsular leaflet. And you can see that tapered tip of the blade is getting right where we need to underneath that proximal leaflet without causing any additional damage to our capsular leaflet. And as we work again from an anterior to posterior direction, you can see we've got some soft bone back here. But we're going to clean that up. And we now have a very nice plane between that capsule proximally and that labrum, which is where we're going to place our anchors for labor repair. So as I continue to carefully work with a very precise and accurate resection, this is the point where I'll typically switch between the curved Torpedo and that h50 RF wand to help peel that capsule further off the acetabular rim. And this is going to give us that view for labor repair and anchor insertion. That is going to help in not only placing the anchors in the right position, but also anatomically getting that labrum back on the acetabular rim. So again, we're working more posterior. Oftentimes you get some of that superior lateral acetabular rim at this point that's overhanging. And so we're carefully working and elevating that capsule. See there's the lateral most point. So we're going to respect that work in that space. And that's the bone that we're going to target to complete our tuberoplasty. So I'm again switching between COAG and cut to help not only with our resection of this tissue and develop that plane, but I also really focus on hemostasis throughout the case because that's going to help us keep our pump pressures lower and help avoid putting too much fluid in that hip. And we all know some things, although rare, we worry about things like abdominal compartment syndrome by too much fluid or too much time in the hip. So it's important to work with low pressure as well as timely and as efficiently as we can, which is where these instruments really come in useful. So we've got some of that bone exposed. Now we're going to switch back switch back to that BR. And so now we've developed that plane where we're going to do our labor repair. And so at this point I'm going to use the BR on forward to be a little more aggressive. And again I'm keeping the BR away from that labor because again we don't want to cause any iatrogenic damage. Working above the labrum I'm going to use the BR on reverse. And what's great about it is on reverse. You can use the BR right above the labrum. And you're pushing that labral tissue away so you don't have to worry about damaging it, which is a great tip. Switching between again both forward and reverse. On the BR, you can change how aggressive or precise you want to be. Again, forward is going to give you that more aggressive resection. Reverse is going to give you more precise and polished resection. And so you can see we've got that acetabular rim cleaned off very nicely. And this is where our labrum and our labor repair is going to take place. Switching again to To forward. So I want to be a little more aggressive. And now we've got a great space. Again you can see for our labor repair. So with that you're looking again from the mid anterior portal looking posterior on a right hip. And we're working through that anterolateral portal. We've got the labrum below us. We've developed this plane between the labrum and the capsule. And we've performed our tuberoplasty. And now we can proceed to labor repair. And then I'll switch back to the Torpedo. And that's really going to help. Just clean up and give us the view we need. Because again, one of the difficult things with hip arthroscopy is getting the right view to see where we're working and to see our anchor insertion for labor repair. So again, you can see very precise resection with this curved Torpedo. And that tapered tip allows me to get proximally and help elevate that tissue and really get that over the top view that we like to see when we're performing our labor repair.

Travis Menge, MD (Grand Rapids, MI), demonstrates an arthroscopic cam resection using a curved hip burr, the ApolloRF® H50 probe, and DualWave™ outflow tubing.

Cam Resection Using a Curved Hip Burr, the ApolloRF® H50 Probe, and DualWave™ Outflow Tubing

My name is Doctor Travis Menge from Grand Rapids, Michigan, and today we're looking at a right hip for an arthroscopic camera section and femoral plasty. We're viewing through the mid anterior portal and we're working through our anterolateral portal. As you can see, we've got a large cam lesion looking from anterior to posterior. I typically start off using the H50 RF wand to help delineate where the extent of my cam is. Again, from a posterior to anterior direction, this wand allows me to retract the distal leaflet of the capsule and evaluate the extent of the Cam lesion without removing excessive tissue from the capsular tissue. To get the appropriate visualization, once I identify where the Cam lesion is, I typically will use the h50 RF to debride and remove some of the overlying cartilage or fibrous tissue that is often covering the Cam lesion. And again you can see this large Cam lesion. And this h50 RF wand does a great job in helping you outline the extent of the Cam deformity. Once we've identified and outlined our Cam lesion and the area of resection I'll use the curved shaver. The Torpedo to gently remove some of the edges of our capsule while maintaining the surrounding normal, healthy tissue for later capsular repair. What's great about this Torpedo is number one. The curved angle allows you to reach posteriorly as well, as it's a very precise and accurate resection. You can see we're cleaning up the edges of that capsule, but we're not removing or debriding an excessive amount of capsular tissue, which could compromise our capsular repair at the end of the case. Additionally, the tapered nose of this blade allows me to accurately resect the tissue that I would like to without causing excessive resection of the surrounding healthy tissue. We're now using a 5.0mm curved bur to address and resect this cam deformity. What's great about the curvature of this bur is that it really allows you to work posteriorly, and especially posterolateral, where sometimes it's difficult to access and you can create a nice resection. Again, working from a more posterior to anterior direction as you recreate the normal offset of the femoral head and neck junction. Another great tip with this bur is you is you can change how aggressive you'd like to resect by either using forward, which is more aggressive, or reverse on the foot pedal, which is going to be more of a polishing type resection. So to start off, I'll typically use a more aggressive resection with forward as we outline and resect this cam deformity. And the curved burr has a unique advantage of allowing you not only to access that posterior cam, but also the anterior cam much better than a straight burr. Another benefit with the curved burr is you spend less time switching portals as you're working on resecting a cam, especially large cam, where you often have to switch portals multiple times throughout the case. As you can see with the curved burr, as we're working on that margin to reshape that femoral head neck junction, you get excellent contouring with very precise removal of that cam deformity as we work more posterior and posterolateral. This burr allows you to access a lot of that cam that you'd have a hard time normally accessing with a straight burr. And often I'll switch between our h50 RF wand to work posteriorly and posterolateral as we debride the fibrous tissue covering the cam lesion, and as we continue to work more posteriorly, we want to internally rotate the foot and bring the leg into extension to help access that area. Now we're going to switch back to the curved bur. You can see how this curve allows you to work posteriorly and get the hard to reach areas of a large cam. Now the bone on this cadaver is very soft, but you can see the accessibility that you get with this curved bur compared to a straight bur. Additionally, the DualWave outflow is keeping our visualization clean throughout the resection and allowing an optimal resection with minimal debris blocking our view. As you can see, the curved bur is resecting the bone very nicely and allowing access as we move anterior in the hip. Here we are with completion of our camera section. Using the curved bur, you can see the access that the bur gave us to go all the way posterior as we work anteriorly as well. You can see that labrum is repaired very nicely, and we've got a great suction seal between the labrum and the femoral cartilage.

Flexural Strength of the Arthrex ApolloRF® H50 and Smith & Nephew HipVac® 50 Ablation Probes

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Cam Resection Using a Curved Hip Burr, the Apollo^RF® H50 Probe, and DualWave™ Outflow Tubing

Flexural Strength of the Arthrex Apollo^RF® H50 and Smith & Nephew HipVac® 50 Ablation Probes

Synergy^RF™ Bipolar Ablation System With Apollo^RF® H50 Probe

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Synergy^RF™ Bipolar Ablation System With Apollo^RF® H50 Probe

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Hip Next Generation in Soft-Tissue Repair and Reconstruction

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Cam Resection Using the Apollo^RF® H50 Probe and 5 mm Curved Burr

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Acetabuloplasty Preparation for Labral Repair

Cam Resection Using a Curved Hip Burr, the Apollo^RF® H50 Probe, and DualWave™ Outflow Tubing

White Papers (2)

Abrasion Resistance of the Arthrex Apollo^RF® H50 and Smith & Nephew HipVac® 50 Ablation Probes

Flexural Strength of the Arthrex Apollo^RF® H50 and Smith & Nephew HipVac® 50 Ablation Probes

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ApolloRF-H50-Tasthaken

Educational Resources and Products

Featured Resources

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All Products

Cam Resection Using a Curved Hip Burr, the ApolloRF® H50 Probe, and DualWave™ Outflow Tubing

Flexural Strength of the Arthrex ApolloRF® H50 and Smith & Nephew HipVac® 50 Ablation Probes

SynergyRF™ Bipolar Ablation System With ApolloRF® H50 Probe

Videos

Documents

Languages

Broschüren (1)

SynergyRF™ Bipolar Ablation System With ApolloRF® H50 Probe

Kataloge (1)

Hip Next Generation in Soft-Tissue Repair and Reconstruction

Operationstechnikvideos (1)

Cam Resection Using the ApolloRF® H50 Probe and 5 mm Curved Burr

Produktdemonstrationen (2)

Acetabuloplasty Preparation for Labral Repair

Cam Resection Using a Curved Hip Burr, the ApolloRF® H50 Probe, and DualWave™ Outflow Tubing

White Papers (2)

Abrasion Resistance of the Arthrex ApolloRF® H50 and Smith & Nephew HipVac® 50 Ablation Probes

Flexural Strength of the Arthrex ApolloRF® H50 and Smith & Nephew HipVac® 50 Ablation Probes

Related Products (1)

Related Products (1)

AR-9835

Cam Resection Using a Curved Hip Burr, the Apollo^RF® H50 Probe, and DualWave™ Outflow Tubing

Flexural Strength of the Arthrex Apollo^RF® H50 and Smith & Nephew HipVac® 50 Ablation Probes

Synergy^RF™ Bipolar Ablation System With Apollo^RF® H50 Probe

Synergy^RF™ Bipolar Ablation System With Apollo^RF® H50 Probe

Cam Resection Using the Apollo^RF® H50 Probe and 5 mm Curved Burr

Cam Resection Using a Curved Hip Burr, the Apollo^RF® H50 Probe, and DualWave™ Outflow Tubing

Abrasion Resistance of the Arthrex Apollo^RF® H50 and Smith & Nephew HipVac® 50 Ablation Probes

Flexural Strength of the Arthrex Apollo^RF® H50 and Smith & Nephew HipVac® 50 Ablation Probes