Foot and Ankle

<p>Thomas G. Harris, MD (Pasadena, CA), demonstrates various instruments within the Arthroscopic Instrument System as well as the application of AlloSync<sup>™</sup> Expand demineralized cortical fibers.</p>

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VID1-001560-en-US | A | Arthroscopic Instrument System

Thomas G. Harris

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Arthroscopic Instrument System

My name is Tom Harris from Pasadena, California. Happy to show you all the arthroscopy set. The new version of it provides a lot of different options for this. We'll start off by showing some of the sharp and blunt elevators. So this is a nice tool to not necessarily cut cartilage but just to elevate cartilage. You can also kind of tap the cartilage from the top down and just get a feel for how soft the cartilage is. And if there's a lesion underneath the cartilage itself. And there are four different ring sets in this set of different sizes and alignments. The small angled curette and because of that angle, makes it nice to just define our edges now and just get a little deeper into where that lesion is, you can see that it looks like it's relatively well contained. It doesn't seem to go into that lateral gutter. The set comes with cupped curettes both straight and curved. Here's an example of the curved large curette, and that we can come in through that same portal. And if we need to just kind of dig out a little bit more bone underneath, we can do that. Really sharp edges there, just to really get down to the subchondral area and past all that cartilage. And now you're getting into some more of the Subchondral area, and you can see there's a stable rim laterally. And the area here, you can start seeing some of that bone underneath that area that you want to penetrate with your microfracture. Another nice thing about the curettes or the ring curettes or the osteotomy. All the instruments have a nice knob that's been placed on them. So for tactile stimulation, tactile feedback that you can just put your finger there and know that the working end is directly 180 degrees from that. This is a nice tool and a nice addition to the set. This is a cupped curette as well, but it's a little bit smaller and there's different sizes of that. It's got an angle to it. If you need to get really in the back of the ankle joint, and then there's a straight side to it, and when you put it in the ankle it's really a nice size. So that again a little bit too straight. So we'll switch to the other side and go to the curved side. And then we can just get in the back if you need to. Really useful tool to have in the set And you can just kind of level this off a little more. We'll also just mention the double ended curettes, which can serve as a shovel or a rake. And you'll see if there's a really posterior or real anterior lesion they need to cut or push. This almost works like a rake or a shovel. Not as useful for this particular lesion, but if there's something more in the back or something more in the front, then you can use that. But you can see a newer tool here that has some nice applications to it as well. For ankle fusions, anytime you want to have osteotomy to prepare a joint for a fusion, there's three different osteotomies in here. There's a nice straight one. So if you were going to prepare the tibia for an ankle fusion, this would be a great a great tool in your warehouse. And the same thing here. This one's got a little bit more curve to it. This would work a little bit better on the talus because it's got a nice curve as we go through that area. So not necessarily germane to this particular lesion, but something that's nice to have for your ankle arthroscopic fusions. And then lastly, something that is pertinent to this case would be the tropics. And we have four different options here for us. For this case we've employed a 90 degree. It's always kind of kind of come in from the side here. And then you can see you've just got the nice color coded nature of it there. And then we'll go over the nice attachments to it. So instead of just pushing down with your hand, which we've done in the past, now we have a nice attachment that's going to fit onto this. So this is the attachment rod and the strike attachment which is a new addition to this arthroscopy set which makes it easier to impact. And it goes into there's a little hole right here that fits in there nicely. And then you push straight down and it locks onto there as well. So you've got a nice area to impact that's a little bit more close in terms of the direction of the impact. And so as we watch on the arthroscopic, you can see how that goes in there nicely and kind of buries it all the way to the edge of that gold area. And if we want to do a different angle you can see some of that fat removing is what we want to see. Maybe we'll go a little bit more right in the center portion of it there. Nice. Great. We have a nice lesion nice hole. And we'll go back with the shaver at that point. Nice options here for different angles. You can see that's the the 90 degree option there. There's both a 30 as well as a 60. Also another nice tool that's a welcome addition to the arthroscopy set is the Syndesmosis probe. And the Syndesmosis probe has both a two and a three millimeter metal ball on the tip. And it can just measure if there's any instability within the syndesmosis. So, as we put it in our particular case here, we look at the interosseous membrane. We can see in this particular case there's no obvious diastasis that can be accessed. There's also a whole list of different graspers that can be used in this new set. So here's an example of a posteriorly tilted curved grasper. And it's been really tested to get in the back of the ankle really nicely based on that angle curvature. And you can see it does really work well. We're already able to put this in the back of the tibia there. And then also included in this set here is the GPS targeting guide. And this can be helpful for those who like to drill these particular lesions if they're in a difficult area to access the microfracture. Also, they can be helpful to put your six, 7 or 7.0 screws in to help with an arthroscopic fusion to just line them up exactly where you want them to go. Another addition to this set is the new probe, and I'll show you inside the joint here why it's so nice. And that has really nice gradations of of measurements. The very tip of the probe is two millimeters. So if you need to measure the depth you can do that. But it's often hard to measure for some other probes you're just kind of guessing. And then this particular probe, you really do know you have two millimeter increments. And that really helps you determine the size of the osteochondral lesion you're dealing with, which is really, really helpful in terms of prognosis and how you're going to treat it. Another nice component to the ankle arthroscopy set is the cannula, which is new for bone graft. And the cannula is accompanied by a tamp. So this can be filled in with ArthroCell. Or today we're going to demonstrate a new AlloSync expand graft. We'll place it in this area. And then it can be pushed and placed into the joint, which is a nice option not necessarily for Osteochondral defect, but more for an arthroscopic effusion, or where you're trying to deliver a large amount of bone graft into a joint. The joint has already been dried. You can see that the graft is already starting to expand as it comes into any parts of the joint that were already wet. We can apply more fluid to watch it expand even more. So you can see it expanding there in real time really does fill up the whole joint nicely. And you can see those long fibers kind of expanding there as well. So in closing you can see this arthroscopy set is a really comprehensive set. It is an upgrade from what we have been using in the past. It has every option available for you. It's really been designed to obtain good access to both the posterior and the anterior aspect of the joint.

Arthroscopic Instrument System

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