Name: Diagnostic Ankle Arthroscopy Using the NanoNeedle Scope
Uploaded: 2022-09-12T00:00:00Z
Channel: Arthrex
Description: Matthew Brant, DPM (Sewell, NJ), performs diagnostic ankle arthroscopy using the NanoNeedle scope.

Imaging and Resection

<p>Matthew Brant, DPM (Sewell, NJ), performs diagnostic ankle arthroscopy using the NanoNeedle scope.&nbsp;</p>

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VID1-003256-en-US | A | Diagnostic Ankle Arthroscopy Using the NanoNeedle Scope

Matthew Brant

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Diagnostic Ankle Arthroscopy Using the NanoNeedle Scope

Hi, my name is Matt Brant. I'm a reconstructive orthopedics in Sewell, new Jersey. And today we're going to be doing a diagnostic arthroscopy of the ankle. We're going to be using the nano needle today, which is a new design. It's still a 1.9mm scope but a little different in design. It's a little bit more versatile in that the buttons are detached. Still with video and picture capability. We're going to be using the 3.3 high flow sheath today one straight, one angled. And we have the option of a dull and a sharp obturator. And now we're going to transition over to the ankle. All right. So to make my portals I feel for the tibiotalar joint. I feel where the tibialis anterior tendon runs and stay just medial to that. And I'll insert a needle into the joint. And then I'll insufflate the joint with some saline. Remove the needle. Make my portal. And I'll use a stat to stat down into the capsule. So I like to first insert the obturator so that I can feel that I'm in the joint. Then remove that and place it into the trocar. So then I insert my obturator with the trocar into the joint. Remove the obturator and insert the nano needle until we can begin to see some cartilage and know that we're in the joint. And then I can direct the scope laterally to where I can feel it. And I'll make my second portal. And I'll just back my scope up out of the way so I can enter the joint. And I like to insert the blunt obturator reader first. So I know that I'm in the joint and I've triangulated. So then I can insert my nano saber. Shaver. Into the joint and begin debriding some of this synovitis from the anterior aspect of the joint. So I make sure to visualize the shaver at all times, so I'm not damaging any cartilage causing any iatrogenic defects. So I can open up the front of the joint and get a better view. So I can sweep the nano saber across the joint. I can piston it, I can rotate it. The nano saber is 2.8mm. Which allows me to move around the joint, see what I need to see, take out which tissue I need to remove. And I'll open up the joint laterally, removing some of the scar tissue. The nano shaver handpiece allows me to kind of choke up on the shaver and fine tune my movements around the joint so I can accomplish what I'm trying to accomplish. As compared to traditional larger shaver handles. We're looking in from the medial portal. Looking across the joint, you can see the anterior aspect of the tibia and our Taylor dome, and we can slide the nano needle across and evaluate into our lateral gutter. We can check out our syndesmosis which is right in here. She does not appear to have any instability. We would breed in through into here in our anterior talofibular ligament. If you were going to do an ArthroBrostrom, you'd insert your anchors here and here into the fibula, which is right here. And we can look into our down into our medial gutter. Way down in through there. She's got a little osteochondral defect right here on the medial dome. So if we were to treat this, we could use our scope in this portal. Then change our scope into the lateral portal and curette this microfracture that. Sometimes we'll use a heavier shaver on a braider and remove some portion of this anterior aspect of the tibia. If someone has an exostosis anteriorly or impingement syndrome, we can look down into the Taylor neck. Below the articular surface. So Then I can rotate and shift my scope into the lateral portal so I can get a better look at the medial side. To breed out any more. Tissue that I need to. Look over at the medial malleolus. So we can take a look at the lateral ankle and look into the area of the syndesmosis right here. This patient does have an effect on the lateral dome. If we were to stress the ankle rotate the foot externally this area here would note separation. And this patient is stable. In conclusion, the nano needle and the nano saber allow for increased versatility and control with increased ergonomics to maneuver through small joints of the foot and ankle, and allows me more precise control and maneuverability in my foot and ankle cases.

Diagnostic Ankle Arthroscopy Using the NanoNeedle Scope

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