Name: Nano Elbow Arthroscopy Case Presentation
Uploaded: 2025-01-31T00:00:00Z
Channel: Arthrex
Description: John Zvijac, MD (Miami, FL), presents an elbow case using Nano arthroscopy.

Imaging and Resection

<p>John Zvijac, MD (Miami, FL), presents an elbow case using Nano arthroscopy.</p>

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VID1-007007-en-US | A | Nano Elbow Arthroscopy Case Presentation

John Zvijac, MD

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Nano Elbow Arthroscopy Case Presentation

Hi, I'm John Vijayakar, an orthopedic surgeon from Miami, Florida, and I'd like to present to you today a case of synovial chondromatosis of the elbow, in which I utilize the nano needle scope for treatment of the pathology. This was a 30 year old, right hand dominant male recreational athlete, baseball pitcher who had a three month history of pain, locking and swelling of his elbow. He denies any specific trauma or prior injury. On physical examination, the patient had a moderate effusion, had range of motion on the right of 5 to 120 degrees with pain on forced flexion and extension and ranges. Of note, his left elbow had range of motion from hyper 2 to 135 degrees. Pronation and supination were equal on the right and left elbow strength were five over five flexion, extension, pronation and supination, and he had otherwise a normal muscle and neurologic exam. Here you can see on the pre-op x rays that he had loose bodies in both the anterior and posterior aspect of the elbow, viewing on both the lateral as well as AP views of the elbow on his preoperative MRI. You can see that he has a significant effusion, and there are loose bodies in both the anterior and posterior aspect of the elbow. You can also see on the coronal views loose bodies in multiple compartments of the elbow. The decision was made to do a diagnostic arthroscopy with removal of loose bodies and a synovectomy, utilizing the nano needle arthroscope system. My technique for nano elbow arthroscopy is available on the Arthrex website. I use the same instrumentation for all my elbow arthroscopies, which include the 125 millimeter nano needle scope, a high flow elbow access sheath kit for percutaneous entry, two nano working cannulas the Nano Saber Sabre blade, which fits onto Arthrex small joint handpiece after initial diagnostic imaging, you can see that we are able to do a synovectomy of the posterior aspect of the elbow through an accessory portal. This is readily able to be undertaken due to the fact that the nano needle has such a small diameter, and allows for accessory portals in an easy fashion. We first we do the Synovectomy and then, as you can see, we can readily remove these loose bodies with the use of a grasper in a similar fashion. In the anterior chamber, we're able to work through these anterior, radial and ulnar portals to do a complete synovectomy of the elbow, and then go ahead with the grasper and remove these multiple loose bodies. And here you can see the multiple loose bodies that were removed from the elbow. I was able to take these videos and pictures with the use of the nano needle to document the loose bodies, which have been successfully removed. Postoperatively. The patient started physical therapy on day two with active range of motion modalities and elbow wrist hand exercises on his first postoperative visit. On day six, the patient had no effusion. He had taken no pain medicine other than one acetaminophen. On the day of surgery and took no other pain medicines. After the surgical procedure, by week five, he had full range of motion hyper 2 to 135 degrees, and he started his throwing program by post-op week eight. The patient was back playing baseball and doing all of his activities. This case exemplifies the use of smaller camera to treat serious elbow symptoms. The patient had a great outcome with decreased pain scores in the first week. This was a result of decreased fluid flow, smaller portals, no fluid extravasation, and less soft tissue trauma. For this reason I choose nano needle system for elbow arthroscopies. Thank you for your time.

Nano Elbow Arthroscopy Case Presentation

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