Name: Incisionless Synovectomy and Synovium Biopsy Using the NanoScope™ Operative Arthroscopy System and GraftNet™ Device
Uploaded: 2020-05-06T00:00:00Z
Channel: Arthrex
Description: Chad D. Lavender, MD (Scott Depot, WV), presents a case in which an incisionless synovectomy was performed using the NanoScope™ operative arthroscopy system and GraftNet™ autologous tissue collector.

<p>Chad D. Lavender, MD (Scott Depot, WV), presents a case in which an incisionless synovectomy was performed using the NanoScope™ operative arthroscopy system and GraftNet™ autologous tissue collector.</p>

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VID1-000748-en-US | A | Incisionless Synovectomy and Synovium Biopsy Using the NanoScope™ Operative Arthroscopy System and GraftNet™ Device

Chad Lavender

Human

A video recording of a surgical technique on a live patient in an operating room setting or a cadaveric demonstration.

Eine Videoaufnahme einer Operationsanleitung an einem lebenden Patienten oder Patientin in einem Operationssaal oder eine Demonstration an einem Humanpräparat.

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Incisionless Synovectomy and Synovium Biopsy Using the NanoScope™ Operative Arthroscopy System and GraftNet™ Device

This is Doctor Chad Lavender presenting my technique incisionless Synovectomy and synovium biopsy using the NanoScope and the Arthrex GraftNet. This patient is an 80 year old female. She had left knee pain and presented to the office with swelling for three days. She had a subjective fever pain with ambulation. No history of previous trauma. Her exam showed 0 to 115 degrees. Range of motion. Severe pain on motion. Negative instability. Testing. Grade three plus effusion with warmth of the knee but no erythema. Standard x rays show some degenerative arthritis of the left knee with some chondrocalcinosis in the medial joint space. So the laboratory analysis showed ESR of 82, a CRP of 2.46, and the synovial fluid aspiration showed white blood count of 49,000. The ppms were 85% and gram stain was negative. So for this patient, we elected to do an incisionless synovectomy debridement and biopsy. We used the Arthrex GraftNet to harvest the synovial tissue from the knee. We start by placing a spinal needle into the patellofemoral joint, through which we slide a nitinol wire, and then the spinal needle gets replaced with a standard small cannula, and the NanoScope is inserted into the knee. In similar fashion, we establish a percutaneous medial portal with a spinal needle and a nitinol wire, and then we go in with our shaver, which has an Arthrex GraftNet attached, and we do the synovectomy the debridement, and we obtain and harvest synovial tissue. And you can see from outside of the knee joint, the GraftNet has been attached to the shaver and is harvesting that synovium. We continue to perform a standard synovectomy with the GraftNet applied to the shaver, which is harvesting the synovial tissue. Here you can see we get the synovial tissue from the GraftNet that's placed into a sterile cup on the back table. And here you can see there was no incision made on the knee. And finally the pathology and the biopsy results are performed. Notice on the biopsy the cellular architecture is maintained even through the shaver and the GraftNet At some technique pearls. When changing compartments, redirect the NanoScope nano instruments inserted percutaneously as shown here, prevent the need for an incision. This technique can also be applied to the painful total knee arthroplasty, so some advantages of this technique. It eliminates the need for an incision. There is decreased risk of infection and complications, earlier recovery, and range of motion from less painful procedure. This could be used in procedure rooms in office, and it's better than an aspiration with a very similar risk profile. Our current indications for this technique. Knee effusions with a confusing clinical picture. Those compromised patients such as ICU patients, patients at risk for anesthesia, and then patients that we need to obtain a correct tissue diagnosis, such as total knee arthroplasty. So some future considerations. Should we change our diagnostic regimen from standard aspirations. And also we feel this is useful for diagnosing and managing the painful joint replacement. Thank you.

Incisionless Synovectomy and Synovium Biopsy Using the NanoScope™ Operative Arthroscopy System and GraftNet™ Device

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