The CoolCut™ Curved Burrs are the next advancement in hip arthroscopy from Arthrex. The concave and convex curves are based on our popular hip length shaver blades and are designed to access difficult to reach pathology commonly found in hip arthroscopy.

Imaging and Resection

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Ein Dokument mit Informationen über Arthrex Produkte und Produktlinien.

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CoolCut™ Specialty Series: Hip-Length Shaver Blades and Burrs

Imaging & Resection: New Product & Technique Highlights

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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Animationen, die die Funktionen und Vorteile eines bestimmten Produkts demonstrieren.

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Product Demonstrations

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.

James Guerra, MD, (Naples, FL) presents the advantages of the Retractable Hood FlushCut™ Oval Burrs.

Retractable Hood FlushCut™ Oval Burrs

The retractable hood. Flushcut Orville Burr features cutting flutes that are flush with the outer diameter of the outer tube. This provides the benefit of using the shaft as a cutting depth guide during procedures where a flat surface is desired, such as an acromial plasty. By using the shaft as a depth stop and keeping the position parallel to the surface during use, the ideal chromoplasts can be completed quickly. No other arthroscopic burr on the market today has this advantage. Also, as the name suggests, these products feature a retractable hood that allows the surgeon to alter the amount of burr hed exposed without removing the device from the operative site or opening a second device using the same product. For bone debris, procedures such as an acromial, plasty can be completed with the hood in place to protect the surrounding soft tissues, and when necessary, the hood can be retracted to allow full burr head exposure for addressing other pathology, such as a distal clavicle resection. The retractable hood FlushCut oval burrs feature a working length of 13cm and are available in two burr head diameters five and 5.5mm. Look for more pointers and pearls on the SynergyResection page at Arthrex.

James Guerra, MD, (Naples, FL) presents the features and benefits of the retractable hood hip-length round burrs.

Retractable Hood Hip-Length Round Burrs

The retractable hood. Hip length round burrs feature a working length of 18cm and are available in three burr head diameters, four millimeters, five millimeters, and a new 5.5mm size, which is our largest hip length burr. These products feature a retractable hood that allows the surgeon to alter the amount of burr head exposure during use, without the need to remove the device from the operative site. This variable exposure design provides optimum surgical efficiency using the same product. Acetabular preparations can be made with the hood in place to protect the labrum and surrounding tissues when performing a hip labor repair procedure, and when necessary, the hood can then be retracted to allow full burr head exposure for addressing other hip pathology, such as a Cam lesion. Look for more pointers and pearls on the SynergyResection page at Arthrex. Com.

Shoulder

Peter Millett, MD, (Vail, CO) performs a live surgery using knotless BioComposite™ SwiveLock® suture anchors with FiberTape® to complete a quick and secure double-row rotator cuff repair that restores the rotator cuff footprint and maximizes contact between the tendon and bone. Dr. Millett prefers a totally knotless construct to help evenly spread the load across the entire construct. He also highlights use of the SutureLasso™ for retrograde suture passage and uses a PowerPick™ to prepare a bleeding bone bed in the rotator cuff footprint.

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.

Operationstechnikvideos

Gravação em vídeo de uma técnica cirúrgica em um paciente em uma sala de cirurgia ou uma demonstração cadavérica.

Vídeos de técnicas cirúrgicas

Grabación en vídeo de una técnica quirúrgica de un paciente en un quirófano o una demostración cadavérica.

Videos de técnicas quirúrgicas

Surgical Technique Videos

SpeedBridge™ Rotator Cuff Repair Using the SpeedBridge™ Implant System

My name is Peter Millett. We're here at the Vail Valley Medical Center, and we're going to demonstrate a case of rotator cuff repair using a SpeedBridge kit. This is a 58 year old gentleman with a left shoulder injury. He had an acute on chronic injury to his left shoulder. And he is a medium sized supraspinatus tear extending into the leading edge of the infraspinatus. It looks like it's a crescent shaped tear based on his MRI. So we hope to demonstrate the principles of achieving a very good biomechanically strong and also a biologically friendly rotator cuff repair to enhance healing and optimize your results. You can see how that elevator is retracting the tear up so I can see inside of it. Clean off the footprint and try and remove all the soft tissue so that we get healing from the bone up to the tendon. So we're going to use the SpeedBridge kit, which has four anchors in it and one punch. Two anchors are loaded preloaded with sutures and two are for the lateral row. So in this case the tendon is hanging down. So I'm just going to put this elevator in again here posteriorly. And just try and adduct the arm as much as we can. And my assistance is going to pull a little bit of lateral traction. The TRIMANO really helps a lot to get this angle. He has a fairly lateral acromion. So we want to make sure we get a good angle with the anchor going in perpendicular to the bone. So this is our posterior medial anchor 4.75mm SwiveLock. It's a biocomposite anchor. So the anchor has to be flush with the bone before you start advancing it. It's getting a good purchase. And this anchor is vented. You can see some of the vents there that allows for access to the marrow. Now there's sutures on this which you can use if you like and incorporate into your repair if you like to tie knots. In this case, we're going to do an all knotless type repair. And that anchors designed it's fully threaded. It's designed to sit flush on the cortex. So use a 90 degree straight lasso. Here, I'll come in from my posterior portal. And then with a grasper through the posterior lateral portal. Here, figure out exactly where the tissue needs to go and penetrate through. And I can look underneath. See the tip of this come through so we can see exactly where it's going to enter the joint here. And just grab the wire. And then we will retrieve the sutures. The sutures are come together to win. Just a one suture facilitates passage either with the lasso or with a Scorpion passer. And we'll just pull the sutures really tight this point to get all the slack out. And now we're going to do our anteromedial. So we'll switch the scope and place that in the posterior lateral viewing portal. So we'll come in with a punch through here. There's the articular margin. So we use that as a landmark. I also want it to be about a centimeter from this other Our anchor. So we can get it fairly perpendicular. I can put an elevator in too, just as an additional retractor. I'll come in with our anchor. Sink it down. The anchor is flush with the bone. Here. It's squeaking. It's making a good contact with the bone. And the anchor, as I mentioned, is designed to be just flush with the cortex. That's some of the best bone. So the anchor is fully threaded to take advantage of that. So it has very good initial fixation strength. If you want you can pack the cannula up just a little bit and make sure it's flush which it is. And then we'll pull out the suture that's on the eyelet. Now to pass through the rotator cuff I'll abduct it again with the TRIMANO and all these little moves. Really just help with your visualization. I'll come with the lasso and a grasper. Right. So I'll just grab the tissue first, and then I'll come in percutaneously through the anterior cannula. There's my lasso. So now what I can do is I can actually lift up on it. And you can see the smooth synovial tissue right there that tells you you're right at the articular margin. So you're not over reducing this tendon. You're just repairing it right back to its anatomic footprint. It's a good landmark to use. And we'll pass the suture. Now we'll just cut these two tapes so they're separate. And we'll cut the one on the back too. And now what I like to do just before I put my lateral row in, is take a grasper and just reduce the tissue, figure out where everything is going to go based on where the sutures are. This is a 45 degree PowerPick here to create some additional channels for healing. So the tendon is going to go to go over this, so hopefully they'll act as little anchor points and healing places for the rotator cuff tendon. And a larger tear will tend to start with the lateral side that has the least tension and work towards the more tension. So we gradually reduce the tear. But with a smaller tear like this, I don't think it's as critical. This is a SutureTape retriever. It has a little roller on it that acts like a pulley, because there's so much friction with the tape that regular grasper, it's a little bit difficult to retrieve, but that's what gives it such good fixation laterally with the knotless technique with the tape. So we grab that. You can see the roller device there and then we'll retrieve it. And then what I do is I use this cannula actually to help me reduce and figure out where I want to put my lateral anchor. It's provisional reduction here. And then I'll take the opus device and we will remove the periosteum here laterally. The best bone is first at the articular margin. Then second is out here laterally. We're working now so we'll have really good fixation. And then I'll take a punch. And the arm is abducted now, so we have good access for our lateral row. Second line is the SwiveLock line. The first line is for a fully threaded Corkscrew. And then I'm going to just grab the suture with a hemostat and pull it through the threader. And then I'm going to just pull the threader. And now the anchor is loaded. And I'll align it so that the sutures are coming from medial. And then the tag ends are coming out laterally so that when we get in there it doesn't have any twists in it. I like to put about eight millimeters of slack into the system. And then what we'll do is we'll kind of hover it and then we'll compress it down. And I think what we can do now is we can just take a little mallet and I can tap this down. In place. And now I can just double check my tension, which looks good now. So I'm happy with that. If I wasn't happy with it, I could back the whole construct out and start over. But I'm happy with it. So now I'll just advance my lateral anchor in place and then we'll take a FiberTape cutter next and cut the tag ends. It looks like it's flushed. So we'll we can pull the whole construct out. And you have these little sutures here. If you wanted to, you could use those to repair a dog ear if there was one. In this case, we don't really have anything. But if you wanted to, you could use those just like you'd use it from a regular anchor. I'm going to pull them out, but they're available as an option. And then Holly's going to come in again with the Grasper now and feed it through. And we've put that threader onto the FiberTape cutter. So now we can just easily. Cut it. And what I'll do now is retrieve the sutures again. Here's the first suture. And. Here's the second suture. Good. Okay. Now, like I was saying, I can use this to help my provisional reduction. And at this point, you can see it seems like we're running out of out of a little bit of real estate, but if we take the TRIMANO and we just internally rotate the arm a little bit, now we have plenty of room to put our posterolateral anchor in. We can look at it, figure out exactly where we want to go and repair it. So again we'll clear off the periosteum. That's about where we want our anchor to go. Just make a little spot where we want our anchor to go. We can look at our other anchor before just to make sure we like it. Maybe I'll go just a tiny bit posterior. Okay, great. Okay, so now we'll come in with our punch and we will punch for our posterior. Lateral. Past the SwiveLock line the second line. And then we'll put fourth anchor in. Very nice. And we're just threading that through. So again we have to get the right tension. So we will go past the hole a little bit by about 8 to 10mm. Millimeters. Drop it in. I think that's pretty good. So I'll just tap that in place now. And now what I can do is I can check everything before it looks like it's pretty solid. And now I'll just secure it in place. And it's nice and flush with the tuberosity. So we'll take that extra suture out. And then the final step, we'll just cut it. Okay. Great. Perfect. You can see all the blood coming out of the anchor. And that's our final repair. That's it. Speedbridge. Thank you.

Burr, Round, Concave Curved, HL, 8 Flute, 5.0 mm x 19 cm

Kugelfräse, konkav gebogen, Hüftlänge, 8-schneidig, 5.0 mm x 19 cm,steril

Burr, Round, Concave, HL 8 Flute, 5.0 mm x 19 cm

Fresa, redonda, cóncava, longitud de cadera, 8 estrías, 5 mmx 19 cm

Femoral Neck Osteochondroplasty for Cam Impingement

Femoral neck osteochondral plasty for cam impingement. Hip joint access is initiated by inserting a spinal needle into the joint space, removing the inner stylet, and then inserting a nitinol wire. A metal cannula and obturator are then inserted over the top of the nitinol wire, and the obturator is removed, leaving the cannula in place. A scope and quick connect bridge are attached to the metal cannula for viewing inside the joint. Another spinal needle is used to create a mid anterior portal in the same manner with the insertion of another metal cannula. Insert the CapsuleCut blade through the metal cannula and perform an inter portal capsulotomy to connect the two portals. Next, insert a switching stick and then a clear detachable half pipe cannula to facilitate insertion of the Apollo bipolar wand. The Apollo wand is then used to cauterize the inter portal cut before the CapsuleCut blade is inserted again to create an optional T capsulotomy. Down the femoral neck. Traction is then reduced and the hip is flexed to relax the capsule and bring the cam deformity in view. The Apollo wand is then used to debride the periosteum away from the deformity, and mark the position of the cam resection. A curved, concave 5.0mm round burr is then inserted and used to decompress the femoral neck. The curved burr allows for easier access to the posterolateral area on the neck. The cam resection is complete once sphericity of the femoral head is achieved.

CoolCut™ Curved Burrs

Educational Resources and Products

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Acetabuloplasty Preparation for Labral Repair

Femoral Neck Osteochondroplasty for Cam Impingement

Retractable Hood Hip-Length Round Burrs

Imaging & Resection: New Product & Technique Highlights

CoolCut™ Blade Series: Shaver Blades and Burrs

CoolCut™ Specialty Series: Hip-Length Shaver Blades and Burrs

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Surgical Technique Videos (1)

SpeedBridge™ Rotator Cuff Repair Using the SpeedBridge™ Implant System

Brochures (2)

CoolCut™ Specialty Series: Hip-Length Shaver Blades and Burrs

Imaging & Resection: New Product & Technique Highlights

Product Demonstrations (3)

Acetabuloplasty Preparation for Labral Repair

Retractable Hood FlushCut™ Oval Burrs

Retractable Hood Hip-Length Round Burrs

CoolCut™ Curved Burrs (1)

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