New Flexible Arthroscopic Retractor
by Bruce Levy, MD
Arthrex recently released the new Flexible Arthroscopy Retractor (FAR) for knee surgery.
I designed the FAR with Arthrex to allow better exposure at the base of the PCL facet for tibial tunnel/socket placement when performing PCL reconstruction or PCL avulsion repair. I found that exposure to this area was always difficult; not only to visualize the area but I also had fear of getting too close to the neuro-vascular bundle. We wanted to create something that could be inserted and removed easily and would help surgeons better see this tricky area.
The FAR is made from flexible, tear-resistant polyurethane. This is the same material used to protect the 2.4 guide pins and spade tip guide pins. After a series of trial and error with sizes and shapes, we found a reproducible device that met all the goals mentioned above.
I was pretty excited the first time I tried the actual device. It was easy to insert and remove, gave me excellent exposure to the PCL facet, and the water pressure from the pump kept the FAR expanded, thus moving the posterior capsule away from the surgical field. Although not designed to protect neuro-vascular injury, I have to say it made me feel better having the FAR in place.
To place it, you simply pinch the tip with a snap and insert it into the knee either through a PM portal or any anterior portal. It is then manipulated to the back of the knee at the base of the PCL facet. To remove, simply pull on the suture and it will easily come out any portal.
I have found the FAR to be extremely instrumental for PCL surgery and hope other surgeons will find this advancement just as helpful.