Name: Tibial Bone Marrow Aspiration Pearls
Uploaded: 2016-07-21T00:00:00Z
Duration: 4 min 3 s
Channel: Arthrex

Orthobiologics

Not Hidden

English  - en

video

VPT1-00583-EN | A | Tibial Bone Marrow Aspiration Pearls

Human

A video of a live presentation reviewing Arthrex products or techniques.

Video einer Live-Präsentation, die Arthrex Produkte oder Techniken überprüft.

Präsentationsvideos

Presentation Videos

Vídeo de apresentação ao vivo analisando produtos ou técnicas da Arthrex.

Apresentação vídeos

Video de presentación en vivo que revisa los productos o técnicas de Arthrex.

Video presentaciones

Tibial Bone Marrow Aspiration Pearls

Hello. My name is Doctor Steve Votto. I'm from Grant Bone and Joint Center in Columbus, Ohio. I'm here today to present my technique of enhanced microfracture technique for the treatment of osteoarthritis using bone marrow concentrate. The aspiration technique is done through a blunt biopsy cannula that is inserted again through a small skin incision in the anterior lateral arthroscopy portal. We performed that at the beginning of the procedure, so that we do not have any extravasation of fluid into the biopsy site. If the arthroscopy had already started when we introduced the tip of the cannula, it is inserted at approximately 30 degrees from the vertical of the tibia outward and 30 degrees lateral. So essentially we're trying to sneak behind the tibial tubercle. Once the cannula goes down to the tibial surface and we palpate that, we gently tap it into place through the cortex. And advance it approximately 3 to 4cm into the tibia. As vertical as we can go. This is indicated typically by the markings on the shaft of the cannula. The cannula is. Trocar is then removed and a vacuum aspiration syringe is locked into place. This is heparinized. We also provide heparinized the cannula. The bone marrow is aspirated in ten milliliter increments to allow equalization of aspiration pressure to a total up to 60ml. Average aspiration time is 1 to 3 minutes. A small caveat. Females typically aspirate quicker than males. If the flow of the aspirate slows, we can then rotate the cannula to expose the fenestrations on the side. Typically there are five small holes on the side of the cannula. The more important issue is try not to advance the cannula into the tibia to avoid any type of impaction. The bone marrow concentrate is then concentrated by the Arthrex Angel system, for which a volume of 60ml takes approximately 17 minutes. Step one targeting and approach and the introduction of the jamshidi needle into the tibia. I basically approached this by outlining my landmarks for the anterior lateral arthroscopy portal. I make a small incision. I slide down to the proximal tibia and angle it approximately 30 degrees away from the tibia, trying to keep it as vertical as possible and 30 degrees away, sneaking behind the tibial tubercle. Once we penetrate 3 to 4cm into the tibia, by noting the side markings on the cannula, we place a Luer lock syringe on the system, which is heparinized, and we start the aspiration. We perform the aspiration in ten kHz increments, allowing the pressure to equalize each step of the way. If the aspiration slows down, you can gently twist the cannula side to side, exposing the holes to a different area of the tibia. And if it slows down completely, you can actually withdraw the cannula one cc at a time, exposing it again to a different area. One important point is not to advance it, especially not advancing it without the blunt trocar in place. Once the specimen is done, we gently lift the entire system up and hand it off for concentration, which typically takes 15 to 17 minutes with the Angel Arthrex Arthrex system.