3 - Ortho - Arthroscopy Flashcards
What is the angle of inclination with regard to arthroscopes? What is the most common angle of inclination used?
Angel between axis of arthroscope and a line perpendicular to the surface of the lens.
30 and 70 are most common
What is the field of view in an arthroscope
viewing angle encompassed by the lens varies according to the type of arthroscope. Greater angle = larger blind spot
What is the common recommendation for an inflow pump setting on initial insertion of the arthroscope.
generally 30 mmHg below systolic BP
monitor for extravasation
What is the modern arthroscopy requires the surgeon to utilize in arthroscopy technique?
Triangulation - 2 portals (working/viewing)
What are some contraindications for arthroscopy?
Overlying or systemic infection - may seed joint
Complete joint collapse/ Loss of joint space (relative)
Describe the standard portals for knee arthroscopy
Anterolateral - most common starting/entry portal used for visual portal. 1cm above lateral joint line and 1cm lateral to patella tendon
Anteromedial - most common working portal. 1 cm above medial joint line, 1cm inferior to tip of patella, 1cm medial to edge of patella tendon
What joint do you usually use a canullus for?
Shoulder
Knee not common
Review, become familiar with meniscal tears
LOOK AT POWERPOINT PICS
What are the 3 meniscus zones?
white-white: avascular (common place of tears) poor healing potential too (likely will just take out to prevent joint impingement
red-white: some blood supply but still poor performing of a direct repair
red-red: highly vascular: good repair potential, may directly repair
Describe the Outerbridge Classifications of Arthritis of Articular Cartilage
0 - Normal
I - Cartilage with softening and swelling
II - Partial-thickness defect with fissures on the surface that does not reach the subchondral bone or exceed 1.5cm
III - Fissuring to the level of subchondral bone in an area with a diameter more than 1.5cm
IV - Exposed subchondral bone
Describe Pathologic cynovial plica (plica syndrome)
Pathologic redundancy that presents as a synovial fold that becomes inflammed and thickened
Spans from genu articularis, coursing over far medial aspect of MFC to attach to distomedial aspect of the intraarticular synovial lining
Can be debrided if causing severe symptoms
Describe the portals important in arthroscopy of the shoulder.
Posterior portal: VIEWING PORTAL 2cm distal/medial to posterolateral acromial border (through “soft spot” interval between infraspinatus (suprascapular n.)and teres minor (axillary n.)
Anterior Portal: WORKING PORTAL anteromedial to coracoid through rotator interval (between supraspinatus and subscapularis)
Describe the lesion grading system for SLAP lesions of the shoulder.
I - Labral and Biceps Tendon Fraying, Root in tact
II - Labral fraying and biceps tendon root detached
III - Bucket handle labral tear, biceps root detached (separated from bucket handle)
IV - Bucket handle labral tear, biceps root detached (connected to bucket handle)
What is a common complication that makes hip arthroscopy less used?
Greater danger of iatrogenic nerve injruy (LFC n.)
Describe the uses of different portals of the hip.
Anterolateral: Camera
Mid-Anterior Portal: working portal
