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Arthroscopy > Boot Camp Articles > Flashcards

Boot Camp Articles Flashcards

1
Q

tourniquet level

A

350 mmHg

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2
Q

tourniquet placement for arthroscopy

A
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3
Q

3 ways to create varus and valgus force on the knee during procedure

A

1) leg holder
2) post + figure of 8
3) assistant

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4
Q

draping for arthroscopy

A

first drape tails up

second tails down

angled drape for arm board

arthroscopic drape over foot with rubber seal up past knee

stockinette on foot

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5
Q

hip positioning for arthroscopy

A

ipsilateral hip on edge of bed

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6
Q

which joint line is more superior?

A

lateral

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7
Q

surface landmarks for arthroscopy

A

patella

tibial tubercle

patella tendon

medial joint line

lateral joint line

head of fibula

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8
Q

which incision orientation is more cosmetic?

A

horizontal

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9
Q

which optional port can you use for fluid outflow?

A

superomedial

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10
Q

where do you place ports?

A

anterolateral 1 cm above joint line just next to patellar ligament

anteromedial 1 cm above joint and 1 cm medial to patellar ligament

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11
Q

what is the first step after marking surface anatomy for ports?

A

local anaesthetic

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12
Q

how do you make the incision for ports?

A

4-5 mm horizontal with blade facing away from patella ligament

stay away from ligament, cartilage and meniscus

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13
Q

how do you insert ports?

A

index finger along port

anterolateral first

angle parallel to tibial plateau directed between the condyles

push into the intercondylar notch

pull back so the canulla is just out of the notch

straighten knee

advance canulla into suprapatellar pouch

remove obturator

put in camera

start fluid flow

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14
Q

with the camera in place and fluid flowing, what is the anteromedial port for?

A

working with instruments

create under direct vision from the already inserted camera using a spinal needle

make sure the needle can reach the posterio horn of the medial meniscus or your angle is off

then remove needle and make a similar incision - watch for fluid eruption

place instruments via canulla

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15
Q

which is turned on first, light or irrigation?

A

irrigation - this avoids thermal damage

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16
Q

order of places to scope

A

suprapatellar pouch

patellar surface

trochlear groove

medial gutter down to the tibia

straighten the knee and apply valgus force

medial compartment

inspect medial meniscus

cartilage on medial condyle and medial tibial plateau

bend knee to 90°

intercondylar notch

ACL, PCL

into the triangle formed by ACL, lateral meniscus, lateral femur

varus force with figure 4 or assistance or leg holder

lateral meniscus and femoral and tibial cartilage

popliteal hiatus and popliteal tendon

lateral gutter

reposition the medial canulla through the notch then reinsert the camera

view posteromedial compartment

access posterolateral compartment via the triangle

17
Q

A

A

ACL

18
Q

B

A

PCL

19
Q

what might you find in the suprapatellar pouch?

A

plica

loose bodies

patellar chondromalacia

trochlear chondromalacia

20
Q

what might you find in the lateral gutter?

A

loose bodies

femoral osteophytes

21
Q

what might you find in the medial gutter?

A

loose bodies

femoral osteophytes

22
Q

what might you find in the intercondylar notch?

A

loose bodies

trochlear chondromalacia

ACL tear

PCL tear

23
Q

where do root tears occur?

A

in the posterior compartments

24
Q

quick order of spots to check in arthroscopy

A

suprapatellar pouch

lateral gutter

medial gutter

medial compartment

intercondylar notch

lateral compartment

posterior medial compartment

posterior lateral compartment

25
Q

4 advanced techniques for treating cartilage damage

A

microfracture

abrasion arthroplasty

osteochondral autograft

osteochondral allograft

26
Q

most frequently encountered pathology in knee arthroscopy

A

meniscal tear

27
Q

treatments for meniscal tears

A

partial meniscectomy if inner avascular part using biter, then shaver

28
Q

how do you stop a biter from creating a loose body?

A

let go of the biter and rest it on the back of the knee

turn of the fluid

remove biter

insert shaver

turn suction back on

29
Q

how can you tell if an ACL is torn if it has scarred to the PCL?

A

empty lateral wall of the intercondylar notch

30
Q

what is the main treatment for cartilage damage during arthroscopy?

A

chondroplasty

where rough and loose areas are shaved and smoothed

Arthroscopy (1 decks)

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