A Porcine Model For Arthroscopy

Dinato, Mauro César Mattos e; Freitas, Marcio de Faria; Iutaka, Alexandre Sadao

doi:10.3113/fai.2010.0178

Cited by 8 publications

(5 citation statements)

References 10 publications

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“…Conventional arthroscopes are hand-held, and as such, their ability for repeatable detailed observations and/or precise quantitative measurements of tears, lesions, and extrusions in cartilaginous joint structures in real-time may be limited compared to the high resolution potential for a mounted device such as the one in the present study. The present study did not employ a disease model so images of the cartilaginous joint structures are expected to be comparable to healthy joints and other medical porcine arthroscopy validation studies [50], [51]. A considerable level of detail, including striations in the ligaments (Fig.…”

Section: Resultsmentioning

confidence: 99%

“…The present study was conducted on porcine joints, an animal model that has been used for arthroscopic training [50], [51] and for studying articular cartilage, ligament, and meniscal degeneration [53], [54]. Unlike previous studies [50], [51], the porcine limbs collected from local butchers already had the majority of all muscle and skin removed making joint inflation and lavage impractical, and as such, small amounts of connective tissue needed to be removed. This made it easier to monitor the probe on approach and adjust the articulated PALOMINO positioning arm to match the planes of the sample and the GRIN objective.…”

Section: Resultsmentioning

confidence: 99%

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Pre-Clinical Translation of Second Harmonic Microscopy of Meniscal and Articular Cartilage Using a Prototype Nonlinear Microendoscope

Baskey

Andreana

Lanteigne

et al. 2019

IEEE J. Transl. Eng. Health Med.

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Previous studies using nonlinear microscopy have demonstrated that osteoarthritis (OA) is characterized by the gradual replacement of Type II collagen with Type I collagen. The objective of this study was to develop a prototype nonlinear laser scanning microendoscope capable of resolving the structural differences of collagen in various orthopaedically relevant cartilaginous surfaces. The current prototype developed a miniaturized femtosecond laser scanning instrument, mounted on an articulated positioning system, capable of both conventional arthroscopy and second-harmonic laser-scanning microscopy. Its optical system includes a multi-resolution optical system using a gradient index objective lens and a customized multi-purpose fiber optic sheath to maximize the collection of backscattered photons or provide joint capsule illumination. The stability and suitability of the prototype arthroscope to approach and image cartilage were evaluated through preliminary testing on fresh, minimally processed, and partially intact porcine knee joints. Image quality was sufficient to distinguish between hyaline cartilage and fibrocartilage through unique Type I and Type II collagen-specific characteristics. Imaging the meniscus revealed that the system was able to visualize differences in the collagen arrangement between the superficial and lamellar layers. Such detailed in vivo imaging of the cartilage surfaces could obviate the need to perform biopsies for ex vivo histological analysis in the future, and provide an alternative to conventional external imaging to characterize and diagnose progressive and degenerative cartilage diseases such as OA. Moreover, this system is readily customizable and may provide a suitable and modular platform for developing additional tools utilizing femtosecond lasers for tissue cutting within the familiar confines of two or three portal arthroscopy techniques.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Pre-Clinical Translation of Second Harmonic Microscopy of Meniscal and Articular Cartilage Using a Prototype Nonlinear Microendoscope

Baskey

Andreana

Lanteigne

et al. 2019

IEEE J. Transl. Eng. Health Med.

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“…It is especially challenging to achieve proficiency in arthroscopic surgery without hands-on repetition [13], and although computer simulators have been available for several years, fluid management, dynamic resistance, and haptic feedback are valuable simulation features afforded to the trainee learning on flesh-and-bone specimens. Training with human cadaveric models is expensive, and porcine knees, with anatomy similar to the human knee, are inexpensive and readily available [10,11,16,21]. Although arthroscopic training using porcine knees is not a novel concept, studies have not shown that the porcine knee is similar enough to the human cadaveric knee for arthroscopic skills assessment [3,10,21].…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, the porcine (pig) knee is known to have similar anatomy to the human knee, and specimens are readily available and easily acquired in most communities [10,11,21]. Porcine knees can be obtained for a cost of less than USD 30 per specimen, and the associated costs of storage and disposal are also lower than those associated with human specimens.…”

Section: Introductionmentioning

confidence: 99%

A Porcine Knee Model Is Valid for Use in the Evaluation of Arthroscopic Skills: A Pilot Study

Martin

Gillis

Leiter

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Previously validated knee arthroscopy evaluation tools have used human cadaveric knees. This is unsustainable because of the cost and scarcity of these specimens. Porcine (pig) knees are anatomically similar, affordable, and easily obtainable; however, whether porcine knees represent a suitable alternative to human specimens has not been evaluated. Questions/purposes The purpose of this study was to determine whether porcine knees are similar to human cadaveric knees for the assessment of knee arthroscopy skills by evaluating (1) the validity of the porcine model (whether trainees of the same level of ability scored similarly when using the two models) and (2) the reliability of the porcine model (whether surgeons with experience achieved higher scores than surgeons with less experience in the porcine model). Methods Eleven orthopaedic surgery residents (five junior residents and six senior residents), one orthopaedic sports medicine fellow, and three attending orthopaedic surgeons were enrolled. Participants were provided instructions for a proper arthroscopic examination of the knee and asked to identify, and then probe, the listed anatomic structures on both the human and porcine knee specimens. Each participant was asked to demonstrate the following skills: joint manipulation, instrument control and triangulation, fluid management, maintenance of field of view, economy of movement, and efficiency. The Objective Assessment of Arthroscopic Skills (OAAS) and checklist for diagnostic arthroscopy of the knee were used for skills assessment by one observer. Internal consistency, a measure of how well the assessment tool measures the skills being studied, was determined by Cronbach's a and group differences investigated by paired t-test and Wilcoxon signed-rank tests where appropriate. Based on a sample size calculation, a total of 37 subjects would be required for the full-scale research study to achieve a power of 0.80, with a set at 0.05, to detect a difference in OAAS score of 4.73 (25%). This value is outside of the 95% confidence intervals for the human knee. Results We found the porcine model to have a high level of face validity. There was no difference with the numbers available in total OAAS scores (mean ± SD; 95% confidence interval [CI]) within subjects between the human (18.93 ± 7.54; 14.76-23.11) and porcine (17.87 ± 6.36; 14.34-21.39) knees (p = 0.433). There was also no The institution of one or more of the authors (RKM, JL, PM) has received, during the study period, funding from the OMeGA Medical Grants Association. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Clinical Orthopaedics and Related Research 1 neither advocates nor endorses the use of any treatment, drug, or device. Readers are encouraged to always seek additional information, including FDA approval status, of any drug or device before clinical use. Each author from the instituti...

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“…Pigs, dogs and horses were considered as viable models for teaching basic arthroscopic skills. These animals have previously been used in biomechanical and tissue healing studies of anterior cruciate ligament grafts and arthroscopy . In our study, these joints did not allow good flexion until the posterior cruciate ligament was severed.…”

Section: Introductionmentioning

confidence: 99%