Editorial Commentary: What You See Is What You Get—Is In-Office Needle Arthroscopy Ready for Prime Time?

McIntyre, Louis F.

doi:10.1016/j.arthro.2019.06.032

Arthroscopy: The Journal of Arthroscopic & Related Surgery

2019

DOI: 10.1016/j.arthro.2019.06.032

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Editorial Commentary: What You See Is What You Get—Is In-Office Needle Arthroscopy Ready for Prime Time?

Louis F. McIntyre

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Cited by 5 publications

(3 citation statements)

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“…In addition, in-office needle arthroscopy (IONA) has become increasingly popular for the evaluation of cartilage injuries, ligamentous status, and meniscus pathology. 16 , 17 , 18 , 19 , 20 The IONA procedure allows for the direct visualization and evaluation of intra-articular knee structures, including the status of the surgically repaired meniscus.…”

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confidence: 99%

In-Office Needle Arthroscopy Can Evaluate Meniscus Tear Repair Healing as an Alternative to Magnetic Resonance Imaging

DiBartola¹,

Rogers²,

Kurzweil

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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Purpose To assess the healing of horizontal cleavage tears of the meniscus 1 year after surgical repair and to determine what modality is best to determine healing. Methods Patients were prospectively followed for 12 months after surgical meniscus repair using a circumferential compression stitch. Inclusion criteria were preoperative magnetic resonance imaging (MRI) evidence of horizontal cleavage tear, age between 18 and 50 years, and no concomitant anterior cruciate ligament reconstruction. Patients were excluded if they were >50 years old, had a meniscus tear pattern other than horizontal cleavage tear, and underwent concomitant ligament reconstruction. MRIs were performed 1-year postoperatively for evaluation of repair healing. Preoperative and postoperative MRIs of tears were evaluated blindly by a musculoskeletal radiologist. In-office needle arthroscopy was performed at 6 months post-operatively. Results Eight patients were included and had surgery between March 2016 and November 2017. There were 4 medial and 4 lateral meniscus tears. No patients had recurrence of preoperative symptoms or evidence of retear. Six repairs evaluated by in-office needle (at 5.9 months postsurgery) arthroscopy demonstrated complete healing. Seven of the 8 patients had grade III changes on preoperative MRI, and 1 patient had grade IIc changes. On postoperative MRI, 5 of 7 patients had grade III changes, 1 patient had IIc changes, and 1 had IIb changes. There was no significant difference in the proportion of patients with grade III changes preoperatively compared with postoperatively ( P = .57). One of 8 patients with preoperative MRIs demonstrated extrusion where no patients demonstrate postoperative MRI evidence of extrusion ( P = .47). Conclusions Horizontal cleavage meniscal tears repaired with a circumferential compression stitch demonstrate healing on in-office needle arthroscopy 6 months after surgery. No evidence of incomplete or failed healing was found. MRI at 1 year after surgery demonstrated residual tear evidence for all patients. Level of Evidence IV, therapeutic case series.

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confidence: 99%

In-Office Needle Arthroscopy Can Evaluate Meniscus Tear Repair Healing as an Alternative to Magnetic Resonance Imaging

DiBartola¹,

Rogers²,

Kurzweil

et al. 2021

Arthroscopy, Sports Medicine, and Rehabilitation

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“…D iagnostic needle arthroscopy (NA) has been gaining popularity as a cost-effective alternative to magnetic resonance imaging. [1][2][3][4][5] Typically, NA is used as an in-office, diagnostic procedure. 6,7 As resolution and image quality improve, however, several potential advantages make NA appealing for broader therapeutic applications in the operating room.…”

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confidence: 99%

Diagnostic Needle Arthroscopy and Partial Medial Meniscectomy Using Small Bore Needle Arthroscopy

Quinn

Lang

Gilmer

2020

Arthroscopy Techniques

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As resolution and image quality improve, several potential advantages make needle arthroscopy (NA) appealing for broader therapeutic applications in the operating room. The smaller camera size and weight allow for a minimally invasive approach with smaller incisions than standard arthroscopy and decreased arthroscopic fluid use. Differences in the technology, such as a 0-degree optic and less rigid instrumentation necessitate a novel technique to accommodate thorough diagnostic arthroscopy as well as new approaches to therapeutic procedures. This manuscript introduces our preferred approach to diagnostic arthroscopy and partial medial meniscectomy with NA and small-bore instruments. The minimally invasive nature of this technology may decrease postoperative pain and improve return of comfort and function.

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“…Diagnostic needle arthroscopy (NA) has been gaining popularity as a cost-effective alternative to magnetic resonance imaging (MRI). 1 , 2 , 3 , 4 , 5 Typically, NA is used as an in-office diagnostic procedure. 6 , 7 As resolution and image quality improve, however, several potential advantages make NA appealing for broader therapeutic applications in the operating room.…”

mentioning

confidence: 99%

Diagnostic and Therapeutic Shoulder Arthroscopy Using a Small-Bore Needle Arthroscope

Shafi

Lang

Kassam

et al. 2020

Arthroscopy Techniques

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As resolution and image quality improve, several potential advantages make needle arthroscopy (NA) appealing for broader therapeutic applications in the operating room. Smaller camera size and weight allow for a minimally invasive approach with smaller incisions than standard arthroscopy and decreased use of arthroscopic fluid. Differences in the technology, such as a 0 optic and less rigid instrumentation, necessitate a modified technique to accommodate thorough diagnostic arthroscopy as well as modified approaches to therapeutic procedures. This article introduces our preferred approach to diagnostic arthroscopy of the glenohumeral joint and subacromial space with needle arthroscopy and small-bore instruments. This technique could increase efficiency and decrease operative time with certain arthroscopic procedures, and it may improve patient outcomes.

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Editorial Commentary: What You See Is What You Get—Is In-Office Needle Arthroscopy Ready for Prime Time?

Cited by 5 publications

References 6 publications

In-Office Needle Arthroscopy Can Evaluate Meniscus Tear Repair Healing as an Alternative to Magnetic Resonance Imaging

In-Office Needle Arthroscopy Can Evaluate Meniscus Tear Repair Healing as an Alternative to Magnetic Resonance Imaging

Diagnostic Needle Arthroscopy and Partial Medial Meniscectomy Using Small Bore Needle Arthroscopy

Diagnostic and Therapeutic Shoulder Arthroscopy Using a Small-Bore Needle Arthroscope

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