{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["11(11)"],"submitter":[null],"pubmed_abstract":["Diagnostic needle arthroscopy performed in office is a safe and cost-effective method for accurate evaluation of intra-articular pathology, improving clinical decision making. This minimally invasive approach is an effective alternative to traditional diagnostic techniques of diagnostic surgical arthroscopy and magnetic resonance imaging (MRI). Needle arthroscopy is considered low-risk, with an extremely low complication rate when performed with appropriate technique and indications. The purpose of this article is to describe an approach to an in-office diagnostic procedure using a needle arthroscopy system. Technique Video Video 1 Standard arthroscopic approach to the left knee via anterolateral and anteromedial portals. Place the patient in a supine or sitting position, with the left knee at ∼90°, and sterilely prep the left knee. Anesthetize the anterolateral and anteromedial standard portal sites with ∼15 cc of local anesthetic (1% lidocaine with epinephrine and 0.5% Marcaine without epinephrine) on a 25-gauge needle, creating a wheel. Next, insufflate the joint via the anterolateral portal using 20 cc of .25% Marcaine without epinephrine on a 20-gauge needle. After an additional re-prep of the knee with chlorohexidine, wait about 5 minutes, and then place sterile blue drapes at the proximal tibia and distal femur to create a sterile field. Introduce the 2.2-mm inflow NanoScope™ (Arthrex) sheath with the sharp trocar into the anterolateral portal, which is the primary viewing portal, and withdraw the trocar, and then attach the one-way stop valve to the sheath. Insert the 1.9-mm NanoScope™ (Arthrex) needle arthroscopy system, which is approximately one-third of the size of a standard arthroscopy camera. Connect a 30-cc syringe of sterile 0.9% normal saline to the NanoScope™ (Arthrex) via the one-way stop valve, open the valve, and use all 30 cc to insufflate the joint. This is followed by connecting another 30 cc of sterile saline to the one-way stop valve to inject as needed, while performing a standard diagnostic left knee arthroscopy to identify and assess any intraarticular pathology. In this particular patient, a medial femoral condyle defect is identified. If needed, a 2.0-mm NanoProbe (Arthrex) or other NanoSope™ (Arthrex) instrumentation can be used for both diagnostic and therapeutic treatment. This is inserted into the anteromedial portal, which is the accessory portal. If possible, have an assistant available to provide valgus stress or assist in patient knee positioning, as the arthroscopy is being performed. At the conclusion of the standard diagnostic needle arthroscopy, aspirate as much fluid off the knee as possible through the NanoSope™ (Arthrex), while it remains inserted in the anterolateral portal. Remove the scope and resolve any bleeding by applying pressure with sterile gauze. Apply Steri-Strips to the percutaneous portal sites, followed by gauze and an ACE wrap. The patient may ambulate immediately afterward. Post-procedure antibiotics may be considered"],"journal":["Arthroscopy techniques"],"pagination":["e1923-e1927"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC9705598"],"repository":["biostudies-literature"],"pubmed_title":["In-Office Diagnostic Needle Arthroscopy Using the NanoScopeTM Arthroscopy System"],"pmcid":["PMC9705598"],"additional_accession":[]},"is_claimable":false,"name":"In-Office Diagnostic Needle Arthroscopy Using the NanoScopeTM Arthroscopy System","description":"Diagnostic needle arthroscopy performed in office is a safe and cost-effective method for accurate evaluation of intra-articular pathology, improving clinical decision making. This minimally invasive approach is an effective alternative to traditional diagnostic techniques of diagnostic surgical arthroscopy and magnetic resonance imaging (MRI). Needle arthroscopy is considered low-risk, with an extremely low complication rate when performed with appropriate technique and indications. The purpose of this article is to describe an approach to an in-office diagnostic procedure using a needle arthroscopy system. Technique Video Video 1 Standard arthroscopic approach to the left knee via anterolateral and anteromedial portals. Place the patient in a supine or sitting position, with the left knee at ∼90°, and sterilely prep the left knee. Anesthetize the anterolateral and anteromedial standard portal sites with ∼15 cc of local anesthetic (1% lidocaine with epinephrine and 0.5% Marcaine without epinephrine) on a 25-gauge needle, creating a wheel. Next, insufflate the joint via the anterolateral portal using 20 cc of .25% Marcaine without epinephrine on a 20-gauge needle. After an additional re-prep of the knee with chlorohexidine, wait about 5 minutes, and then place sterile blue drapes at the proximal tibia and distal femur to create a sterile field. Introduce the 2.2-mm inflow NanoScope™ (Arthrex) sheath with the sharp trocar into the anterolateral portal, which is the primary viewing portal, and withdraw the trocar, and then attach the one-way stop valve to the sheath. Insert the 1.9-mm NanoScope™ (Arthrex) needle arthroscopy system, which is approximately one-third of the size of a standard arthroscopy camera. Connect a 30-cc syringe of sterile 0.9% normal saline to the NanoScope™ (Arthrex) via the one-way stop valve, open the valve, and use all 30 cc to insufflate the joint. This is followed by connecting another 30 cc of sterile saline to the one-way stop valve to inject as needed, while performing a standard diagnostic left knee arthroscopy to identify and assess any intraarticular pathology. In this particular patient, a medial femoral condyle defect is identified. If needed, a 2.0-mm NanoProbe (Arthrex) or other NanoSope™ (Arthrex) instrumentation can be used for both diagnostic and therapeutic treatment. This is inserted into the anteromedial portal, which is the accessory portal. If possible, have an assistant available to provide valgus stress or assist in patient knee positioning, as the arthroscopy is being performed. At the conclusion of the standard diagnostic needle arthroscopy, aspirate as much fluid off the knee as possible through the NanoSope™ (Arthrex), while it remains inserted in the anterolateral portal. Remove the scope and resolve any bleeding by applying pressure with sterile gauze. Apply Steri-Strips to the percutaneous portal sites, followed by gauze and an ACE wrap. The patient may ambulate immediately afterward. Post-procedure antibiotics may be considered","dates":{"release":"2022-01-01T00:00:00Z","publication":"2022 Oct","modification":"2025-04-04T19:37:56.02Z","creation":"2025-04-04T19:37:56.02Z"},"accession":"S-EPMC9705598","cross_references":{}}