Medulloscopy of the tibia: initial report of a new technique

This study shows the ability of 3 standard endoscopic instruments to access the length of the intramedullary canal through a technique that we have termed "medulloscopy." Cadaveric studies were performed to determine the dimensions of the proximal tibia and the relative abilities of a knee arthroscope, a hip arthroscope, and a flexible rhinolaryngoscope to visualize the length of the intramedullary canal of the tibia. The 3 endoscopes were able to access the length of the intramedullary canal in the following proportions: 19.1% +/- 1.0% for the knee arthroscope, 29.1% +/- 3.8% for the hip arthroscope, and 84.1% +/- 1.8% for the flexible scope (P <.05). The proximal aspect of the intramedullary canal of the tibia can be visualized with standard knee and hip arthroscopic equipment. A flexible rhinolaryngoscope was required to access the distal tibia. Further studies are needed to determine the specific indications for intramedullary arthroscopy.