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Full-Endoscopic Interlaminar Approach for Decompression of Lateral Recess Stenosis

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Revision Lapidus Arthrodesis by Bone Endoscopy.

¹Department of Orthopaedics and Traumatology, North District Hospital, Sheung Shui, NT, Hong Kong SAR, China.

Arthroscopy Techniques

|October 7, 2016

Summary

Revision bone endoscopy effectively treats symptomatic nonunion of the first tarsometatarsal joint. This technique addresses screw loosening, bone cysts, and the screw tract, resolving co-pathologies in revision arthrodesis.

Area of Science:

Orthopedic Surgery
Foot and Ankle Surgery
Minimally Invasive Procedures

Background:

Symptomatic nonunion of the first tarsometatarsal joint often requires revision arthrodesis.
Previous transarticular screw fixation can lead to screw loosening and bone cyst formation, complicating revision.
Standard arthroscopic revision may be insufficient for managing dilated screw tracts and associated bone cysts.

Purpose of the Study:

To describe a novel technique for revision arthrodesis of the first tarsometatarsal joint using bone endoscopy.
To address symptomatic nonunion, screw loosening, bone cysts, and dilated screw tracts in a single procedure.
To present bone endoscopy as a viable solution for complex revision cases.

Main Methods:

Bone endoscopy was utilized for revision arthrodesis in patients with symptomatic nonunion of the first tarsometatarsal joint.

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The screw tract served as the portal for accessing the nonunion site, bone cysts, and the screw tract itself.

Zonal debridement and bone grafting were performed on the bone cysts, nonunion site, and screw tract via endoscopy.

Main Results:

Bone endoscopy allowed for comprehensive management of co-pathologies associated with first tarsometatarsal nonunion.
The technique facilitated debridement and bone grafting within the screw tract and cyst formations.
This approach offers a solution for complex revision scenarios previously challenging with standard arthroscopy.

Conclusions:

Bone endoscopy is an effective method for revision arthrodesis in symptomatic first tarsometatarsal joint nonunion with screw loosening and bone cysts.
The technique allows for simultaneous treatment of the nonunion, screw tract, and bone cysts.
This minimally invasive approach resolves multiple co-pathologies, offering a promising solution for revision surgery.