Incisionless Synovium and Bone Biopsy of a Painful Total Knee Arthroplasty

Knee arthroscopy has evolved greatly from its inception in the 20th century. Arthroscopic synovectomy is performed in the case of infection or significant synovitis. We continue to develop more minimally invasive procedures, and the NanoScope (Arthrex, Naples, FL) has provided a new generation of possibilities. The system does not require the use of a standard incision or portal, and using the GraftNet (Arthrex), we can harvest tissue with a standard shaver for further evaluation. This technique provides an option to perform a synovial and bone biopsy in a painful total knee arthroplasty without the use of standard arthroscopy portals through an incisionless approach. This technique provides distinct advantages over a more open approach in the setting of a prosthetic joint. Specifically, this technique is useful for a difficult-to-diagnose painful total knee arthroplasty.