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Arthroscopically Assisted Suprapatellar Tibial Nail Removal.

Alexandre Coelho1, Juan Francisco Sánchez-Soler1,2, Juan Manuel Fernández-Dominguez3

  • 1Orthopedic Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.

Arthroscopy Techniques
|September 1, 2023
PubMed
Summary

This study presents an arthroscopically assisted technique for suprapatellar tibial nail removal, preserving the patellar tendon and minimizing knee pain. It offers a minimally invasive solution for implant removal after tibial fracture fixation.

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Area of Science:

  • Orthopedic Surgery
  • Biomedical Engineering
  • Arthroscopy

Background:

  • Intramedullary nailing is a primary fixation method for tibial shaft fractures.
  • The infrapatellar approach is the traditional gold standard, but the suprapatellar approach offers benefits like ease of use for proximal fractures and reduced anterior knee pain.
  • Implant removal via the suprapatellar approach is challenging, often necessitating a new transpatellar tendon incision.

Purpose of the Study:

  • To describe a novel arthroscopically assisted technique for suprapatellar tibial nail removal.
  • To evaluate the advantages of using the same suprapatellar approach for both insertion and removal.
  • To minimize secondary damage to the patellar tendon and prevent intra-articular cartilage injury.

Main Methods:

  • Arthroscopically assisted suprapatellar tibial nail removal.
  • Utilizing the same surgical approach and instrumentation employed for nail insertion.
  • Direct arthroscopic visualization of the patellofemoral joint during removal.

Main Results:

  • The described technique allows for tibial nail removal through the original suprapatellar approach.
  • Preservation of the patellar tendon integrity, avoiding secondary damage.
  • Direct visualization aids in preventing iatrogenic cartilage injury and identifying associated intra-articular lesions.

Conclusions:

  • Arthroscopically assisted suprapatellar tibial nail removal is a viable and advantageous technique.
  • This method preserves the patellar tendon and reduces the risk of knee joint complications.
  • It offers a minimally invasive option for implant removal, enhancing patient outcomes.