Orthopedic Arthroscopy Implants Surgical Techniques

🦴 ORTHOPEDIC ARTHROSCOPY IMPLANTS – SURGICAL TECHNIQUE

1. Preoperative Planning

• Detailed clinical evaluation and history

• Imaging:

  • MRI (ligaments, cartilage, labrum)

  • X-ray (bone alignment)

• Selection of:

  • Implant type (anchor, screw, button, etc.)

  • Material (Titanium / Bioabsorbable PLA)

  • Size (based on anatomy and graft)

• Plan:

  • Portal placement

  • Tunnel positioning (ACL/PCL)

  • Graft type (hamstring, patellar tendon, allograft)

👉 Proper planning is critical for accurate implant positioning and long-term fixation success.

2. Patient Positioning & Setup

• Knee Arthroscopy: Supine, leg holder

• Shoulder Arthroscopy:

  • Beach-chair OR lateral decubitus

• Apply:

  • Tourniquet (if required)

  • Sterile draping

• Administer:

  • General or regional anesthesia

3. Portal Creation & Diagnostic Arthroscopy

• Standard portals:

  • Anterolateral (viewing)

  • Anteromedial (working)

• Insert arthroscope and:

  • Evaluate joint structures

  • Identify:

    • Ligament tears (ACL/PCL)

    • Meniscus injury

    • Cartilage defects

👉 Address associated pathology before implant fixation.

4. Site Preparation

Bone Preparation

• Debride damaged tissue

• Create fresh bleeding bone bed

• Use burr/shaver for:

  • Cartilage lesions

  • Tendon footprint

Soft Tissue Preparation

• Mobilize tendon/ligament

• Remove fibrotic tissue

• Ensure adequate length for fixation

5. IMPLANT-SPECIFIC SURGICAL TECHNIQUES

A. 🔩 Interference Screw Technique (ACL/PCL Reconstruction)

Steps:

1. Drill tibial and femoral tunnels

2. Pass prepared graft through tunnels

3. Maintain tension under arthroscopic visualization

4. Insert screw:

   • Alongside graft inside tunnel

   • Using guidewire (if cannulated)

5. Compress graft against tunnel wall

Key Points:

• Ensures strong graft fixation

• Correct placement prevents graft slippage

• Bio screws eliminate removal surgery

B. 🧵 Suture Anchor Technique (Rotator Cuff / Labrum Repair)

Steps:

1. Drill pilot hole at insertion site

2. Insert anchor using inserter

3. Pass sutures through tissue:

   • Mattress / simple configuration

4. Tie arthroscopic knots

5. Confirm fixation stability

Key Points:

• Provides soft tissue-to-bone fixation

• Requires accurate angle and depth control

C. 🔘 Button / Adjustable Loop Fixation

Steps:

1. Prepare graft and loop system

2. Pass through bone tunnel

3. Flip button on cortical surface

4. Tension adjustable loop

5. Lock graft in position

Advantages:

• Adjustable tensioning

• Strong cortical fixation

• Minimally invasive

D. 🪡 Arthroscopy Staple Technique

Steps:

1. Prepare bone surface

2. Position ligament/tendon

3. Insert staple:

   • With or without pilot holes

4. Impact staple into bone

Applications:

• Meniscus repair

• Ligament fixation

• Tendon attachment

E. 🧿 Loop Washer Technique

Steps:

1. Place washer over fixation site

2. Pass sutures through tissue

3. Apply controlled tension

4. Tie sutures over washer

5. Verify compression and alignment

👉 Provides even force distribution and secure fixation

F. 🧷 Cannulated Screw Technique

Steps:

1. Insert guidewire

2. Drill over guidewire

3. Advance cannulated screw

4. Confirm position under imaging

Advantage:

• High precision placement

• Minimally invasive approach

G. 🧴 Arthroscopy Cannula Technique

Steps:

1. Establish portal

2. Insert cannula into joint

3. Use for:

   • Instrument passage

   • Suture management

4. Remove after procedure

6. Intraoperative Assessment

• Check:

  • Graft tension

  • Implant stability

  • Range of motion

• Perform:

  • Lachman test (ACL)

  • Rotational stability

• Arthroscopic confirmation

7. Wound Closure

• Irrigation with saline

• Close portals:

  • Sutures / steri-strips

• Apply sterile dressing

• Immobilize (brace/sling)

8. Postoperative Protocol

Immediate:

• Pain management

• Limb elevation

• Partial weight-bearing (if allowed)

Rehabilitation:

• Phase 1: Passive ROM

• Phase 2: Active ROM

• Phase 3: Strengthening

• Phase 4: Return to activity

Follow-up:

• Clinical + radiological evaluation

9. Complications & Precautions

• Infection

• Implant loosening/failure

• Graft failure

• Tunnel widening

• Soft tissue irritation

👉 Avoid by:

• Accurate implant placement

• Proper sizing

• Controlled tensioning

✅ Key Advantages of Jindal Medi Surge Arthroscopy Implants

• Minimally invasive application

• Wide implant range (screws, anchors, buttons)

• Bioabsorbable options

• High fixation strength

• Reduced recovery time

📌 Conclusion

The surgical technique for arthroscopy implants from Jindal Medi Surge follows standard minimally invasive orthopedic principles with implant-specific adaptations. Success depends on:

• Accurate tunnel/anchor placement

• Proper implant selection

• Controlled graft tension

• Structured rehabilitation