Probing forces of menisci: what levels are safe  for arthroscopic surgery

Probing forces of menisci: what levels are safe for arthroscopic surgery

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : Gabrie¨lle J. M. Tuijthof • Tim Horeman • Matthias U. Schafroth • Leendert Blankevoort • Gino M. M. J. Kerkhoffs
  • چاپ و سال / کشور: 2010

Description

Purpose To facilitate effective learning, feedback on performance during arthroscopic training is essential. Less attention has been paid to feedback on monitoring safe handling of delicate tissues such as meniscus. The goal is to measure in vitro probing forces of menisci and compare them with a theoretical maximum probing force (TMPF). Method Menisci samples of ten cadavers were mounted on force platforms to measure probing forces up to 20 N in three directions. Nineteen subjects participated: six novices (experience \60 arthroscopies), ten intermediates ([60 arthroscopies), and three faculty ([250 a year). All had to perform three tasks on each meniscus sample with an arthroscopic probe: push three times on the superior meniscal surface, perform one continuous run on the superior meniscal surface, and push three times on the inferior meniscal surface. The absolute maximum probing force (AMPF) was determined for each condition. A multivariable linear regression analysis was performed to assess the influence of experience on the force magnitude (P\0.05). AMPFs were compared to the TMPF (estimated to be 8.5 N). Results The AMPF of the push task was on average 2.8 N (standard deviation (SD) of 0.8 N), of the continuous run task 2.5 N (SD 0.9 N), and of the pull task 3.9 N (SD 2.0 N). Significant difference was present between experts and novices (P\0.05). The AMPFs are in the same order of magnitude as the TMPF. Conclusion The results indicate the necessity of using a safety level for tissue manipulation when training arthroscopy and a value for is magnitude
Knee Surg Sports Traumatol Arthrosc (2011) 19:248–254 DOI 10.1007/s00167-010-1251-9 Received: 17 May 2010 / Accepted: 9 August 2010 / Published online: 3 September 2010
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