TY - JOUR
T1 - Shoulder and Knee Arthroscopy Access Point
T2 - Prospective Comparison of Sonographic and Palpatory Detection – Which Method is Better for Novices?
AU - Weimer, Andreas Michael
AU - Weimer, Johannes M.
AU - Berthold, Svenja
AU - Stein, Stephan
AU - Müller, Lukas
AU - Buggenhagen, Holger
AU - Balser, Gerd
AU - Stankov, Kay
AU - Sgroi, Mirco
AU - Schmidmaier, Gerhard
AU - Kloeckner, Roman
AU - Schamberger, Christian
N1 - Publisher Copyright:
© 2024. The Author(s).
PY - 2023/11/6
Y1 - 2023/11/6
N2 - Purpose Arthroscopy is one of the most common interventions in orthopedics. Hence it is important to train users early in order to ensure the safest possible identification of access portals (AP). This prospective study aimed to compare a palpatory (PalpMethod) with a sonographic (SonoMethod) method for AP location in the shoulder and knee joints. Materials and Methods The study included trainee doctors (n = 68) attending workshops (lasting approx. 90 minutes). In these workshops a teaching video initially demonstrated the PalpMethod and SonoMethod of AP identification. An experienced operator first marked the access portals on the test subject with a UV pen (determined ideal point [DIP]). Adhesive film was then affixed to the puncture regions. Subsequently participants marked on shoulders and knees first the point determined by palpation, then the point determined by sonography. Analysis involved DIP visualization with a UV lamp and employed a coordinate system around the central DIP. In addition, participants completed an evaluation before and after the workshop. Results The analysis included 324 measurements (n = 163 shoulders and n = 161 knees). The majority of participants had not previously attended any courses on manual examination (87.9 %) or musculoskeletal ultrasound (93.9 %). Overall, the markings participants made on the shoulder using the SonoMethod were significantly closer to the DIP than those made by the PalpMethod (Palp 18.8mm ± 14.5mm vs. Sono 11.2mm ± 7.2mm; p < 0.001). On the knee, however, the markings made by the PalpMethod were significantly closer to the DIP overall (Palp 8.0mm ± 3.2mm vs. Sono 12.8mm ± 5.2mm; p < 0.001). Conclusion The results show that the SonoMethod produces more accurate markings on the shoulder, while the PalpMethod is superior for the knee.
AB - Purpose Arthroscopy is one of the most common interventions in orthopedics. Hence it is important to train users early in order to ensure the safest possible identification of access portals (AP). This prospective study aimed to compare a palpatory (PalpMethod) with a sonographic (SonoMethod) method for AP location in the shoulder and knee joints. Materials and Methods The study included trainee doctors (n = 68) attending workshops (lasting approx. 90 minutes). In these workshops a teaching video initially demonstrated the PalpMethod and SonoMethod of AP identification. An experienced operator first marked the access portals on the test subject with a UV pen (determined ideal point [DIP]). Adhesive film was then affixed to the puncture regions. Subsequently participants marked on shoulders and knees first the point determined by palpation, then the point determined by sonography. Analysis involved DIP visualization with a UV lamp and employed a coordinate system around the central DIP. In addition, participants completed an evaluation before and after the workshop. Results The analysis included 324 measurements (n = 163 shoulders and n = 161 knees). The majority of participants had not previously attended any courses on manual examination (87.9 %) or musculoskeletal ultrasound (93.9 %). Overall, the markings participants made on the shoulder using the SonoMethod were significantly closer to the DIP than those made by the PalpMethod (Palp 18.8mm ± 14.5mm vs. Sono 11.2mm ± 7.2mm; p < 0.001). On the knee, however, the markings made by the PalpMethod were significantly closer to the DIP overall (Palp 8.0mm ± 3.2mm vs. Sono 12.8mm ± 5.2mm; p < 0.001). Conclusion The results show that the SonoMethod produces more accurate markings on the shoulder, while the PalpMethod is superior for the knee.
UR - http://www.scopus.com/inward/record.url?scp=85189863485&partnerID=8YFLogxK
U2 - 10.1055/a-2271-0098
DO - 10.1055/a-2271-0098
M3 - Journal articles
AN - SCOPUS:85189863485
SN - 2509-596X
VL - 10
SP - 23
EP - 29
JO - Ultrasound International Open
JF - Ultrasound International Open
ER -