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CC BY-NC-ND 4.0 · Ultrasound Int Open 2024; 10: a22710098
DOI: 10.1055/a-2271-0098
Original Article

Shoulder and Knee Arthroscopy Access Point: Prospective Comparison of Sonographic and Palpatory Detection – Which Method is Better for Novices?

Andreas Michael Weimer   ‡
1   Clinic for Trauma and Reconstructive Surgery, University Hospital Heidelberg, Heidelberg, Germany (Ringgold ID: RIN27178)
,
Johannes M. Weimer    ‡
2   Rudolf-Frey Teaching Department, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany (Ringgold ID: RIN39068)
,
Svenja Berthold
3   Department for Orthopaedics and Trauma Surgery, University Medical Centre Mannheim, Mannheim, Germany (Ringgold ID: RIN36642)
,
Stephan Stein
1   Clinic for Trauma and Reconstructive Surgery, University Hospital Heidelberg, Heidelberg, Germany (Ringgold ID: RIN27178)
,
Lukas Müller
4   Department of Diagnostic and Interventional Radiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany (Ringgold ID: RIN39068)
,
Holger Buggenhagen
2   Rudolf-Frey Teaching Department, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany (Ringgold ID: RIN39068)
,
Gerd Balser
2   Rudolf-Frey Teaching Department, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany (Ringgold ID: RIN39068)
,
Kay Stankov
5   Corporate Finance, Technical University of Darmstadt, Darmstadt, Germany (Ringgold ID: RIN26536)
,
Mirco Sgroi
6   Department of Orthopaedic Surgery, Ulm University Medical Center, Ulm, Germany (Ringgold ID: RIN27197)
,
Gerhard Schmidmaier
1   Clinic for Trauma and Reconstructive Surgery, University Hospital Heidelberg, Heidelberg, Germany (Ringgold ID: RIN27178)
,
Roman Kloeckner    *
7   Institute of Interventional Radiology, University Medical Center Schleswig Holstein Campus Lübeck, Lübeck, Germany (Ringgold ID: RIN54360)
,
Christian Schamberger   *
1   Clinic for Trauma and Reconstructive Surgery, University Hospital Heidelberg, Heidelberg, Germany (Ringgold ID: RIN27178)
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Abstract

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.

Keywords

musculoskeletal ultrasound - arthroscopy - ultrasound-guided procedure - knee joint - shoulder joint

‡ These authors contributed equally to this work and share first-authorship.


* These authors contributed equally to this work and share senior authorship.


Zusatzmaterial



Publication History

Received: 06 November 2023

Accepted after revision: 03 February 2024

Article published online:
04 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Bibliographical Record
Andreas Michael Weimer, Johannes M. Weimer, Svenja Berthold, Stephan Stein, Lukas Müller, Holger Buggenhagen, Gerd Balser, Kay Stankov, Mirco Sgroi, Gerhard Schmidmaier, Roman Kloeckner, Christian Schamberger. Shoulder and Knee Arthroscopy Access Point: Prospective Comparison of Sonographic and Palpatory Detection – Which Method is Better for Novices?. Ultrasound Int Open 2024; 10: a22710098.
DOI: 10.1055/a-2271-0098
 

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