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Clinically-driven approach to improve arthroscopic techniques

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In this paper, a clinically-driven approach is introduced as the starting point for the improvement of arthroscopic techniques. The approach was divided into two phases. Phase 1 consisted of a combination of observations and discussions that resulted in the definition of clinically-relevant research topics. Phase 2 consisted of an interview which aimed at analysis of the general opinion on arthroscopy, and which assigned a priority ranking to the topics. Six research topics were defined. Based on the information collected, the conclusion is that the surgeons are satisfied with current arthroscopic techniques. A majority gives priority to the optimization of cartilage treatment and to the design of a steerable arthroscopic cutter. A minority gives priority to the expansion of arthroscopic techniques. The two-phase approach was fruitful in terms of establishing clinical problem areas, and of involving surgeons in the technical improvement of arthroscopic techniques.

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  1. 1.

    Ampat G, Bruguera J, Copeland SA (1997) Aquaflo pump vs FMS 4 pump for shoulder arthroscopic surgery. Ann R Coll Surg Engl 79:341–344

  2. 2.

    Balazs M, Feussner H, Hirzinger G, Omote K, Ungeheuer A (1998) A new tool for minor-access surgery. IEEE Eng Med Biol Mag 17:45–48

  3. 3.

    Boer KT den, Jong T de, Dankelman J, Gouma DJ (2001) Problems with laparoscopic instruments; opinions of experts. J Laparoendosc Adv Surg Tech A 11:149–156

  4. 4.

    Boer KT den, Straatsburg IH, Schellinger AV, Wit LTh de, Dankelman J, Gouma DJ (1999) Quantitative analysis of the functionality and efficiency of three surgical dissection techniques. J Laparoendosc Adv Surg Tech A 9:389–395

  5. 5.

    Boer KT den, Wit LTh de, Davids PHP, Dankelman J, Gouma DJ (2001) Analysis of the quality and efficiency of learning laparoscopic skills. Surg Endosc 15:497–503

  6. 6.

    Chen FS, Frenkel SR, Di Cesare PE (1999) Repair of articular cartilage defects: part I. Basic science of cartilage healing. Am J Orthop 28:31–33

  7. 7.

    Chen FS, Frenkel SR, Di Cesare PE (1999) Repair of articular cartilage defects: part II. Treatment options. Am J Orthop 28:88–96

  8. 8.

    Faraz A, Payandeh S (1997) Synthesis and workspace study of endoscopic extenders with flexible stem. J Mech Des 119:412–414.

  9. 9.

    Grimbergen CA, Dankelman J, Stassen HG (1998) Man-machine systems aspects of minimally invasive surgery and interventional techniques. The Delft-Amsterdam cooperation. Min Invas Ther Allied Technol 7

  10. 10.

    Grimbergen CA, Jaspers JEN, Herder JL, Stassen HG (2001) Development of laparoscopic instruments. Min Invas Ther Allied Technol 10:145–154

  11. 11.

    Hashimoto D (1997) Development of ojigi electrocautery and other ojigi instruments. Min Invas Ther Allied Technol 6:287–290

  12. 12.

    Lundeen RO (1994) Arthroscopic fusion of the ankle and subtalar joint. Clin Podiatr Med Surg 11:395–406

  13. 13.

    Noyes FR, Spievack ES (1982) Extraarticular fluid dissection in tissues during arthroscopy. Am J Sports Med 10:346–351

  14. 14.

    Ogilvie-Harris DJ, Weisleder L (1995) Fluid pump systems for arthroscopy: a comparison of pressure control versus pressure and flow control. Arthroscopy 11:591–595

  15. 15.

    Parisien JS (1998) Arthroscopy of the posterior subtalar joint. In: Parisien JS (ed) Current techniques in arthroscopy. Thieme, New York, pp 161–168

  16. 16.

    Schurr MO, Melzer A, Dautzenberg P, Neisius B, Trapp R, Buess G (1993) Development of steerable instruments for minimal invasive surgery in modular conception. Acta Chir Belg 93:73–77

  17. 17.

    Sjoerdsma W (1998) Surgeons at work: time and actions analysis of the laparoscopic surgical process. PhD thesis, Delft University of Technology, Delft, The Netherlands, pp 77–91

  18. 18.

    Stassen HG (1997) Technical assessment of new technology. Proceedings of the First Annual Symposium on New Interventional Technology in an Era of Evidence Based Medicine. Amsterdam 1997

  19. 19.

    Stassen HG (2000) The influence of new technology on the human-machine interaction in biomedical engineering: a challenge or a problem? Proceedings of the 7th IFAC Symposium on automated systems based on human skill, Aachen, Germany, 2000, pp 99–107

  20. 20.

    Stassen HG (2001) Biomedical engineering: an interesting multidisciplinary human-machine systems field with many problems and challenges. Proceedings of the 8th IFAC/IFIP/IFORS/IEA Symposium on analysis, design, and evaluation of human-machine systems, Kassel, Germany, 18 September 2001, pp 507-516

  21. 21.

    Stassen HG, Dankelman J, Grimbergen CA (1999) Open versus minimally invasive surgery: a man-machine system approach. Trans Inst Meas Control 21:151–162

  22. 22.

    Tasto JP, Laimins PD (1998) Recent advances in ankle arthroscopic techniques. In: Parisien JS (ed) Current techniques in arthroscopy. Thieme, New York, pp 181–194

  23. 23.

    Tol JL, Struijs PAA, Bossuyt PMM, Verhagen RAW, van Dijk CN (2000) Treatment strategies in osteochondral defects of the talar dome: a systematic review. Foot Ankle Int 21:119–126

  24. 24.

    Tuijthof GJM (2003) Technical improvement of arthroscopic techniques. Delft University of Technology, Delft, The Netherlands

  25. 25.

    van Dijk CN, Kort NP (1998) Tendoscopy of the peroneal tendons. Arthroscopy 14:471–478

  26. 26.

    van Dijk CN, Kort NP, Scholten PE (1997) Tendoscopy of the posterior tibial tendon. Arthroscopy 13:692–698

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This research is part of the Minimally Invasive Surgery and Interventional Techniques program (http://mms.tudelft.nl/misit/index.htm) and is done in close cooperation with the Academic Medical Center in Amsterdam. Furthermore, the authors wish to thank R. te Slaa and H. Verburg from the Reinier de Graaf Gasthuis in Delft and D. Wouters from the Talma Sionsberg in Leeuwarden for their hospitality and cooperation.

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Correspondence to G. J. M. Tuijthof.

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Tuijthof, G.J.M., van Dijk, C.N., Herder, J.L. et al. Clinically-driven approach to improve arthroscopic techniques. Knee Surg Sports Traumatol Arthrosc 13, 48–54 (2005). https://doi.org/10.1007/s00167-003-0437-9

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  • Arthroscopy
  • Interview
  • Clinically-driven approach
  • Evaluation
  • Observations