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Iatrogenic Articular Cartilage Injury in Arthroscopic Hip and Knee Videos and the Potential for Cartilage Cell Death When Simulated in a Bovine Model
Journal article   Open access   Peer reviewed

Iatrogenic Articular Cartilage Injury in Arthroscopic Hip and Knee Videos and the Potential for Cartilage Cell Death When Simulated in a Bovine Model

Jocelyn Compton, Michael Slattery, Mitchell Coleman and Robert Westermann
Arthroscopy, Vol.36(8), pp.2114-2121
08/01/2020
DOI: 10.1016/j.arthro.2020.02.017
PMCID: PMC9126109
PMID: 32145300
url
https://www.ncbi.nlm.nih.gov/pmc/articles/9126109View
Open Access

Abstract

Purpose: To determine the incidence and characterize the severity of iatrogenic cartilage injuries. Methods: Technique videos of arthroscopic femoral acetabular impingement procedures and meniscus repairs on VuMedi (n = 85) and Arthroscopy Techniques (n = 45) were reviewed and iatrogenic cartilage injuries were identified and graded (minor, intermediate, and major injury) by 2 independent reviewers. To demonstrate that even minor injuries on a cellular scale result in damage, a bovine osteochondral explant was used to create comparable minor iatrogenic injuries at varied forces that do not disrupt the articular surface (1.5 N, 2.5 N, and 9.8 N). Dead chondrocytes at the site of injury were stained with ethidium homodimer-2 and imaged with an Olympus FV1000 confocal microscope. chi(2) tests were used for analysis; all results with P < .05 were considered significant. Results: In total, 130 videos of arthroscopic meniscus and femoral acetabular impingement procedures were analyzed and the incidence of iatrogenic cartilage injury was 73.8%. There were 110 (70.0%) minor, 35 (22.3%) intermediate, and 11 (7.0%) major iatrogenic injuries. All forces tested in the minor injury bovine model resulted in chondrocyte death at the site of contact. Conclusions: Iatrogenic articular cartilage injuries are common in arthroscopy, occurring in more than 70% of the surgeon-published instructional videos analyzed. At least some chondrocyte death occurs with minor simulated iatrogenic injuries (1.5 N).
Life Sciences & Biomedicine Orthopedics Science & Technology Sport Sciences Surgery

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