Skip to main content
Erschienen in: Archives of Orthopaedic and Trauma Surgery 11/2014

01.11.2014 | Trauma Surgery

Novel endoscopic sacroiliac screw removal technique: reduction of intraoperative radiation exposure

verfasst von: Michael Oberst, Gerhard Konrad, Georg W. Herget, Abdelrehim El Tayeh, Norbert P. Suedkamp

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 11/2014

Einloggen, um Zugang zu erhalten

Abstract

Objective

We report in the following on our technique of endoscopic sacroiliacal screw removal as a new extra-articular endoscopic method in soft tissue surgery, aimed at the reduction of radiation exposure for both the patient and the surgical teams.

Summary of background data

Patients who underwent endoscopic implant removal from the dorsal pelvic ring (Group A) were retrospectively compared with a control group, in which the screws were removed via the conventional approach (Group B). The parameters of interest were the extent of x-ray exposure in seconds and surgical duration in minutes as well as approach related peri- and postoperative complications.

Results

34 screws were removed endoscopically from 28 patients in group A and 35 screws from 29 patients in group B. The mean skin-to-skin time in group A was 36.1 (15–111) min and 32.7 (12–114) min in group B. The difference was not statistically significant (p > 0.05). The average radiation time in group A was 5.7 ± 3.2 s (range, 0–101 s), while in group B the radiation time was significantly longer (52.6 ± 23 s (range, 0–239 s); p = 0.005).

Conclusions

Endoscopic screw removal from the posterior pelvic ring reduces the intraoperative radiation time whereas the skin-to-skin times do not differ from the conventional procedure.

Level of evidence

Case–control study, Level III.
Literatur
1.
Zurück zum Zitat Diaz AA, Miguel A (2002) Endoscopic resection of a distal femoral osteochondroma: description of the technique and case report. Arthroscopy 18(5):23EPubMedCrossRef Diaz AA, Miguel A (2002) Endoscopic resection of a distal femoral osteochondroma: description of the technique and case report. Arthroscopy 18(5):23EPubMedCrossRef
2.
Zurück zum Zitat Stricker SJ (1995) Extraarticular endoscopic excision of femoral head chondroblastoma. J Pediatr Orthop 15(5):578–581PubMedCrossRef Stricker SJ (1995) Extraarticular endoscopic excision of femoral head chondroblastoma. J Pediatr Orthop 15(5):578–581PubMedCrossRef
3.
Zurück zum Zitat Fukunaga S, Futani H, Yoshiya S (2007) Endoscopically assisted resection of a scapular osteochondroma causing snapping scapula syndrome. World J Surg Oncol 22(5):37CrossRef Fukunaga S, Futani H, Yoshiya S (2007) Endoscopically assisted resection of a scapular osteochondroma causing snapping scapula syndrome. World J Surg Oncol 22(5):37CrossRef
4.
Zurück zum Zitat Saisu T, Kamegaya M, Watanabe A, Ochiai N, Takahashi K (2008) Endoscopic surgery for chronic osteomyelitis. Extending across the physis a report of two cases. J Bone Joint Surg Am 90(8):1744–1750PubMedCrossRef Saisu T, Kamegaya M, Watanabe A, Ochiai N, Takahashi K (2008) Endoscopic surgery for chronic osteomyelitis. Extending across the physis a report of two cases. J Bone Joint Surg Am 90(8):1744–1750PubMedCrossRef
5.
Zurück zum Zitat Härle A (1985) Die optisch kontrollierte Markausräumung bei der Osteomyelitis-Behandlung. Z Orthop 123:388–394PubMedCrossRef Härle A (1985) Die optisch kontrollierte Markausräumung bei der Osteomyelitis-Behandlung. Z Orthop 123:388–394PubMedCrossRef
6.
Zurück zum Zitat Stauber MH, Basset GS (1994) Pedicle screw placement with intraosseous endoscopy. Spine 19(1):57–61PubMedCrossRef Stauber MH, Basset GS (1994) Pedicle screw placement with intraosseous endoscopy. Spine 19(1):57–61PubMedCrossRef
7.
Zurück zum Zitat Bojkow WP, Karalin AN (1989) Bone marrow endoscopy. Orthop Travmatol Protez 3:68–69 Bojkow WP, Karalin AN (1989) Bone marrow endoscopy. Orthop Travmatol Protez 3:68–69
8.
Zurück zum Zitat Oberst M, Bosse A, Holz U (2006) Intramedullary fracture reduction of long bone under visual control. Experimental results of an endoscopic technique. Arthroscopy 22(6):686.e1–686.e5CrossRef Oberst M, Bosse A, Holz U (2006) Intramedullary fracture reduction of long bone under visual control. Experimental results of an endoscopic technique. Arthroscopy 22(6):686.e1–686.e5CrossRef
9.
Zurück zum Zitat Oberst M, Niemeyer Ph, Suedkamp NP (2007) Endoscopic controlled intramedullary fracture reduction. A case report about closed fracture reduction under visual control. Arch Orthop Trauma Surg 127(8):647–649PubMedCrossRef Oberst M, Niemeyer Ph, Suedkamp NP (2007) Endoscopic controlled intramedullary fracture reduction. A case report about closed fracture reduction under visual control. Arch Orthop Trauma Surg 127(8):647–649PubMedCrossRef
10.
Zurück zum Zitat Johnson LL, Morrison KM, Wood DL (2000) The application of arthroscopic principles to bone grafting of delayed union of long bone fractures. Arthroscopy 16:279–289PubMedCrossRef Johnson LL, Morrison KM, Wood DL (2000) The application of arthroscopic principles to bone grafting of delayed union of long bone fractures. Arthroscopy 16:279–289PubMedCrossRef
11.
Zurück zum Zitat Kim SJ, Shin SJ, Yang KH, Moon SH, Lee SC (2000) Endoscopic bone graft for delayed union and nonunion. Yonsei Med J 41:107–111PubMedCrossRef Kim SJ, Shin SJ, Yang KH, Moon SH, Lee SC (2000) Endoscopic bone graft for delayed union and nonunion. Yonsei Med J 41:107–111PubMedCrossRef
12.
Zurück zum Zitat Roberts CS, Walker JA, Statton J, Seligson D (2001) Medulloscopy for sepsis or non-union: early clinical experience with the tibia and femur. Arthroscopy 17(9):E39PubMedCrossRef Roberts CS, Walker JA, Statton J, Seligson D (2001) Medulloscopy for sepsis or non-union: early clinical experience with the tibia and femur. Arthroscopy 17(9):E39PubMedCrossRef
14.
15.
Zurück zum Zitat Toms AD, Leese N, Gregson PA, McGeoch C (2001) The use of the cystoscope in revision hip arthroplasty. J Arthroplasty 16(4):543–544PubMedCrossRef Toms AD, Leese N, Gregson PA, McGeoch C (2001) The use of the cystoscope in revision hip arthroplasty. J Arthroplasty 16(4):543–544PubMedCrossRef
16.
Zurück zum Zitat Oberst M, Schlegel K, Mory C, Suedkamp N (2005) Endoscopically controlled removal of a broken intramedullary nail. A new technique. Injury Extra 36:582–585CrossRef Oberst M, Schlegel K, Mory C, Suedkamp N (2005) Endoscopically controlled removal of a broken intramedullary nail. A new technique. Injury Extra 36:582–585CrossRef
17.
Zurück zum Zitat Cole JD, Blum DA, Ansel LJ (1996) Outcome after fixation of unstable posterior pelvic ring injuries. Clin Orthop Relat Res 329:160–179PubMedCrossRef Cole JD, Blum DA, Ansel LJ (1996) Outcome after fixation of unstable posterior pelvic ring injuries. Clin Orthop Relat Res 329:160–179PubMedCrossRef
18.
Zurück zum Zitat Keating JF, Werier J, Blachut P, Broekhuyse H, Meek RN, O’Brien PJ (1999) Early fixation of the vertically unstable pelvis: the role of iliosacral screw fixation of the posterior lesion. J Orthop Trauma 13:107–113PubMedCrossRef Keating JF, Werier J, Blachut P, Broekhuyse H, Meek RN, O’Brien PJ (1999) Early fixation of the vertically unstable pelvis: the role of iliosacral screw fixation of the posterior lesion. J Orthop Trauma 13:107–113PubMedCrossRef
19.
Zurück zum Zitat Matta JM, Saucedo T (1989) Internal fixation of pelvic ring fractures. Clin Orthop Relat Res 242:83–97PubMed Matta JM, Saucedo T (1989) Internal fixation of pelvic ring fractures. Clin Orthop Relat Res 242:83–97PubMed
20.
Zurück zum Zitat Routt ML Jr, Kregor PJ, Simonian PT, Mayo KA (1995) Early results of percutaneous iliosacral screws placed with the patient in the supine position. J Orthop Trauma 3:207–214CrossRef Routt ML Jr, Kregor PJ, Simonian PT, Mayo KA (1995) Early results of percutaneous iliosacral screws placed with the patient in the supine position. J Orthop Trauma 3:207–214CrossRef
21.
Zurück zum Zitat Schweitzer D, Zylberberg A, Córdova M, Gonzalez J (2008) Closed reduction and iliosacral percutaneous fixation of unstable pelvic ring fractures. Injury 8:869–874CrossRef Schweitzer D, Zylberberg A, Córdova M, Gonzalez J (2008) Closed reduction and iliosacral percutaneous fixation of unstable pelvic ring fractures. Injury 8:869–874CrossRef
22.
Zurück zum Zitat Remiger A, Engelhardt P (1996) Percutaneous iliosacral screw fixation of vertical unstable pelvic ring fractures. Swiss Surg 2(6):259–263PubMed Remiger A, Engelhardt P (1996) Percutaneous iliosacral screw fixation of vertical unstable pelvic ring fractures. Swiss Surg 2(6):259–263PubMed
23.
Zurück zum Zitat Routt ML Jr, Simonian PT, Mills WJ (1997) Iliosacral screw fixation: early complications of the percutaneous technique. J Orthop Trauma 11(8):584–589PubMedCrossRef Routt ML Jr, Simonian PT, Mills WJ (1997) Iliosacral screw fixation: early complications of the percutaneous technique. J Orthop Trauma 11(8):584–589PubMedCrossRef
24.
Zurück zum Zitat Yücel N, Lefering R, Tjardes T, Korenkov M, Schierholz J, Tiling T, Bouillon B, Rixen D (2004) Is implant removal after percutaneous iliosacral screw fixation of unstable posterior pelvic ring disruptions indicated? Unfallchirurg 107(6):468–474PubMedCrossRef Yücel N, Lefering R, Tjardes T, Korenkov M, Schierholz J, Tiling T, Bouillon B, Rixen D (2004) Is implant removal after percutaneous iliosacral screw fixation of unstable posterior pelvic ring disruptions indicated? Unfallchirurg 107(6):468–474PubMedCrossRef
25.
Zurück zum Zitat Oberst M, Bosse A, Holz U (2002) Intramedullary bone endoscopy (IBE). First results of experimental intramedullary endoscopy of long bone. Unfallchirurg 105(9):853–855PubMedCrossRef Oberst M, Bosse A, Holz U (2002) Intramedullary bone endoscopy (IBE). First results of experimental intramedullary endoscopy of long bone. Unfallchirurg 105(9):853–855PubMedCrossRef
26.
Zurück zum Zitat Oberst M, Bosse A, Holz U (2004) Intramedullary pressure during endoscopy of the long bone: experimental results of a new endoscopic technique. Arthroscopy 20(5):552–555PubMedCrossRef Oberst M, Bosse A, Holz U (2004) Intramedullary pressure during endoscopy of the long bone: experimental results of a new endoscopic technique. Arthroscopy 20(5):552–555PubMedCrossRef
27.
Zurück zum Zitat Altman DT, Jones CB, Routt ML Jr (1999) Superior gluteal artery injury during iliosacral screw placement. J Orthop Trauma 13(3):220–227PubMedCrossRef Altman DT, Jones CB, Routt ML Jr (1999) Superior gluteal artery injury during iliosacral screw placement. J Orthop Trauma 13(3):220–227PubMedCrossRef
Metadaten
Titel
Novel endoscopic sacroiliac screw removal technique: reduction of intraoperative radiation exposure
verfasst von
Michael Oberst
Gerhard Konrad
Georg W. Herget
Abdelrehim El Tayeh
Norbert P. Suedkamp
Publikationsdatum
01.11.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
Archives of Orthopaedic and Trauma Surgery / Ausgabe 11/2014
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI
https://doi.org/10.1007/s00402-014-2076-7

Weitere Artikel der Ausgabe 11/2014

Archives of Orthopaedic and Trauma Surgery 11/2014 Zur Ausgabe

Arthroscopy and Sports Medicine

ACL injuries and stem cell therapy

Arthroscopy and Sports Medicine

Complications after arthroscopic knee surgery

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.