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Arthroscopic image distortion—part II: the effect of lens angle and portal location in a 3D knee model

  • Experimental Study
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Distortion in arthroscopic views can interfere with accurate graft placement in ACL reconstruction, yet the effect of arthroscopic lens angle and portal location on image distortion is unknown. The purpose of this study was to quantify the image distortion resulting from the use of angulated arthroscope lenses through multiple portals, thereby identifying the optimal parameters to minimize distortion.

Methods

A uniform grid of dots was attached to the lateral wall of the intercondylar notch of a Sawbones® knee model. The inferior half of the lateral wall was divided equally along the distoproximal axis into three regions—shallow, central, and deep. Each region was imaged using five different arthroscopic configurations [0° arthroscope through anteromedial (AM) portal, 30° arthroscope through AM and anterolateral (AL) portals, 70° arthroscope through AM and AL portals]. For each configuration, the differences in magnification and deformity ratios between the three regions were calculated.

Results

Less than 100 % of central region magnification was observed in the deep region, while more than 100 % was found in the shallow region. The AL approach produced larger magnification errors in the shallow region, as compared to the AM approach. Deformity ratios less than 100 % were found with both 0° and 30° arthroscopes, whereas deformity ratios exceeding 100 % were found with 70° arthroscopes.

Conclusions

The least distorted and the most consistent image of the femoral ACL insertion is provided through the AM portal using either a 30° or 70° arthroscope lens. Surgeons should carefully select the arthroscope and portal to minimize image distortion and ensure accurate surgical procedure.

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Acknowledgments

The authors would like to acknowledge Smith and Nephew for using the arthroscopy system and their endoscopic research and development laboratory.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA

    Yuichi Hoshino, Benjamin B. Rothrauff, Daniel Hensler, Freddie H. Fu & Volker Musahl

  2. Department of Orthopaedic Surgery, Kobe Kaisei Hospital, 11-15 Shinohara-Kitamachi, 3-Chome, Nada-ku, Kobe, 657-0068, Japan

    Yuichi Hoshino

  3. Department of Trauma Surgery, Trauma Center Murnau, Murnau, Germany

    Daniel Hensler

Authors
  1. Yuichi Hoshino
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  2. Benjamin B. Rothrauff
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  3. Daniel Hensler
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  4. Freddie H. Fu
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  5. Volker Musahl
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Correspondence to Yuichi Hoshino.

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Hoshino, Y., Rothrauff, B.B., Hensler, D. et al. Arthroscopic image distortion—part II: the effect of lens angle and portal location in a 3D knee model. Knee Surg Sports Traumatol Arthrosc 24, 2072–2078 (2016). https://doi.org/10.1007/s00167-014-3268-y

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  • DOI: https://doi.org/10.1007/s00167-014-3268-y

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