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*1Department of Orthopedic Surgery, Shioya Hospital of International* 

*3Keio University Faculty of Nursing and Medical Care, Tokyo,* 

*5Department of Orthopedic Surgery, Terada Hospital, Tokyo,* 

Itsuki Yuzawa5, Kengo Harato6 and Seiji Saito1

*University of Health and Welfare, Tochigi, 2Department of Surgery, Josai Hospital, Tochigi,* 

*4Masumoto Clinic, Tokyo,* 

*Japan* 

Shinichi Maeno1, Daijo Hashimoto2, Toshiro Otani3, Ko Masumoto4,

*6Department of Orthopedic Surgery, Kawasaki Municipal Kawasaki Hospital* 

Indication of the intraarticular arthroscopy, which was originally developed in knee surgery, has been expanded dramatically in accordance with the development of the instruments, including electric coagulator or pressure and flow-control pump. It is widely used not only in the major joints such as knee, shoulder, and hip, but also in the small joints, in hand and foot. It is also applied to outside the joint cavities, such as in the bursae (Verdonk et al., 1988; Klein, 1996; Bradley & Dillingham, 1998; Ogilvie-Harris & Gilbart, 2000), bone marrow of femur or tibia (Roberts et al., 2000,2001; Kwak et al., 2009), and around the tendon sheath (van Dijk et al., 1997, 1998; Steenstra & van Dijk, 2006; Lui, 2007).

Possible indications for the extraarticular procedures around the knee are; lateral release for painful bipartite patella, excessive lateral pressure syndrome, and recurrent dislocation of the patella (Maeno et al., 2008,2010), bursectomy for prepatellar bursa, and medial patellofemoral ligament (MPFL) reconstruction. It can be expanded to any other

A conventional arthroscopy setup is used. Either a hanger or a coil shaped lifter is needed. The hanger is shaped in a semi-circular, similar to those used in infantile gasless laparoscopic surgery (Takasago Medical Industry, Tokyo, Japan). The coil-shaped lifter is created from an endotracheal tube stylet (Muranaka Medical Instruments, Osaka, Japan). The tip end is bent manually to form a spiral shape, creating a coil about 5 cm in diameter,

We describe herein extra-articular arthroscopy using a lifting hanger.

**1. Introduction** 

**2. Indication** 

**3. Instruments** 

with about 3 loops (Fig 1).

extraarticular works around the knee.

[42] Bae DK, Nam GU, Sun SD, Kim YH. The clinical significance of the complete type of suprapatellar membrane. *Arthroscopy* 1998;14(8):830-835. **13** 

Shinichi Maeno1, Daijo Hashimoto2, Toshiro Otani3, Ko Masumoto4, Itsuki Yuzawa5, Kengo Harato6 and Seiji Saito1 *1Department of Orthopedic Surgery, Shioya Hospital of International University of Health and Welfare, Tochigi, 2Department of Surgery, Josai Hospital, Tochigi, 3Keio University Faculty of Nursing and Medical Care, Tokyo, 4Masumoto Clinic, Tokyo, 5Department of Orthopedic Surgery, Terada Hospital, Tokyo, 6Department of Orthopedic Surgery, Kawasaki Municipal Kawasaki Hospital Japan* 
