Arthroscopy

Dr. Martin performs arthroscopic surgery on the hip, shoulder, and knee.

Non-Arthritic Hip Disorders can be treated arthroscopically.

  • Labral Tears
  • Femoroacetabular Impingement (FAI)
  • Chondral Defects
  • Synovitis
  • Loose Bodies
  • Internal Snapping Hip Syndrome
  • External Snapping Hip Syndrome (Iliotibial Band Syndrome)
  • Gluteus Medius Tears
  • Tumors
  • Instability: Shoulder Stabalization
  • Tendinitis, Bursitis & Impingement: Removal of Inflammed Tissue/ Bursa, Subacromial Decompression
  • Rotator Cuff Repair
  • Labral Repair
  • Arthritis: Acromioclavicular Resection
  • Suprascapular Nerve Entrapment: Decompression
  • Ligament Tears: Reconstruction
    • Anterior Cruciate Ligament (ACL)
    • Posterior Cruciate Ligament (PCL)
    • Medial Collateral Ligament (MCL)
    • Lateral Collateral Ligament (LCL)
  • Repair of Traumatic Dislocation
  • Meniscal Tears: Repair/ Debridement
  • Chondral Injury: Repair
Hip Labral Repair
Repaired Hip Labrum Restoring the Joint Seal (arrows)

Arthroscopic Technique Videos

Using a Combined In-Out and All-Inside Technique to Repair Bucket-Handle Medial Meniscus Tears Without a Safety Incision

Long-term evidence demonstrates superior functional and radiographic scores for patients with repaired menisci vs partial or complete removal. This has encouraged orthopedic surgeons to repair torn menisci for long-term preservation of the joint. In this video, Dr. Martin describes his efficient, combined technique for treating bucket-handle medial meniscal tears that yields a strong, durable repair while avoiding damage to adjacent neurovascular structures.

Kucharik MP, Eberlin CT, Cherian NJ, Summers MA, Martin SD. Using a Combined Inside-Out and All-Inside Technique to Repair Bucket-Handle Medial Meniscal Tears Without a Safety Incision. Arth Tech. (In Press, February 2023)

Harvest and Application of Bone Marrow Aspirate Concentrate to Address Acetabular Chondral Damage During Hip Arthroscopy

Martin SD, Eberlin CT, Kucharik MP, Cherian NJ. Harvest and Application of Bone Marrow Aspirate Concentrate to Address Acetabular Chondral Damage During Hip Arthroscopy. JBJS Essential Surgical Techniques 13(2):e22.00010, April-June 2023. https://doi.org/10.2106/JBJS.ST.22.00010

To View All 13 Technique Videos, Please CLICK HERE

Harvest_and_Application_of_Bone_Marrow_AspirateDownload

Use of Stem Cells with Arthroscopic Hip Labral Repair

By using BMAC to augment labral repairs and coat chondrolabral junction breakdown, we are able to introduce mesenchymal stem cells to peripheral acetabular tissue with little to no drawbacks, while avoiding donor-site morbidity, open procedures, and multiple surgeries.

Stelzer JW, Martin SD. Use of Bone Marrow Aspirate Concentrate with Acetabular Labral Repair for the Management of Chondrolabral Junction Breakdown. Arthrosc Tech. 2018 Oct; 7(10): e981–e987. Published online 2018 Sep 1. doi:10.1016/j.eats.2018.06.003. PMID:30377577

Puncture Capsulotomy During Hip Arthroscopy for Femoroacetabular Impingement: Preserving Anatomy and Biomechanics

We describe an arthroscopic technique for the treatment of labral pathology and femoroacetabular impingement that provides excellent access to the central and peripheral compartments while preserving the biomechanically crucial components of hip joint stability.

Conaway WK, Martin SD. Puncture Capsulotomy during Hip Arthroscopy for FAI: Preserving Anatomy and Biomechanics. Arthrosc Tech. 2017 Dec; 6(6): e2265–e2269. Published online 2017 Nov 27. doi:10.1016/j.eats.2017.08.036.

“In-Round” Labral Repair After Acetabular Recession Using Intermittent Traction

The prevalence of hip arthroscopy has increased exponentially with the advent of arthroscopic labral repair techniques for femoroacetabular impingement. The goal of arthroscopic labral repair is to re-create the anatomic suction seal of the labrum against the femoral head. This technique re-creates the native anatomy and biomechanics of the hip after acetabular recession and labral repair while decreasing traction time.

Skelley NW, Conaway WK, Martin SD. “In-Round” Labral Repair After Acetabular Recession Utilizing Intermittent Traction. Arthrosc Tech. 2017 Oct; 6(5): e1807–e1813. Published online 2017 Oct 9. doi:10.1016/j.eats.2017.08.036.

Arthroscopic Treatment of Pigmented Villonodular Synovitis of the Hip Using Puncture Capsulotomy

Pigmented villonodular synovitis (PVNS) is a monoarticular, benign tumor arising from the synovium. Although classically treated with open synovectomy, arthroscopic treatment has demonstrated good clinical outcomes. 

Nazal MR, Parsa A, Martin SD. Arthroscopic Treatment of Pigmented Villonodular Synovitis (PVNS) of the Hip utilizing Puncture Capsulotomy Arthroscopy Techniques. Arthrosc Tech. 2019 Jun;8(6): e641–e646. Epub 2019 Jun 2. doi: 10.1016/j.eats.2019.02.007

Knee Joint Preservation Techniques

The information below is generalized. Patients’ treatments can vary depending on injury size and any concomitant procedures done.

MACI (Matrix-induced Autologous Chondrocyte Implantation)

  • Two-part procedure commonly used to treat cartilage defects/lesions of the knee or kneecap
  • Patient’s own cells are harvested, grown, and reimplanted
  • 1st Arthroscopic Procedure – Cartilage biopsy/harvest
    • Evaluation of the condition of the cartilage, remove damaged tissue from the knee (if necessary), and harvest a bit of cartilage from non-weightbearing regions of the knee
    • Procedure takes ~30 minutes and involves 2 small incisions
    • Following the first procedure, the patient can immediately bear weight and return to activity as tolerated. Most can return to work within a day or two. 
  • Cartilage Preparation
    • Harvested cartilage is sent to a laboratory to grow on a collagen membrane/matrix for approximately one month
      • New cartilage cells are stored and usable for up to 5-years.  
  • 2nd Open Procedure – Cartilage Implantation
    • Newly grown cartilage is cut to precisely fit the patient’s defect and glued into place
    • Procedure takes ~1 hour and involves an open approach with a larger incision
    • Following the second procedure, patients will be expected to wear a brace for 6 weeks and use a continuous passive motion machine (CPM). Patients will start physical therapy 4-6 weeks after surgery. However, recovery timelines may differ if additional procedures are needed.  
  • Your specific recovery timeline will be clearly outlined by Dr. Martin at the time of the procedure.  

Osteochondral Grafting

  • Commonly used to treat lesions/defects in the knee that involve both cartilage and underlying bone
    • Replaces lesion with healthy tissue (the graft)
  • Depending on the size of the lesions, the graft my come from
    • Patient’s own body (osteochondral autograft)
      • If lesion is small (< 2cm), the graft can come from peripheral non-weight bearing areas of the patients knee
    •  Tissue donor (osteochondral allograft)
      • If the lesion is medium or large (> 2cm), the graft will come from a tissue donor
  • Joint malalignment, ligamentous instability, and meniscal deficiency may be addressed at the time of surgery (if indicated)
    • Maximizes longevity of the graft and prevents additional damage or injury
  • Following surgery, patients will be expected to wear a brace, refrain from weight bearing, and use a continuous passive motion machine (CPM) for 6 weeks. After 6 weeks, patients can gradually increase weight bearing and forgo the use of a brace. Return to sport typically occurs after 6-9 months. 
  • Your specific recovery timeline will be clearly outlined by Dr. Martin at the time of the procedure.  

Microfracture

  • Commonly used to treat cartilage lesions/defects that expose the underlying bone in the knee by using the body’s own healing abilities 
  • Performed arthroscopically through three small incisions
    • First, the surgeon evaluates the lesion and removes any loose or unstable cartilage, ensuring a smooth and stable cartilage surface surrounds the lesion. 
    • Multiple holes, or ‘microfractures’, are then created in the bone underneath the lesion. 
    • Blood and bone marrow cells travel through the holes and combine on the surface of the lesion, forming a “marrow-rich clot” that serves as the basis for new tissue formation. 
  • New tissue formation is a gradual process
    • It may take 2-6 months after surgery for patients to experience significant improvement in pain and function
  • Following surgery, patients will be expected to wear a brace, refrain from weight bearing, and use a continuous passive motion machine (CPM) for 6 weeks. After 6 weeks, patients can gradually increase weight bearing and forgo the use of a brace. Return to sport typically occurs after 6-9 months.  
  • Your specific recovery timeline will be clearly outlined by Dr. Martin at the time of the procedure.