A drill guide for arthroscopic drilling of osteochondral lesions of the knee

The Knee 1994; 1: 69

Short communication

A drill guide for arthroscopic drilling of osteochondral lesions of the knee S Williams,

J Ireland, A J Smyth

Knee Unit, Holly House Hospital, Buckhurst Hill, Essex, UK Summary A drill guide and its method of use for arthroscopic knee

drilling of osteochondral

lesions

in the

are described.

Key words:

Drill guide, osteochondral

lesions

Introduction

Drilling of osteochondral lesions is an established arthroscopic procedure’. It is conveniently done using a 1.5 mm Kirschner wire. Flexibility of the wire may cause technical difficulty in accurate placement of the drill holes. Bending and breakage of the wire can also occur. To overcome these problems, arthroscopic sheaths’v2 or a special drill guide3 have been used. A drill guide and its method of use are described here. The instrument The drill guide is made of stainless

steel and has a cannulated shaft measuring 60 mm in length with an inside diameter of 2.0 mm. The tip of the shaft is rounded. The other end of the shaft is attached to the main body of the instrument at an angle of 60”. A Tufnell handle measuring 75 mm permits adequate grip, with helpful control of rotation (Figure 1).

Figure 1. Drill guide.

Method of use

The instrument is held by the operator and triangulated with the arthroscope. Once the drill guide has been positioned, the Kirschner wire, mounted on a power drill, is passed through the cannula by an assistant. To avoid excessive penetration, the exposed length of the Kirschner wire on the drill is noted. It is not difficult to drill anterior osteochondral lesions. In dealing with posterior lesions, the knee is flexed and an additional portal may be required after approximating a spinal needle to the lesion. By this manoeuvre, the drill holes can be placed accurately and as perpendicular to the osteochondral lesion as possible (Figure 2). Accepted: October 1993 Correspondence and reprint requests to: S Williams D Orth, DNB Orth, MCh Orth, Research Registrar, Knee Unit, Holly House Hospital, Buckhurst Hill, Essex IG9 5HX, UK @ 1994 Butterworth-Heinemann 0968-0160/94/0106Y-U1

Ltd

Figure 2. Technique chondral lesions.

for drilling posterior osteo-

References 1

Dandy DJ. Arthroscopic Surgery of the Knee. Edinburgh: Churchill Livingstone, 1981.

2

Guhl JF. Arthroscopic treatment of osteochondritis dissecans. Clin Orthop 1982; 167: 65-74 Rae PJ, Noble J. Arthroscopic drilling of osteochondral lesions of the knee. J Bone Joint Surg [Br] 1989; 71B:

3

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