Advancing Knee Arthroscopy Surgeries with Endoscopic and B-Mode Ultrasound Imaging

Knee arthroscopy is a minimally invasive surgery where surgeons utilize arthroscopes to visualize the internal structure of the knee to evade the need of large incisions. However, conventional knee arthroscopy currently lacks long term effectiveness which can be partially attributed to the lack of visibility: current arthroscopes provide only superficial morphology of tissues and hence leads to inaccuracy procedures. To solve this issue, combining ultrasound imaging in conjunction with the traditional optical modality has been investigated. An external ultrasound can allow the surgeon to track the whereabouts of the surgical instruments inside the knee, while an ultrasound arthroscope using a modified intravenous ultrasound can allow the surgeon to receive depth-resolved information, such as evaluating the properties and integrity of cartilage and tissue around the joint in three-dimension (3D) structure. In this work, we developed a simulation program to mimic ultrasound arthroscopy implementations for optimizing the design of ultrasound arthroscopy devices for knee surgery. Moreover, a 3D model of the human knee was developed and cross-sectional images from this model served as the imaging targets for the simulation. Ultrasound images with high consistency to targets were received in the simulation. The optimized combination of using endoscopic (internal) and B-mode (external) ultrasound imaging is a new design that can create positive outcomes for many different stakeholders. Patients will benefit from an improved surgery procedure which ensures less error and a better outcome. It is anticipated that this study will serve as a stepping stone for future research and eventually test trials that employ the dual ultrasound devices method in clinical settings.