Elizabeth Hofheinz, M.P.H., M.Ed. • Wed, December 21st, 2016
In-Office Arthroscope for Knees, Shoulders!
A method to save time, money, and reduce stress on the patient…what could it be? A new handheld imaging system from Trice Medical called Mi-eye 2™ which costs about as much as a cell phone and is fully reimbursed by Medicare and private payers.
The image quality is clear enough that, says Dr. James Gladstone at Mount Sinai in New York City, it can give MRIs a run for their money.
James N. Gladstone, M.D. is co-chief of the Sports Medicine Service at The Mount Sinai Hospital, and associate professor of Orthopaedic Surgery, in the Department of Orthopaedics at the Icahn School of Medicine at Mount Sinai. He specializes in sports medicine, arthroscopic surgery, and knee and shoulder reconstructive surgery and told OTW, “The Mi-eye 2™, the second generation of this tool, is essentially an in-office arthroscope for use on knees and shoulders. (In theory, it can be used on any joint because it is tiny.) The doctor numbs the area and inserts the 14-gauge needle to puncture the skin and the joint capsule. Once in the joint he deploys a lever, which pushes out the scope that contains a digital camera. The scope has a port through which one can inject saline to help visualize the environment.”
“It is very exciting to be able to do all of this during an office visit.”
“The Mi-eye 2™ has increased resolution and a better viewing angle (now 120 degrees) such that when you are looking at anything in the joint it’s very similar to what you see in the operating room.”
“Everything is housed in one unit with a USB cable that connects to a tablet-sized screen. If you are suspicious of something in the office, you can administer lidocaine to the knee or shoulder and 10 minutes later insert the scope. The patient can come to the office and leave with a definitive diagnosis.”
“The probes for the Mi-eye 2™ are $450 while an MRI can be close to $2,000. We are still defining what the Mi-eye 2™ is good for and how it should be used. Just today I had a patient with an osteochondral plug that someone put in two years ago, but he was still in pain. He had an MRI and the area didn’t look like it had healed well. The Mi-eye 2™ gave me more of a definitive look at the surface of the cartilage. I could clearly see that it had not healed. So for this patient the next step is a major procedure. We did, however, avoid a formal arthroscopy with time out of work…not to mention anesthesia. And an ability to plan the definitive procedure at the time of the office visit.”
“You have to learn where it fits in your practice. As you use it more, you will understand where it can be helpful. It sure beats the logistics surrounding an MRI, such as having your office staff tied up on the phone getting authorization, then scheduling the appointment for an MRI, and having to tell the patient to come back on a different day to review results. This is the wave of the future as far as injury diagnosis goes.”