title: Evaluation of an endoscopic procedure for the treatment of docking site nonunion.
abstract: OBJECTIVE
  To determine the effectiveness of an endoscopic docking site surgery during the use of a classic bone transport technique for dealing with bone loss.
  
  
  METHODS
  Retrospective comparative study.
  
  
  METHODS
  Level I trauma center.
  
  
  METHODS
  Nine patients treated with endoscopic docking site surgery (group 1) were compared with 18 patients treated with standard open grafting of the docking site (group 2). All 27 bone transports with distraction osteogenesis were performed for the treatment of segmental tibial bone defects.
  
  
  METHODS
  In group 1, 6 tibial and 3 tibiotalar docking sites were endoscopically treated. Anteromedial (instrumentation) and anterolateral (visualization) portals were used without a tourniquet, using a 30-degree arthroscope and a motorized 5-mm shaver/abrader. Fibrous tissue was removed, bone ends abraded, and the bone canal cleaned with bone grafting.
  
  
  METHODS
  Clinical and radiographic.
  
  
  RESULTS
  Bone transport lengthening was 9.7 and 9.1 cm in groups 1 and 2, respectively. Consolidation at the docking site occurred in 8 patients (89%) in group 1. The docking site consolidation time and index lengthening were lower in group 1 (18 vs. 20 weeks for group 2 and 1.59 vs. 1.82 mo/cm in group 1 vs. group 2). Time in the external fixator was similar between the 2 groups (461 vs. 466 days in group 1 vs. group 2). Normal alignment was observed in both groups.
  
  
  CONCLUSIONS
  This study provides evidence that minimally invasive endoscopic docking site treatment during bone transport is a safe and viable technique using a common arthroscopic instrumentation.
authors.affiliation: *Department of Orthopedic Surgery and Traumatology, Niguarda Hospital, Milan, Italy; †Department of Orthopaedic Surgery, Wake Forest University School of Medicine, Winston-Salem, NC; and ‡Department of Experimental Medicine, University of Milano-Bicocca, Monza, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Sala
authors.forename: Enzo
authors.initials: E
authors.lastname: Marinoni
authors.forename: Anna N
authors.initials: AN
authors.lastname: Miller
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pesenti
authors.forename: Fabio
authors.initials: F
authors.lastname: Castelli
authors.forename: Salvatore
authors.initials: S
authors.lastname: Alati
authors.forename: Andrea
authors.initials: A
authors.lastname: Coppadoro
authors.forename: Dario
authors.initials: D
authors.lastname: Capitani
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D004724:Endoscopy; D005260:Female; D017759:Fractures, Malunited / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019857:Osteogenesis, Distraction / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013978:Tibial Fractures / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult