Novel use of a bronchoscope and bariatric needle holder for retrieval of retained intramedullary metalwork during total knee arthroplasty

Retained metalwork during total joint arthroplasties usually occur from accidental misplacement of jig locking pins into the medullary canal via the aperture created for intramedullary referencing. They are associated with significant clinical and financial consequences for the patient, surgeon and health care provider. Hence the imperative to device methods to not only prevent their occurrence but reliably retrieve any trapped foreign body. We describe an easy, reliable, reproducible, fluoroscopy-free and time efficient way to retrieve metalworks trapped in the medullary canal, with the aid of a bronchoscope and a bariatric needle holder. • The described method utilises two instruments which are readily available in theatres – single use flexible bronchoscope and bariatric needle holder. • Prior experience in bronchoscopy or laparoscopic surgery is not required to adapt the instruments for this purpose. • This technique minimises both the stress on the patient and the surgical team.