CHICAGO (AP) — Several top pro athletes and their surgeons say a modern version of an old tool is shaving weeks off the recovery time for certain injuries. And some top doctors think this is only the beginning.
Cy Young Award winners Tarik Skubal and Blake Snell let doctors use the instrument on their prized elbows. Connor Hellebuyck, the 2025 Hart Trophy winner as NHL MVP, trusted it to address issues in his knee. Several NFL players have turned to it,
too.
It’s called the NanoNeedle scope 2.0, a miniaturized, flexible version of the traditional arthroscope. It's very early — there is little published research on the model — but it is accumulating an impressive list of proponents.
“Every time I’ve used it, including when I started using it in the lab, different types of procedures occur to me that we could do,” said Dr. Neal ElAttrache, the head team physician for the Los Angeles Dodgers and Los Angeles Rams.
An arthroscope is a pencil-like tube with a camera that goes into joints, expands the area with salt water or saline, and projects an image onto a screen. Then doctors insert secondary instruments in the same area to perform the surgical procedure.
With the diminished size — 1.9 millimeters in diameter, compared to 4 millimeters for a traditional scope — the NanoNeedle is designed to cause less pain, inflammation and tissue damage, leading to a faster recovery. It uses much less fluid than a traditional scope, and it also is proving to be a valuable tool when it comes to diagnosing the extent of certain injuries.
“Basically, we’re able to accomplish anatomic type of work and repair with far less surgical trauma,” ElAttrache said.
The NanoNeedle was used when Skubal had a loose body removed from his left elbow by ElAttrache on May 6, and again when Snell had a similar elbow surgery on May 19.
When Skubal — a two-time AL Cy Young Award winner who is eligible for free agency after this season — was placed on the injured list, the Detroit Tigers said the ace would be sidelined for two to three months. But he is expected to return on Saturday after pitching five scoreless innings in a rehab start on Sunday — a turnaround of about 5 1/2 weeks.
ElAttrache said he has used the NanoNeedle scope with four patients, but he declined to identify the other two cases. Snell had a bigger operation that also involved the sculpting of a spur, but ElAttrache is optimistic about the timeline for the left-hander's return to the Dodgers.
“The percentage of time out, I think, is going to be about half the time for Snell,” ElAttrache said.
Hellebuyck, a three-time Vezina Trophy winner as the NHL’s top goalie, had arthroscopic surgery on his right knee on Nov. 22. He was expected to be sidelined for four to six weeks, but he was back in net for the Winnipeg Jets after three weeks.
Dr. James Voos, the head team physician for the Cleveland Browns, said he has used the NanoNeedle during procedures on five Browns players, including center Luke Wypler's ankle fracture surgery.
“Ankles and elbows I think are areas where it has had very great utility and then rapidly adopted,” said Voos, who also serves as the president of the NFL Physicians Society. “And we’re finding more and more uses in the knee and shoulder.”
In addition to his duties with the Browns, Voos is the chair of the orthopedics departments at University Hospitals and Case Western Reserve University in Cleveland. He already has seen benefits when it comes to the treatment of younger athletes.
“There are some very challenging elbow injuries in gymnasts and baseball players that the previous cameras were too large for the joint,” Voos said. “They’re designed for adult joints. So the smaller camera allows us to see and work in these smaller spaces. In pediatrics and adolescence, that was more challenging and potentially caused more damage before, some more soft tissue damage.”
The NanoNeedle was developed by Arthrex, a Florida-based company that makes medical supplies. Voos is an educational consultant for Arthrex, and ElAttrache has worked with the company for more than 30 years.
The initial version was created in 2019, according to Ryan Kellar, a senior product manager at Arthrex. There was another version that came out in 2023 before the current model — with upgraded visualization, processing and imaging — was released in August.
“This is our third iteration,” Kellar said. “We already have the fourth iteration coming in the fall. That fourth iteration is going to be everything that this conventional scope is at all the less invasive benefits of nano arthroscopy. So we really believe that nano is the next foundation of less invasive orthopedic care for general population, as well as kind of a gold standard for athletes.”
Dr. Kyle Hammond, the head team physician for the Atlanta Falcons and head orthopedic surgeon for the Atlanta Hawks, has used the NanoNeedle in a teaching setting as an orthopedic surgeon at Emory Healthcare and assistant professor at Emory University School of Medicine. But he hasn't used it on a patient yet.
Hammond said other companies have made similar devices for needle arthroscopy, but he praised the quality of the camera and the video feed with the NanoNeedle, along with its ease of use.
“It really has basically become very similar to what our standard arthroscopy equipment is,” he said. “It’s just on a smaller scale.”
The current version of the NanoNeedle is disposable, raising questions about cost versus the expense of sterilization for the reusable traditional arthroscope. Like anything in science, Hammond said, more usage and research are needed to assess the benefits of the new design versus the standard version of the scope.
“To kind of determine if they have true efficacy over the standard of care, they have to be used for a long period of time and you have to collect data and you kind of have to prove that from a statistical model,” Hammond said.
Dr. Brian Cole, the head team physician for the Chicago Bulls, said the level of adoption will depend in large part on the willingness of clinicians to incorporate the scope into their workflow.
“There’s a sort of econometric analysis on top of a healthcare analysis at the same time,” said Cole, who also is a consultant for Arthrex. “But I would say directionally, this is where we’re going. Less invasive, cost-effective, predictable, eliminating problems that we might or could have with existing technology. So, in that regard, this is very innovative, you know, in my opinion, and it’s consistent with the direction we’re going in.”
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