Complication of the Use of a Radiofrequency Device in Arthroscopic Shoulder Surgery: Second-Degree Burn of the Shoulder Girdle

Kouk, Shalen; Zoric, Bojan; Stetson, William B.

doi:10.1016/j.arthro.2010.10.016

Cited by 24 publications

(15 citation statements)

References 15 publications

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“…6 Several case reports in the shoulder literature have reported second-degree dermal burns after arthroscopy because of skin contact with effluent. 7,8 Described burns were 0.5inch linear streaks oriented according to gravity in the lateral decubitus position. None originated from an arthroscopic portal.…”

Section: Discussionmentioning

confidence: 99%

Dermal Burn During Hip Arthroscopy

Curtin¹,

Friebe²

2014

Orthopedics

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Radiofrequency devices are often used during arthroscopic surgery, most commonly of the shoulder and knee, and increasingly in hip arthroscopy. The most commonly described complication is elevation of joint temperature, leading to capsular shrinkage, chondrolysis, and nerve damage. A less commonly reported complication is that of dermal burns from the heated irrigation fluid. There are several case reports describing dermal burns after shoulder arthroscopy; however, to the authors' knowledge, there are none describing the complication in hip arthroscopy that is often performed by surgeons doing limited if any shoulder arthroscopy. The authors report this case to raise awareness that the use of radiofrequency devices can also lead to extra-articular complications because of the effect of elevated irrigant fluid temperatures on the patient's skin. Sufficiently high temperatures were generated inside the joint, causing a superficial second-degree burn from the outflow irrigant. In the course of instrument switching from sucker/shaver to radiofrequency wand, the outflow valve was inadvertently left open with no attached suction while the radiofrequency wand was in use. Most second-degree burns like the one reported require only conservative therapy with cool compresses to decrease the temperature of the wound. The authors did recommend bacitracin ointment to prevent superficial wound infection, however unlikely with no disruption of the skin. The authors continue to use radio-frequency devices in hip arthroscopy, but are vigilant to maintain dedicated suction at the outflow tubing throughout the procedure. Surgeons should take strict precautions to avoid this preventable complication and follow all manufacturer instructions on the use of such devices.

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Section: Discussionmentioning

confidence: 99%

Dermal Burn During Hip Arthroscopy

Curtin¹,

Friebe²

2014

Orthopedics

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“…Caution should be used when extensively using an RF device during arthroscopic shoulder surgery, because heated effluent may result in skin burns. 17,18 This risk may be minimized by ensuring adequate flow rate across the joint. 19 The main disadvantage of our technique is the amount of flexibility in the shaft of the flexible RF ablator probe.…”

Section: Discussionmentioning

confidence: 99%

Use of a Hip Arthroscopy Flexible Radiofrequency Device for Capsular Release in Frozen Shoulder

Thompson

LeBel

2012

Arthroscopy Techniques

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Adhesive capsulitis is a common and challenging condition to treat. Arthroscopic capsular release is usually contemplated when conservative treatment fails or when there is severe and/or chronic loss of range of motion. This procedure can be difficult to perform because of difficult access to the joint, poor visualization, and loss of working space from retraction of the joint capsule. The articular surfaces and the axillary nerve are also at higher risk of injury. Arthroscopic scissors, shavers, and electrocautery are typically used to perform the capsular release. To perform a safer and more precise arthroscopic shoulder capsular release, a creative and innovative use of a flexible hip arthroscopy radiofrequency ablator is described.

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“…'lık radyofrekans kullanımında ortam sıcaklığının 80 dereceye kadar yükseldiği bildirilmiş-tir (27) . Radyofrekansın aralıksız kullanımı veya topraklama sorunu nedeniyle ikinci ve üçüncü derece cilt yanıkları bildirilmiştir (28) .…”

Section: Portallere Bağlı Komplikasyonlar Eklem Içi Yapıla-rın Hasarunclassified

Review: Complications of Rotator Cuff Surgery

Çelik¹,

Seçkin²,

Akman³

2017

Okmeydani Medical Journal

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ÖZ GİRİŞRotator manşet yırtıkları ve subakromial bölge sorunları omuz ağrısının yaygın nedenlerindendir. Rotator manşet yırtığı, 50-59 yaş aralığında %13 oranda gö-rülürken, bu oran 80 yaş üzerinde %51'e kadar yük-selmektedir (1) .Önceki yıllarda açık girişim ile yapılan rotator manşet onarımı yıllar içinde artroskopik tekniklerin geliş-mesi ile önce artroskopik yardımlı mini-açık tekniğe ardından yalnızca artroskopik tekniğe doğru kaymış-tır. Tedavide öncelikli hedef fonksiyonel bir rotator kablo yaratmak olan bu patolojide uygulanan tekniklerin birtakım komplikasyonları olduğu bilinmelidir. Rotator manşet cerrahisi sonrası kısa ve uzun dönem takip sırasında omuz ekleminde ağrı oluşması önem-senmeli, ağrı nedenleri cerrah tarafından sistematik olarak değerlendirilmelidir (Tablo 1).Rotator manşet cerrahisi komplikasyonları, ameliyat öncesi hastaya ve patolojiye ait sorunlara bağlı komplikasyonlar, ameliyat sırasındaki tekniğe ve cerraha ait sorunlar ile cerrahi sonrası özellikle fizik tedaviye ait sorunlar olarak kabaca üç gruba ayrılarak incelenebilir. Bu komplikasyonlar onarılan manşetin yeniden yırtılması, akromion kırıkları, yineleyen subakromial enflamasyon, heterotopik ossifikasyon, omuz sertliği, enfeksiyon, sinir yaralanmaları, deltoid kasın akromiona dikildiği yerden ayrılması ve omuzun öne çıkığı olarak ortaya çıkabilir (Tablo 2) (3) .Bu bölümde artroskopik omuz cerrahisine bağlı komplikasyonlar ve rotator manşet cerrahisine bağlı komplikasyonlar iki ayrı bölümde değerlendirilmiştir.

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Complication of the Use of a Radiofrequency Device in Arthroscopic Shoulder Surgery: Second-Degree Burn of the Shoulder Girdle

Cited by 24 publications

References 15 publications

Dermal Burn During Hip Arthroscopy

Dermal Burn During Hip Arthroscopy

Use of a Hip Arthroscopy Flexible Radiofrequency Device for Capsular Release in Frozen Shoulder

Review: Complications of Rotator Cuff Surgery

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