Do Arthroscopic Fluid Pumps Display True Surgical Site Pressure During Hip Arthroscopy?

Ross, Jeremy A.; Marland, Jennifer D.; Payne, Brayden; Whiting, Daniel R.; West, Hugh S.

doi:10.1016/j.arthro.2017.08.290

Cited by 12 publications

(11 citation statements)

References 15 publications

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“…Still, one has to think of the negative effects of increased pump pressures and what is more, Ross et al [ 21 ] showed in their study that the operative field fluid pressure and the pressure readout might differ considerably.…”

Section: Discussionmentioning

confidence: 99%

The influence of radio frequency ablation on intra-articular fluid temperature in the ankle joint - a cadaver study

Ahrens

Müeller

Siebenlist

et al. 2018

BMC Musculoskelet Disord

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BackgroundRadio frequency ablation devices have found a widespread application in arthroscopic surgery. However, recent publications report about elevated temperatures, which may cause damage to the capsular tissue and especially to chondrocytes. The purpose of this study was the investigation of the maximum temperatures that occur in the ankle joint with the use of a commercially available radio frequency ablation device.MethodsSix formalin-fixed cadaver ankle specimens were used for this study. The radio frequency device was applied for 120 s to remove tissue. Intra-articular temperatures were logged every second for 120 s at a distance of 3, 5 and 10 mm from the tip of the radio frequency device. The irrigation fluid flow was controlled by setting the inflow pressure to 10 mmHg, 25 mmHg, 50 mmHg and 100 mmHg, respectively. The controller unit voltage setting was set to 1, 5 and 9.ResultsMaximum temperatures exceeding 50 °C/122 °F were observed for all combinations of parameters, except for those with a pressure of 100 mmHg pressure. The main critical variable is the pressure setting, which is highly significant. The controller unit voltage setting showed no effect on the temperature measurements. The highest temperature was 102.7 °C/215.6 °F measured for an irrigation flow of 10 mmHg. The shortest time span to exceed 50 °C/122 °F was 3 s.ConclusionIn order to avoid temperatures exceeding 50 °C/122 °F in the use of radio frequency devices in arthroscopic surgeries of the ankle joint, it is recommended to use a high irrigation flow by setting the pressure difference across the ankle joint as high as feasible. Even short intervals of a low irrigation flow may lead to critical temperatures above 50 °C/122 °F.Level of EvidenceLevel II, diagnostic study.

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Section: Discussionmentioning

confidence: 99%

The influence of radio frequency ablation on intra-articular fluid temperature in the ankle joint - a cadaver study

Ahrens

Müeller

Siebenlist

et al. 2018

BMC Musculoskelet Disord

View full text Add to dashboard Cite

show abstract

“…A gravity system involves hanging bags of saline several feet above the operative site, with the pressure in the joint ranging from 50-120 mmHg depending on the outflow in the system [20]. Pressure, or single-roller, pumps and pressure-and-flow, or double-roller, pumps both are commercially available to provide intra-articular pressure either by regulating the pressure alone or by regulating the pressure and flow in the system [21,22].…”

Section: Arthroscopic Pump Systemsmentioning

confidence: 99%

Improving visualization in shoulder arthroscopy

2023

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Arthroscopic shoulder procedures are one of the most common procedures used to restore function through minimally invasive techniques. With the demand for shoulder arthroscopic procedures comes the need for safe, effective, and efficient surgery that maximizes patient outcomes while minimizing complications. Many variables contribute to visualization in shoulder arthroscopy including vascular anatomy, blood pressure control, arthroscopic pump systems, turbulence control, epinephrine, and tranexamic acid. Furthermore, patient positioning can have a dramatic effect on visualization with both the beach chair position and lateral decubitus positioning having various strengths and weaknesses depending on the intended procedure being performed. The purpose of this review is to examine the benefits and complications reported in the literature for improving visualization in shoulder arthroscopy.

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“…Ross et al 2 are commended for studying an essential piece of equipment during hip arthroscopy: fluid pumps. They raise awareness of the different pump systems: joint calibrated versus gravity equivalent.…”

Section: See Related Article On Page 126mentioning

confidence: 99%

Editorial Commentary: Hip Arthroscopy Pump Pressure Must Be Managed and Monitored

Kocher

2018

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Fluid pump management is essential for successful hip arthroscopy. Low pressures can lead to poor visualization. High pressures can lead to fluid extravasation and complications. Fluid extravasation during hip arthroscopy can lead to intra-abdominal compartment syndrome, which can be life-threatening. Risk factors for extravasation included higher pump pressures and iliopsoas tenotomy. By accurately measuring pump pressures, minimizing the necessary pressure, avoiding excessive capsulotomies, performing iliopsoas tenotomy only if needed and performing it at the end of the operation, and monitoring the patient for abdominal distention and hypothermia, complications can be minimized.

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Do Arthroscopic Fluid Pumps Display True Surgical Site Pressure During Hip Arthroscopy?

Cited by 12 publications

References 15 publications

The influence of radio frequency ablation on intra-articular fluid temperature in the ankle joint - a cadaver study

The influence of radio frequency ablation on intra-articular fluid temperature in the ankle joint - a cadaver study

Improving visualization in shoulder arthroscopy

Editorial Commentary: Hip Arthroscopy Pump Pressure Must Be Managed and Monitored

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