Intra-articular pressures during arthroscopic knee surgery

Ewing, John W.; Noe, Donald A.; Kitaoka, Harold B.; Askew, Michael J.

doi:10.1016/s0749-8063(86)80083-4

Cited by 40 publications

(30 citation statements)

References 6 publications

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“…Ewing and associates [10] described that the mean intra articular pressure during arthroscopy while the knee is in forced flexion is 159 mmHg and in flexion just 78 mmHg [1]. Based on these findings we postulate that an immediate postoperative period in deep flexion could prevent bleeding by raising the intraarticular pressure and thus diminishing the appearance of joint effusion.…”

mentioning

confidence: 67%

Knee Effusion after Arthroscopic Partial Meniscectomy: Prospective Study Comparing Preventing Methods

Pakuts¹,

Martín²

2019

OJO

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Background: Knee joint effusion is a common adverse event after arthroscopic procedures and its prevention is crucial to achieve better clinical outcomes, such as pain relief, improved range of movement and global satisfaction. Objective: The aim of this study is to compare joint effusion after partial arthroscopic meniscectomy between a common postoperative management and a short period in deep flexion. Methods: A prospective study randomizes 62 patients who underwent arthroscopic partial meniscectomy into 2 groups of postoperative care: compression elastic bandage with elevation for 24 hours (compression group) versus immediate postoperative deep flexion for 2 hours (flexion group). Clinical evaluation of effusion was made at 24 hours, 7 days and 1-month post-surgery. Results: Overall at 24 hours patients showed 53% absent effusion, 35% minimum, 11% had mild or more severe effusion. Effusion rates in the compression group were 13%, 10% and 0%; in the flexion group 10%, 6.4% and 0%, at 24 hours, 7 days and 1 month, respectively. There was no statistically significant difference between them (p > 0.05). Conclusion: In the studied population, position of the knee in deep flexion had similar influence in effusion outcomes than a standard widely used treatment, offering an alternative in the postoperative care of the patients.

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mentioning

confidence: 67%

Knee Effusion after Arthroscopic Partial Meniscectomy: Prospective Study Comparing Preventing Methods

Pakuts¹,

Martín²

2019

OJO

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“…Thereby, the focus will be on the intra-articular pressure and the flow, both of which are essential factors for the surgeon. In literature, two values are suggested for the optimal intra-articular pressure: 30 mmHg [9,18] or 60 mmHg to 120 mmHg [2,6]. Care has to be taken to avoid high pressure peaks, since these can cause complications [2,6,12,15,20].…”

Section: Discussionmentioning

confidence: 99%

“…tions are given for the optimal intra-articular pressure [6,8,9], and portal configuration [2,12,15,18].…”

Section: Introductionmentioning

confidence: 99%

Behavior of arthroscopic irrigation systems

Tuijthof

Dusée

Herder

et al. 2005

Knee Surg Sports Traumatol Arthrosc

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In the literature, no consensus exists about optimal irrigation of joints during arthroscopic operations. The goal of this paper is to study the behavior of irrigation systems resulting in the proposal of guidelines for optimal irrigation. To this end, optimal irrigation is defined as the steady state of irrigation of a joint in which a sufficient positive intra-articular pressure and a sufficient flow are maintained. A model of the complete irrigation system was created to schematically elucidate the behavior of pump systems. Additionally, clinical experiments were performed during arthroscopic knee operations in which the pressure at different locations and the irrigation flow were measured. The combination of model prediction and clinical results could well be used to derive guidelines, since the clinical results, which showed considerable variation, were used to verify the model, and the model could be used to explain the typical trends. The main findings are twofold the set pressure is always higher than the intra-articular pressure, and the scope-sheath combination has a significant influence on irrigation control, because of its large restriction. Based on the results, we advice to increase the set pressure during active suction, and to include the sheath-scope combination in the control loop.

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“…Fast movements of a distended joint create pressure peaks of considerable height (Ewing et al 1986, Takeshita et al 1991, Sperber and Wredmark 1993. The tolerance of the joint capsule to high continuous pressure has not been investigated and the pressure limits within which an arthroscopy can be done safely are still not known.…”

Section: Anders Sperber and Torsten Wredmarkmentioning

confidence: 99%