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Low conductivity irrigating solutions for arthroscopy.

B Reagan1, B Zarins, H J Mankin

  • 1Orthopaedic Research Laboratories, Massachusetts General Hospital, Boston 02114.

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|January 1, 1991
PubMed
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For arthroscopic electrosurgery, glycerol 2.6% is a safe and effective nonconductive physiologic solution. It supports cartilage metabolism and is more cost-effective than HEPES buffer.

Area of Science:

  • Biomedical Engineering
  • Orthopedics
  • Biochemistry

Background:

  • Electrosurgery is commonly used in arthroscopy.
  • Current irrigation solutions like saline and Ringer's lactate are conductive, posing risks.
  • A nonconductive, physiologic solution is needed for safe electrosurgery during arthroscopy.

Purpose of the Study:

  • To identify a nonconductive physiologic solution for arthroscopic electrosurgery.
  • To evaluate the effects of different solutions on cartilage metabolism and electrosurgical safety.

Main Methods:

  • Assessed proteoglycan synthesis in bovine articular cartilage slices exposed to various solutions.
  • Evaluated the safety and efficacy of electrosurgical instruments in different solutions within bovine knee joints.

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Main Results:

  • HEPES buffer (0.3 M) and glycerol (2.6%) demonstrated good results in supporting cartilage and allowing safe electrosurgery.
  • Glycerol 2.6% showed slightly better support for cartilage metabolism and was significantly less expensive than HEPES buffer.
  • Ringer's lactate and saline were too conductive; distilled water was nonphysiologic.

Conclusions:

  • Glycerol 2.6% is a safe and effective nonconductive solution for arthroscopic electrosurgery.
  • It supports articular cartilage metabolism adequately for procedures up to 2 hours.
  • Glycerol 2.6% offers a cost-effective alternative to HEPES buffer for this application.