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Lethal air embolism during arthroscopy. A case report.

R Habegger1, R Siebenmann, C Kieser

  • 1Stadtspital Triemli, Zurich, Switzerland.

The Journal of Bone and Joint Surgery. British Volume
|March 1, 1989
PubMed
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A fatal air embolism occurred during knee arthroscopy when air escaped through a fracture into the venous system. Researchers recommend using saline or carbon dioxide instead of air for joint distension to prevent such dangerous complications.

Area of Science:

  • Orthopedic Surgery
  • Medical Device Safety
  • Vascular Complications

Background:

  • Diagnostic arthroscopy is a common procedure for knee injuries.
  • Joint distension is necessary for visualization during arthroscopy.
  • Air has been historically used as a distension medium.

Observation:

  • A case of lethal air embolism occurred during diagnostic knee arthroscopy.
  • The air used for joint distension escaped through an intra-articular fracture.
  • The escaped air entered the patient's venous system, causing the embolism.

Findings:

  • Intra-articular pressure during arthroscopy can significantly exceed venous pressure.
  • This pressure gradient facilitates the escape of distension media into the vasculature.

Related Experiment Videos

  • Air embolism is a rare but potentially fatal complication of arthroscopic procedures.

    • Implications:

    • The use of air for joint distension, particularly in acutely injured knees with potential fractures, poses a significant risk.
    • Saline or carbon dioxide are safer alternatives for joint distension during arthroscopy.
    • This case highlights the critical importance of selecting appropriate distension media to ensure patient safety in orthopedic surgery.